Mehmet Idil

Comparison of transvaginal sonography, saline infusion sonography and hysteroscopy in the evaluation of uterine cavity pathologies

Aims:  To determine whether performing transvaginal sonography (TVS) and saline infusion sonography (SIS) before hysteroscopy could reduce the number of diagnostic hysteroscopies performed for the evaluation of uterine cavity abnormalities.

Hydrosonography in screening for intracavitary pathology in infertile women

Objectives: We evaluated the value of hydrosonography in screening for intracavitary pathologies in infertile patients. Methods: A total of 93 infertile women with suspected intracavitary lesions on transvaginal ultrasonography (TVS) underwent hydrosonography. Specimens obtained either by dilatation and curettage or hysteroscopic resection were compared with findings on TVS and hydrosonography. Results: Pathology confirmed the presence of sonographically diagnosed intracavitary lesions in 40 out of 66 (60%) women. The sensitivity, specificity, positive predictive value, and negative predictive value of TVS for the detection of endometrial cavity lesions were 78%, 38%, 61%, and 59%, respectively. Forty‐six out of 71 (65%) women who were found to have intracavitary lesions on hydrosonography were pathologically confirmed. The sensitivity, specificity, positive and negative predictive value of hydrosonography in the detection of endometrial cavity lesions were 90%, 40%, 65%, and 77%, respectively. Conclusions: Hydrosonography is a useful procedure in screening for intracavitary pathologies and allows differentiation of intracavitary, endometrial, and submucosal abnormalities.

Significance of yolk sac measurements with vaginal sonography in the first trimester in the prediction of pregnancy outcome

Background.The purpose of this prospective clinical study was to determine and evaluate the prognostic value of secondary yolk sac diameter of the embryo on pregnancy outcome.

Does granulosa cell apoptosis have a role in the etiology of unexplained infertility

OBJECTIVE(S) To compare granulosa cell apoptosis in patients with unexplained infertility and tubal factor. Accelerated granulosa cell apoptosis may be the cause of unexplained infertility. STUDY DESIGN Setting was IVF-ET Unit of Cerrahpasa Medical Faculty, Istanbul University. GnRH analogs and gonadotropins were used for ovulation induction in patients with unexplained infertility (n=15) and tubal factor (n=15) undergoing in vitro fertilization and embryo transfer (IVF-ET) procedures. Following HCG injection and follicular aspiration, apoptosis of granulosa cells was assessed using the in situ DNA nick end labelling method and apoptosis rate was further determined by flow cytometry. Apoptosis rates were compared between two groups. Mann-Whitneys U-test and Students t-test were used for statistics. RESULTS Apoptosis rate was significantly higher in the unexplained infertility group (33.20 +/- 35.62% versus 10.10 +/- 17.23%). CONCLUSION(S) Granulosa cell apoptosis seems to have a role in the etiology of unexplained infertility.

Transvaginal ultrasound-guided aspiration and instillation of hyperosmolar glucose for treatment of unruptured tubal heterotopic pregnancy

ObjectivesTo report a case of tubal heterotopic pregnancy (HP) treated conservatively with transvaginal ultrasound-guided aspiration and instillation of hyperosmolar glucose.MethodsAspiration of the tubal ectopic pregnancy and hyperosmolar glucose instillation was performed with a 16-gauge needle under transvaginal ultrasound guidance.ResultsUnruptured tubal HP with positive cardiac activity was treated successfully without any further interventions, and intrauterine pregnancy has reached full-term without any complications.ConclusionsEarly diagnosis of this life-threatening condition is the key to its successful treatment. Transvaginal ultrasound-guided aspiration and hyperosmolar glucose injection can be safely performed for the treatment of unruptured tubal HP.

An alternative treatment option in tubal ectopic pregnancies with fetal heartbeat: aspiration of the embryo followed by single-dose methotrexate administration.

OBJECTIVE To present 13 cases of unruptured tubal ectopic pregnancies successfully treated with ultrasound-guided aspiration and local and systemic methotrexate (MTX) administration. DESIGN Case series. SETTING University hospital. PATIENT(S) Thirteen women with an unruptured tubal ectopic pregnancy. INTERVENTION(S) Transvaginal ultrasound-guided aspiration of the tubal ectopic pregnancy followed by MTX administration into the gestational sac (half of the calculated total dose of 25 mg/m(2)) and intramuscular injection (the remaining half of the calculated total dose of 25 mg/m(2)). MAIN OUTCOME MEASURE(S) Recovery of the patients, successful conservative treatment of the tubal ectopic pregnancies with preservation of the fallopian tubes. RESULT(S) Twelve (92%) of 13 women were successfully aborted, without need for salpingectomy or salpingostomy. CONCLUSION(S) Transvaginal ultrasound-guided aspiration of fetus followed by local and systemic methotrexate administration can be safely used to treat unruptured tubal ectopic pregnancies.

P807 Effects of cigarette smoking on intrauterine insemination outcomes

morphology above 5% according to strict criteria were included in the study. Pregnancy rates after IUI in Group 1 and Group 2 were compared. Results: The groups were comparable in terms of the duration of infertility, and mean age and body mass index and 3rd day FSH, LH and E2 values of women. The pregnancy rate in Group 1 was improved from zero to 3.4% with IUI treatments done after varicocelectomy. However, it was still found to be less than group 2. Group 2 had a pregnancy rate of 10.1% after IUIs. The pregnancy rate in Group 1 despite having varicocelectomy was significantly lower than in Group 2 (p =0.02). Conclusions: It has been found that varicocelectomy has considerably improved the pregnancy rate in couples after IUI treatment. This increase could not reach the pregnancy rates in couples whose male partners did not have varicocele. Further studies with larger groups are needed to have a definitive conclusion.