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Asoglu MR, Bahceci M. Does endometrial thickness affect birth weight and serum levels of pregnancy-associated plasma protein-A in frozen cycles? Eur J Obstet Gynecol Reprod Biol 2023; 284:24-29. [PMID: 36924659 DOI: 10.1016/j.ejogrb.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/14/2023] [Accepted: 03/09/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE To investigate whether endometrial thickness (EMT) affects birth weight and maternal serum pregnancy-associated plasma protein-A (PAPP-A) level in singleton pregnancies following frozen-thawed blastocyst transfer (FET). METHODS This retrospective study included women who underwent first-trimester combined screening for aneuploidy after FET, and subsequently delivered a singleton live birth after 24 weeks of gestation at a private in-vitro fertilization centre. The subjects were stratified into three groups based on EMT percentiles: <7.7 mm (<10th percentile), 7.7-12 mm (10-90th percentile), and > 12 mm (>90th percentile). Multi-variable linear regression analysis was undertaken to identify the association between birth weight and EMT after adjusting for variables with p < 0.1 on univariate analysis. RESULTS In total, 560 women met the inclusion criteria. Mean (±standard deviation) birth weight was 3127 ± 783 g in those with EMT < 7.7 mm, 3225 ± 644 g in those with EMT 7.7-12 mm, and 3256 ± 599 g in those with EMT > 12 mm (p = 0.577). Mean PAPP-A and PAPP-A < 0.5 rates were similar in the three groups. On multi-variate analysis, maternal serum PAPP-A was found to be a significant predictor of birth weight (p = 0.013), but EMT was not found to be predictive of birth weight on univariate or multi-variate analysis. CONCLUSION This study provided a new angle to evaluate the association between EMT and neonatal birth weight by analysing this association along with maternal serum PAPP-A as a marker for placental function, suggesting that EMT is not an independent factor for neonatal birth weight.
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Affiliation(s)
| | - Mustafa Bahceci
- Bahceci Fulya Assisted Reproduction Centre, Istanbul, Turkey
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Turan S, Asoglu MR, Ozdemir H, Seger L, Turan OM. Accuracy of the Standardized Early Fetal Heart Assessment in Excluding Major Congenital Heart Defects in High-Risk Population: A Single-Center Experience. J Ultrasound Med 2022; 41:961-969. [PMID: 34288033 DOI: 10.1002/jum.15782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/27/2021] [Accepted: 07/04/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the ability of standardized early fetal heart assessment (EFHA) that includes the 4-chamber view, outflow tract relationship (OTR), and transverse arches views (TAV) of the great arteries in excluding major congenital heart defects (CHDs) in high-risk populations. METHODS This retrospective study included high-risk pregnancies for CHDs undergoing EFHA at 11-14 weeks of gestation. Risk factors for CHDs were diabetes mellitus, a family history of CHDs, a history of a CHD use of teratogenic medications, seizure disorder, assisted reproductive treatment-conceived pregnancy, presence of at least one of the ultrasound markers: enlarged nuchal translucency (>95th percentile), tricuspid regurgitation, and reversed a-wave in the ductus venosus, presence of an extracardiac or a suspected cardiac anomaly, a high-risk first trimester combined screen result, and multiple pregnancies. EFHA consisted of visualization of 4ChV, OTR, and TAV, with and without power Doppler ultrasound. The primary outcome was the negative predictive value of EFHA in excluding major CHDs. RESULTS EFHA was performed on 1055 fetuses. Of these, 1024 were used for the final analysis. Of these, 94.9% (n = 923) were singleton. The most common indication for EFHA was maternal DM (n = 231, 22.6%). The sensitivity, specificity, false positive, false negative, and accuracy of EFHA were 93.2%, 99.9%, 1.4%, 0.4%, and 99.5% (P < .0001), respectively, in entire included cases. The performance of EFHA was 88%, 99.9%, 1.4%, 0.4%, and 99.5% (P < .0001) respectively when the terminated cases were excluded. CONCLUSION Early fetal heart assessment is feasible for screening for major CHDs in high-risk populations. This approach may be expanded to the general obstetric population.
