Kenan Sofuoğlu

Blood Serum and Seminal Plasma Selenium, Total Antioxidant Capacity and Coenzyme Q10 Levels in Relation to Semen Parameters in Men with Idiopathic Infertility

In this case–control study, we aimed to evaluate the serum and seminal plasma levels of Selenium (Se), total antioxidant capacity (TAC), and Coenzyme Q10 (CoQ-10) and determine their relationship with sperm concentration, motility, and morphology in men with idiopathic infertility. A total of 59 subjects were enrolled in the study. Forty four patients were diagnosed with idiopathic male infertility and had abnormal sperm parameters, and 15 subjects had normal sperm parameters with proven fertility. Serum Se, semen Se, and semen TAC levels were significantly different in the fertile and infertile groups (p < 0.01, p < 0.001, and p < 0.001, respectively). However, serum TAC, serum, and seminal plasma CoQ-10 levels did not differ between fertile and infertile groups. When the levels of the measured parameters were compared in serum and seminal plasma, serum levels of Se were found to be correlated positively with the semen levels in all subjects included into the study (N = 59) (r = 0.46, p < 0.01). A relationship was found between neither serum and semen levels of TAC nor between serum and semen levels of CoQ-10. Correlations among measured serum and semen parameters with sperm parameters demonstrated that both the serum and semen levels of Se were correlated positively with spermatozoa concentration, motility, and morphology. Additionally, seminal plasma levels of TAC correlated positively with all these sperm parameters. On the other hand, seminal plasma levels of CoQ-10 correlated only with sperm morphology but not with concentration or motility. No relationship was observed between serum levels of TAC or serum levels of CoQ-10 and sperm parameters. In conclusion, serum and seminal plasma Se deficiency may be a prominent determinant of abnormal sperm parameters and idiopathic male infertility. Measurement of serum Se levels may help determine nutritional status and antioxidant capacity in infertile patients, which may help distinguish those patients who will benefit from supplementation therapy.

Effects of salpingectomy and antituberculosis treatments on fertility results in patients with genital tuberculosis

The aim of this study was to demonstrate the effects of tubal surgery and antituberculosis treatments in patients with genital tuberculosis.

Antioxidant activity of CAPE (caffeic acid phenethyl ester) in vitro can protect human sperm deoxyribonucleic acid from oxidative damage

PURPOSE Sperm processing (e.g., centrifugation) used in preparation for assisted reproduction can result in excessive generation of reactive oxygen species (ROS) and potential sperm damage. The use of antioxidants during sperm processing has been shown to prevent iatrogenic sperm damage, including DNA damage. In this study, we evaluated the effect of caffeic acid phenethyl ester (CAPE) on oxidative stress mediated sperm dysfunction and DNA damage. METHODS Semen samples were obtained to liquefy at room temperature. After centrifugation and washing protocols, spermatozoa were incubated in a single step supplemented medium with either of 10, 50 or 100 μmol/L CAPE for 2 hours at 36 °C. After incubation period, MDA levels of seminal plasma were measured. The fragmentation in sperm DNA was detected by light microscopy via use of an aniline blue assay, while ultrastructural morphology was analyzed by transmission electron microscopy. RESULTS Significant increase has been observed in percent chromatin condensation (assessed by aniline blue staining) and Malondialdehyde (Mmol/L) in oligoasthenoteratozoospermia group before the centrifugation (0.57 ± 0.15). Incubation of samples with 100 μmol/L CAPE after centrifugation resulted in a significantly lower percent chromatin condensation compared to samples incubated without CAPE (0.42 ± 0.12) (P < 0.0033). Incubation of all samples with CAPE (10 μmol/L, 50 μmol/L, 100 μmol/L.) after centrifugation resulted in a significantly lower percentage of Malondialdehyde levels. CONCLUSIONS The data suggests that preincubation of spermatozoa with the antioxidant CAPE offers protection against oxidative DNA damage in vitro.

Subclinical hypothyroidism: Is it important in intracytoplasmic sperm injection cycles?

Objective: To compare intracytoplasmic sperm injection (ICSI) outcomes of women with subclinical hypothyroidism with those of euthyroid women. Materials and Methods: A retrospective case-control study was conducted. Out of 2529 ICSI cycles evaluated, 41 women with hypothyroidism, 28 women with hyperthyroidism, and 128 women with subclinical hyperthyroidism were excluded, and 2336 cycles were analyzed. Women were identified as having subclinical hypothyroidism (case group, n=105) in the presence of a thyroid-stimulating hormone level >4.5 mU/L and normal free T4 and compared with euthyroid controls (n=2231). Results: The mean age, body mass index, day 3 follicle-stimulating hormone level, and antral follicle count of the study patients were similar to the control group (p>0.5). The cycle cancellation rate of the study group was similar to the control group (13.3% vs. 7.6%, p=0.1). The clinical pregnancy rate was 21.2% in the study group, which was significantly lower than the 35.8% in the control group (p=0.04). The take-home baby rate was also significantly lower in the study group compared with the control groups (13.5% vs. 31.4% respectively, p=0.01). Conclusion: Both the clinical pregnancy rate and the take-home baby rate is lower in women with subclinical hypothyroidism at the time of ICSI cycle.

