Özay Oral

The Effects of Oxidative Stress on Outcomes of Assisted Reproductive Techniques

Purpose: To investigate the impact of oxidative stress on pregnancy success by monitoring malondialdehyde levels in follicular fluid. Methods: Forty five couples were enrolled in this prospective study. Following long protocol of GnRH analogues and r-FSH treatment, oocyte retrieval and intracytoplasmic sperm injection were performed. Malondialdehyde levels were assayed by thiobarbutiric acid reacting substances test. Students t-test and χ2 test were used for statistical analysis. Results: Patients were divided into two groups; group I (pregnancy positive, n = 20), group II (pregnancy negative, n = 25). There was no statistical significant difference in terms of age, infertility period, FSH levels on the third day, number of oocytes retrieved and fertilization rates between the two groups. Pregnancy rates were found to be decreasing in higher malondialdehyde levels. Conclusion: Malondialdehyde can be used as a marker of oxidative stress and a potential marker in predicting assisted reproductive techniques outcome.

Clinical, endocrine, and metabolic effects of acarbose, a α-glucosidase inhibitor, in overweight and nonoverweight patients with polycystic ovarian syndrome

OBJECTIVE To determine the clinical, endocrine, and metabolic effects of acarbose use in overweight and nonoverweight patients with polycystic ovarian syndrome (PCOS). DESIGN Prospective analysis. SETTING Gynecology and infertility clinic of a tertiary care medical center. PATIENT(S) Seventy-four patients with PCOS and 30 healthy women. INTERVENTION(S) Acarbose use. MAIN OUTCOME MEASURE(S) Clinical findings of hyperandrogenism, body mass indices, LH, FSH, DHEAS, total T, PRL, basal insulin, fasting glucose/insulin levels, and lipid profiles. RESULT(S) Acarbose treatment improved LH/FSH levels, decreased total T, DHEAS, basal insulin, low-density lipoprotein, very low-density lipoprotein, and triglyceride levels, and increased high-density lipoprotein levels in patients with PCOS. Basal insulin and fasting glucose/insulin levels reacted more significantly in overweight patients undergoing acarbose treatment. CONCLUSION(S) Acarbose has been found to improve insulin levels and thus glucose/insulin ratios more effectively in overweight patients compared with nonoverweight patients with PCOS. This drug seems to be an effective drug to be used in overweight as well as nonoverweight patients with PCOS.

Aile planlamasında sezaryen esnasında postplasental rahim içi araç uygulaması ve sonuçları

Objective: This study was planned to perform the effectiveness and reliability of IUD application during cesarean section just the postplasentation. Study design: This study was performed at the Zeynep Kamil Education and Research Hospital in Istanbul from January 1, 2000 to June 31, 2001. Intrauterine device ( IUD ) (Copper- T 380 ) was inserted to 72 women during cesarean section with using a ring forceps. The patients were controlled during 1 year. They were evaluated just after the puerperium and the end of the first year to observe any complication. Results: were selected for the trial. All of the women were come to the first visit after the puerperium while only 62 women ( % 80.5 ) out of 72 cases were come to the second visit the end of the first year. In 42 ( % 67 ) out of 62 cases, IUD and strings were in normal localisation. In 9 ( % 14 ) IUD was in normal position whereas string could not be seen. In 7 cases ( % 11 ) only one string was observed in the cervical canal. In 2 cases ( %3.2 ) expulsion was observed. Conclusion: e trial consist of few cases, it was concluded that insertion of IUD during cesarean section is an effective and reliable contraceptive method.

Bir heterotopik gebelik: olgu sunumu

Kombine intrauterin ve ekstrauterin gebelik obstetrikte oldukca nadir gorulen bir durumdur. Heterotopik gebeligi teshis etmek klinik olarak oldukca zordur. Heterotopik gebelik ozellikle yardimli ureme teknikleri sonucu gebelik elde edilmis olgularda, spontan abortus veye dilatasyon kuretaji takiben b HCG seviyesi persiste eden veya yukselen olgularda dusunulmelidir.

Postpartum hemorajide mediolateral epizyotominin etkinliği

Amac: Vaginal dogumlarda mediolateral epizyotominin postparum hemorajide etkinligini arastirmak. Materyal ve Metod: Calisma Haziran 2001- Haziran 2002 tarihleri arasinda Zeynep Kamil Kadin ve Cocuk Hastaliklari Egitim ve Arastirma Hastanesinde planlandi ve yapildi. Calismaya 205 olgu ile baslandi. Cesitli komplikasyonlar nedeniyle 7 olgu calisma kapsamindan cikarildi. Calisma grubuna demografik ozellikleri ayni olan 198 olgu alindi. Calisma grubunu olusturan 132 olguya mediolateral epizyotomi uygulandi. 66 olguya epizyotomi uygulanmadi. Tum olgularda dogum oncesi ve dogumdan 48 saat sonra hemoglobin (Hb) ve hematokrit (Hct) degerleri tesbit edildi. Her iki grubun kendi icinde ve gruplar arasinda hemoglobin ve hematokrit degerleri farklari tesbit edilerek, farklann istatistiksel olarak anlamli olup olmadigi arastirildi. Bulgular: Mediolateral epizyotomi yapilan grupta, sirasiyla dogum oncesi ortalama hemoglobin degeri 11,6±1,3 gr/dl, htc degeri % 35,2 ±3,9 iken, dogumu takiben 48 saat sonra Hb degeri 10,5±1,5 gri di, Hct degeri % 31,8 ± 4,0 olarak tesbit edildi. Epizyotomi yapilmayan grupta sirasiyla dogum oncesi ortalama Hb degeri 11,3±1,3 gr/dl, Hct degeri %34,3 ±3,9 dogumu takiben 48 saat sonra Hb degeri 10,3±1,4 gr/dl Hct degeri % 31,6±4,1 idi. Her iki grubu farkli Hb ve Hct degerlen istatistiksel olarak karsilastirildiginda fark Hb p degeri 0,2; fark Hct p degeri 0,07 olarak bulundu ve istatistiksel bir anlamlilik saptanmadi. Sonuc: Modern obstetrikte epizyotominin rutin uygulanimi halen muhtemel cesitli komplikasyonlanndan dolayi tartisilmaktadir. Calisma grubunun sayisal akligina ragmen mediolateral epizyotominin hemoraji acisindan anneye ek bir yuk getirmedigi sonucuna vardik.

Çocukluk ve adolesan dönemde adneksiyal torsiyon: Olgu sunumu

Adneksiyal torsiyon siklikla reproduktif fonksiyona sahip bir organin kaybedilmesiyle sonuclanan ciddi bir jinekolojik olaydir. Anamnez, klinik, laboratuar ve goruntu yontemleri bir butun olarak ele alindiginda erken tani ve konservatif tedavi yontemlerinin uygulanabilmesi mumkundur. Salpingooferektomi uygulanmis 3 olgu nedeniyle erken tani ve tedavinin onemini vurgulamayi amacladik.