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Affiliation(s)
- Sifa Turan
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Mehmet Resit Asoglu
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Halis Ozdemir
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Lindsey Seger
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ozhan Mehmet Turan
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Ayaz R, Göktas E, Turkyilmaz G, Asoglu MR. PRENATAL IDENTIFICATION OF ABERRANT RIGHT SUBCLAVIAN ARTERY IN ISOLATION: THE NEED FOR FURTHER GENETIC WORK-UP? Acta Clin Croat 2020; 59:582-589. [PMID: 34285428 PMCID: PMC8253070 DOI: 10.20471/acc.2020.59.04.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 09/29/2020] [Indexed: 11/24/2022] Open
Abstract
The objective of this study was to evaluate the association between aberrant right subclavian artery (ARSA) and chromosomal abnormalities. The study included 5211 women having attended our unit for fetal anatomic screening and fetal echocardiography from August 2016 until February 2019. After diagnosing ARSA, prenatal invasive testing was discussed with the patients. ARSA affected fetus was determined in 57 cases; of these, there were 38 cases of isolated ARSA and 19 cases of non-isolated ARSA but associated with soft markers and fetal anomalies. Nineteen patients underwent amniocentesis; Down syndrome was determined in two women, both of them from the non-isolated ARSA group, with fetal hydrops, atrioventricular septal defect and esophageal atresia. Fifteen of 38 patients who declined prenatal diagnostic testing, accepted karyotype analysis after delivery and none of these 15 cases had chromosomal abnormalities. Identification of ARSA should be followed by detailed ultrasound examination to ensure that there are no accompanying soft markers and/or structural defects. Isolated ARSA may not be an indication for karyotype analysis or 22q11.2 microdeletions. Non-ARSA implies a strong predictor of aneuploidy, and when additional findings are detected, invasive testing should be offered to the parents. The association between isolated ARSA and genetic disease should be evaluated in large powered prospective studies.
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Affiliation(s)
| | - Emine Göktas
- 1Division of Perinatology, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey; 2Division of Genetic Disease, Van Regional Training and Research Hospital, Van, Turkey; 3Division of Obstetrics & Gynecology, Van Regional Trainingand Research Hospital, Van, Turkey; 4Bahceci Infertility and IVF Center, Fulya, Istanbul, Turkey
| | - Gurcan Turkyilmaz
- 1Division of Perinatology, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey; 2Division of Genetic Disease, Van Regional Training and Research Hospital, Van, Turkey; 3Division of Obstetrics & Gynecology, Van Regional Trainingand Research Hospital, Van, Turkey; 4Bahceci Infertility and IVF Center, Fulya, Istanbul, Turkey
| | - Mehmet Resit Asoglu
- 1Division of Perinatology, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey; 2Division of Genetic Disease, Van Regional Training and Research Hospital, Van, Turkey; 3Division of Obstetrics & Gynecology, Van Regional Trainingand Research Hospital, Van, Turkey; 4Bahceci Infertility and IVF Center, Fulya, Istanbul, Turkey
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Asoglu MR, Celik C, Ozturk E, Cavkaytar S, Bahceci M. Impact of Isthmocele on Assisted Reproductive Treatment Outcomes: An Age-matched Retrospective Study. J Minim Invasive Gynecol 2020; 28:1113-1120. [PMID: 33038520 DOI: 10.1016/j.jmig.2020.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/01/2020] [Accepted: 10/04/2020] [Indexed: 10/23/2022]
Abstract
STUDY OBJECTIVE To evaluate whether the presence of an ultrasonographic visible isthmocele has an impact on the chance of pregnancy in women undergoing embryo transfer. DESIGN Age-matched retrospective study. SETTING Private-assisted reproductive center. PATIENTS The study included a total of 150 patients with a history of cesarean delivery with 75 isthmocele cases and 75 controls. All patients underwent embryo transfer from January 2017 through June 2018. The diagnosis of isthmocele was based on transvaginal ultrasound assessment. Isthmocele was defined as an anechoic indentation on the previous cesarean scar at the midsagittal plane, with a depth of >1 mm. INTERVENTIONS Embryo transfer. MEASUREMENTS AND MAIN RESULTS The groups were similar in patient and treatment characteristics. The live birth rate was 44% in the isthmocele group and 46.7% in the control group (odds ratio [OR] 0.89; 95% confidence interval [CI], 0.47-1.71; p = .743). The clinical pregnancy rates were 49.3% and 50.7%, respectively (OR, 0.94; 95% CI, 0.50-1.79; p = .870). The miscarriage rate was greater in the isthmocele group (8%) than in the control group (4%); however, it did not reach statistical significance (OR, 2.09; 95% CI, 0.50-8.67; p = .302). The multiple pregnancy rate was similar between the groups (8% vs 5.3%, respectively; OR, 1.54; 95% CI, 0.41-5.70; p = .513). The groups were also similar in ectopic pregnancy rates (p = .560). These outcomes remained similar when adjusted for potential confounders on the regression analysis. CONCLUSION Isthmocele does not seem to have a significant impact on the chance of pregnancy in assisted reproductive treatment settings. However, the embryo transfer procedure may be more difficult in the presence of an isthmocele.