The Assessment of the Relationship Between Endometrial Polyps and Basal Serum Estradiol Levels in Infertility Patients

Implantation is a result of a complex interaction between the hormonally primed endometrium and the conceptus (1). Structural abnormalities such as endometrial polyps, uterine fibroids, Mullerian abnormalities and intrauterine adhesions may interfere with this relationship and contribute to implantation failure and infertility. Endometrial polyps are the commonest form of intrauterine pathologies, being reported with prevalances varying between 7.8% and 34.9%, depending on the population studied (2-4). The mechanism by which endometrial polyps compromise the implantation is not clear. Although the high prevalence of endometrial polyps in infertile women suggests a causative relationship between the presence of endometrial polyps and infertility, a direct causal relationship between endometrial polyps and infertility have only been corroborated in a very limited number of studies (5).

Does the number of prior oocyte retrieval practices increase the amount of blood loss in subsequent OPU procedures

Background: Though OPU is a safe and simple procedure, it may cause damage to pelvic structures and bleeding. It is unclear whether history of a prior OPU poses any risk of increased blood loss in the OPU. We, herein, aimed to evaluate whether mean blood loss and hematologic parameters vary between women with and without the history of an OPU, in an unexplained infertility population. Methods: A prospective case-control study was conducted through the files of patients who underwent IVF/ICSI-ET between June and December 2013. Unexplained infertility patients with a CBC result were assigned to two groups; those undergoing OPU for the first time (Group 1, n=40) and those who were previously subjected to at least 1 procedure (Group 2, n=13). Blood samples were obtained before the ET. Hemoglobin values and changes were compared between the two groups. Results: Delta hemoglobin value did not significantly differ between the groups (p=0.469) and there were no significant difference between the pre- and post-procedure hemoglobin values in the patients with no and at least one OPUs and the total patient population (p=0.792, 0.259 and 0.442, respectively). Conclusions: Our study results reveal that the amount of the blood loss in OPU does not significantly vary between women subjected to the procedure for the first time and for more than 1 time.

Progesterone vaginal capsule versus vaginal gel for luteal support in normoresponder women undergoing long agonist IVF/ICSI cycles

OBJECTIVES The aim of the study was to investigate the effects of two different vaginal progesterone forms, administered for luteal phase support, on pregnancy outcomes in normoresponder women aged < 35, who underwent long agonist IVF/ICSI-ET cycles. MATERIAL AND METHODS A retrospective cohort analysis was designed. Normoresponders with primary infertility, who un-derwent IVF/ICSI-ET cycles employing GnRH analogue and who received progesterone as either capsule or gel form for LPS following a single embryo transfer, were analyzed. The cycles were categorized into two groups: micronized progesterone vaginal capsule 600 mg/day (Group 1, n = 78) and progesterone vaginal gel 180 mg/day (Group 2, n = 99). Positive β-hCG, clinical pregnancy and ongoing pregnancy rates were analyzed. RESULTS Both, demographic and stimulation characteristics were comparable between the groups. No difference was observed between the capsule and the gel groups regarding positive β-hCG (33.3% and 28.3%, respectively; p = 0.580), clinical pregnancy (26.9% and 22.2%, respectively; p = 0.584), and ongoing pregnancy rates (21.8% and 20.2%, respectively; p = 0.942) after treatment completion. CONCLUSIONS In long agonist IVF/ICSI-ET cycles, positive β-hCG, clinical pregnancy and ongoing pregnancy rates do not significantly differ between normoresponder patients receiving micronized progesterone vaginal capsule and those receiv-ing progesterone vaginal gel for LPS.

Vaginal micronized progesterone capsule versus vaginal progesterone gel for lutheal support in normoresponder IVF/ICSI-ET cycles

Objective: To compare the outcomes of luteal phase support by micronized progesteron vaginal capsule 600mg/day and progesterone vaginal gel 180mg/day in the normoresponder IVF/ICSI-ET cycles of the patients down-regulated via GnRH agonist long protocol or fixed antagonist protocol below 40 years of age. Methods: A total of 463 normoresponder cycles between January 2013 and December 2013 were retrospectively analyzed. Those with a BMI>28 kg/m2, any kind of uterine, ovarian or adnexial pathology, any significant systemic, endocrine or metabolic disease or who were reported as azoospermia, were excluded from the study. The patients were grouped according to the usage of micronized progesterone vaginal capsule 600mg/day (Group 1) or progesterone vaginal gel 180mg/day (Group 2) as luteal phase support. Treatment cycle characteristics and pregnancy outcomes were compared between groups. Results: Group-I included 220 cycles and group 2 included 243 cycles. Although the MII oocyte percentage among the total number of MII oocytes was significantly higher in Group-II (77.5% and 80.2%; p=0.034), positive ß-hCG (32.3% and 21.8%; p=0.015) and clinical pregnancy (27.3% and 17.7%; p=0.018) rates were significantly higher in Group-I. No difference was observed between groups regarding the ongoing pregnancy rates (23.2% and 17.3%; p=0.143). Conclusion: Micronized progesterone vaginal capsule 600mg daily used for luteal support in the IVF/ICSI-ET cycles was observed to significantly increase the biochemical and clinical pregnancy rates compared to progesterone vaginal gel 180mg daily. However, no difference was observed between two groups regarding ongoing pregnancy rates.