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Affiliation(s)
| | - Cem Celik
- Bahceci Umut Assisted Reproduction Center (Drs. Celik, Ozturk, and Cavkaytar); Department of Obstetrics and Gynecology, School of Medicine, Uskudar University (Dr. Celik), Istanbul, Turkey
| | - Ebru Ozturk
- Bahceci Umut Assisted Reproduction Center (Drs. Celik, Ozturk, and Cavkaytar)
| | - Sabri Cavkaytar
- Bahceci Umut Assisted Reproduction Center (Drs. Celik, Ozturk, and Cavkaytar)
| | - Mustafa Bahceci
- Bahceci Fulya Assisted Reproduction Center (Drs. Asoglu and Bahceci)
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Abstract
Purpose: The existing literature is scarce regarding outcomes of fresh vs frozen embryo blastocyst transfers in women with endometrioma. The goal of the study was to compare outcomes between fresh and frozen blastocyst transfers (fresh-BT vs. frozen-BT) in endometrioma-affected women. Materials and methods: This study included 315 endometrioma-affected women aged between 20 and 39 years who underwent blastocyst transfer. Primary outcome was live birth rate (an alive birth after 24 completed weeks gestation). Results: The study groups did not differ in terms of patient characteristics and treatment variables. The live birth rate was 40.7% in fresh-BT group and 56.1% in frozen-BT group (OR:1.86, 95% CI:1.18-2.92 p = .007). The approach of frozen embryo transfer was an independent factor of live birth (adjusted OR:1.83, 95% CI:1.16-2.90, p = .009). Conclusion: The approach of frozen blastocyst transfer increases the chance of live birth in endometrioma-affected patients compared with fresh blastocyst transfer. Thus, a frozen embryo transfer may be the choice of strategy in these patients.
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Affiliation(s)
| | - Cem Celik
- Bahceci Umut Assisted Reproduction Center, Istanbul, Turkey
- Department of Obstetrics and Gynecology, School of Medicine, Uskudar University, Istanbul, Turkey
| | - Mustafa Bahceci
- Bahceci Fulya Assisted Reproduction Center, Istanbul, Turkey
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Kiyak H, Seckin KD, Karakis L, Karacan T, Ozyurek ES, Resit Asoglu M. Decidualized juvenile cystic adenomyoma mimicking a cornual pregnancy. Fertil Steril 2020; 113:463-465. [PMID: 32106998 DOI: 10.1016/j.fertnstert.2019.10.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 10/11/2019] [Accepted: 10/12/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To demonstrate the laparoscopic excision technique of a juvenile cystic adenomyoma and show how the decidualization of ectopic endometrial tissue can lead to the misdiagnosis of a focus of ectopic pregnancy. DESIGN Description and step-by-step demonstration of the surgical procedure using a video recording (Canadian Task Force Classification 3). SETTING Teaching and research hospital. PATIENT(S) A 27-year-old gravida 2 parity 1 patient with one previous caesarean delivery presented to the emergency department with symptoms of pelvic pain and delayed menses. Her beta-human chorionic gonadotropin level was 2,161 mIU/mL. On transvaginal ultrasonography the uterine cavity appeared empty without any signs of a gestational sac, and a 42×45 mm heterogeneous mass was observed on the right cornual area. An 18×21 mm cystic area was observed within the mass. A diagnosis of cornual pregnancy was made and two doses of systemic methotrexate treatment were administered. On the 12th day following medical treatment, the patient reported increasing abdominal pain and free fluid was observed in the pouch of Douglas on ultrasonography. The decision to perform laparoscopic cornual excision was made. MAIN OUTCOMES AND MEASURE(S) On laparoscopic exploration a tubal ectopic pregnancy was observed within the left fallopian tube. The presence of two simultaneous ectopic pregnancies, located in the left fallopian tube and the right cornual area, was suspected. However, upon careful inspection, the right fallopian tube appeared normal and the mass initially thought to be a right cornual pregnancy appeared more like a degenerated fibroid. A left salpingectomy was performed and the excision of the mass in the right cornual area was planned. An incision was made over the mass and the cystic inner area containing chocolate-brown colored fluid was drained. As there was no pseudo capsule surrounding the mass, the diagnosis of focal adenomyosis instead of degenerated fibroid was made. No endometriotic foci were observed within the pelvis. Different from the enucleation of a fibroid, the mass was dissected from the middle into two halves until healthy myometrium was reached on the floor of the mass. The two halves of the mass were resected totally by dissecting the adenomyotic tissue from the myometrium starting from the caudal end towards the cranial end. The first layer of the remaining myometrial defect was sutured extracorporeally with No.1 polyglactan sutures. The second and third layers were sutured intracorporeally with V-loc sutures. The resected left fallopian tube containing the ectopic pregnancy and the adenomyotic mass were externalized through a posterior colpotomy incision. RESULT(S) The patient was discharged 24 hours postoperatively without any complications. A diagnosis of juvenile cystic adenoma was made upon histopathological examination. The patient reported subsiding of her dysmenorrhea on the postoperative third month. CONCLUSION(S) Juvenile cystic adenomyosis (JCA), is a rare form of focal adenomyosis which is usually located in close proximity to the uterine insertion of the round ligament, contains a cystic inner area larger than 1 cm and is encountered before the age of 30 years. Some authors reported JCA to be an accessory and cavitated uterine mass (ACUM) anomaly developing as a result of gubernaculum dysfunction. The only difference between the two conditions is reported to be the presence of a denser area of adenomyosis surrounding the cystic area lined with endometrium in JCA than in ACUM. This case has shown that decidual changes observed in ectopic endometrial tissue within an adenomyotic area may be misdiagnosed as a focus of ectopic pregnancy. Atypical endometriomas demonstrating decidual changes may also be misdiagnosed as ovarian malignancies. In non-emergency situations, waiting for the decidualization effect of ectopic endometrium to subside can help in the definitive diagnosis of such cases. Our technique for JCA excision is different from enucleation of a fibroid and may aid in the total resection and dissection of the adenomyotic tissue from healthy myometrium.
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Affiliation(s)
- Huseyin Kiyak
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Education Hospital, University of Health Sciences, Istanbul, Turkey
| | - Kerem Doga Seckin
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Education Hospital, University of Health Sciences, Istanbul, Turkey
| | - Lale Karakis
- Department of Obstetrics and Gynecology, Bahceci Woman Health Center Reproductive Endocrinology and Infertility, Istanbul, Turkey
| | - Tolga Karacan
- Department of Obstetrics and Gynecology, Bagcilar Research and Education Hospital, University of Health Sciences, Istanbul, Turkey.
| | - Eser Sefik Ozyurek
- Department of Obstetrics and Gynecology, Bagcilar Research and Education Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Resit Asoglu
- Department of Obstetrics and Gynecology, Bahceci Woman Health Center Reproductive Endocrinology and Infertility, Istanbul, Turkey
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Takmaz O, Asoglu MR, Yuksel B, Gungor M, Tokat F, Kayhan KC, Ozaltin S, Dogan M, Buyru F, Bastu E. Ovarian incision enhances folliculogenesis: A rat model. J Obstet Gynaecol Res 2020; 46:2043-2049. [PMID: 32643253 DOI: 10.1111/jog.14373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/19/2020] [Accepted: 06/11/2020] [Indexed: 11/29/2022]
Abstract
AIM To determine whether performing incision on the surface of the ovarian cortex in rats advances follicular development. METHODS Five to seven separate superficial incisions were performed on the surface of right ovaries of 6-7-month-old albino Wistar rats. Daily 40 IU of gonadotropins were administered for 14 days. On the 15th day, both ovaries of the rats were removed. The right (incised) ovaries were compared with the contralateral ovaries in terms of ovary's weight, numbers of primordial, primary, secondary and antral follicles, their mean percentages and mean Ki-67 proliferation indices. RESULTS A total of 22 ovaries were evaluated, with 11 right ovaries (incised) and 11 left ovaries (non-incised). The mean weight of ovaries was greater in the right ovaries than in the left ovaries; however, no statistical difference was found between them (0.77 ± 1.22 vs. 0.22 ± 0.08 gr, P = 0.159). The numbers of secondary and antral follicle were statistically higher in the right ovaries than in the left ovaries (4.4 ± 1.5 vs. 2.1 ± 1.6, P = 0.003 and 18.6 ± 8.7 vs. 11.3 ± 7.5, P = 0.046, respectively). The right ovaries also significantly differed from the left ovaries in terms of mean percentages of primordial and antral follicles (P < 0.05 for both). The mean Ki-67 proliferation index had a marginal difference between the groups (P = 0.064). CONCLUSION Performing incisions on the surface of the ovarian cortex in rats may advance the ovarian follicular development. Future animal studies may provide more evidence regarding potential benefits of mechanical stimulation to the ovaries.
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Affiliation(s)
- Ozguc Takmaz
- Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | | | - Bahar Yuksel
- Department of Obstetrics and Gynecology, Esenler Maternity and Children's Hospital, Istanbul, Turkey
| | - Mete Gungor
- Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Fatma Tokat
- Department of Pathology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Kerem Cavit Kayhan
- Department of Pathology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Selin Ozaltin
- Department of Obstetrics and Gynecology, Acibadem Maslak Hospital, Istanbul, Turkey
| | - Murat Dogan
- Department of Obstetrics and Gynecology, Buyukcekmece Mimar Sinan State Hospital, Istanbul, Turkey
| | - Faruk Buyru
- Department of Obstetrics and Gynecology, Acibadem Fulya Hospital, Istanbul, Turkey
| | - Ercan Bastu
- Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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Asoglu MR, Celik C, Serefoglu EC, Findikli N, Bahceci M. Preimplantation genetic testing for aneuploidy in severe male factor infertility. Reprod Biomed Online 2020; 41:595-603. [PMID: 32763130 DOI: 10.1016/j.rbmo.2020.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/17/2020] [Accepted: 06/19/2020] [Indexed: 11/30/2022]
Abstract
RESEARCH QUESTION Does the use of preimplantation genetic testing for aneuploidies (PGT-A) improve outcomes in couples with severe male factor infertility (SMFI)? DESIGN This retrospective cohort study included SMFI cases that underwent blastocyst transfer with/without PGT-A. Inclusion criteria were SMFI (azoospermia and sperm count <1 million/ml), women aged 25-39 years, single vitrified-warmed blastocyst transfer, and no intracavitary pathologies. Patients were divided into PGT-A and non-PGT-A groups. The primary outcome was live birth rate (live birth of an infant after 24 weeks of gestation); secondary outcomes were implantation and clinical pregnancy rates. RESULTS The study included 266 SMFI cases (90 and 176 in the PGT-A and non-PGT-A groups, respectively). Men and women in the PGT-A group were significantly older than those in the non-PGT-A group. The groups did not differ in terms of male factor categories, sperm collection methods or additional female factors. Live birth rates in the PGT-A and non-PGT-A groups were 55.6% and 51.1%, respectively (odds ratio [OR] 1.19, 95% confidence interval [CI] 0.71-1.98, P = 0.495). The implantation rates were 65.6% and 64.2%, respectively (OR 1.06, 95% CI 0.62-1.80, P = 0.827). The clinical pregnancy rates were 62.2% and 58.0%, respectively (OR 1.19, 95% CI 0.71-2.01, P = 0.502). The use of PGT-A was not an independent factor for live birth (aOR 1.33, 95% CI 0.66-2.70, P = 0.421). Advanced age in women was the only independent factor associated with live birth (aOR 0.46, 95% CI 0.22-0.96, P = 0.041). CONCLUSIONS The use of PGT-A does not seem to be an independent factor associated with live birth per transfer in couples with SMFI.
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Affiliation(s)
| | - Cem Celik
- Bahceci Umut Assisted Reproduction Center Istanbul, Turkey; Uskudar University, School of Medicine, Department of Obstetrics and Gynecology Istanbul, Turkey
| | - Ege Can Serefoglu
- Bahceci Fulya Assisted Reproduction Center Istanbul, Turkey; Biruni University, School of Medicine, Department of Urology Istanbul, Turkey
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Asoglu MR, Cutting EM, Ozdemir H, Higgs AS, Siegel GB, Turan OM, Turan S. The rate of undetectable genetic causes by Cell-free DNA test in congenital heart defects. J Matern Fetal Neonatal Med 2020; 35:1484-1490. [PMID: 32338089 DOI: 10.1080/14767058.2020.1757643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The study aimed to estimate the rate of genetic causes that were undetectable by Cell-free DNA (cfDNA) test in prenatally diagnosed congenital heart defect (CHD) cases based on an assumption that cfDNA would accurately detect common aneuploidies including trisomy 21/18/13/45X, and del22q11.2.Methods: This study included prenatally diagnosed CHD cases with diagnostic genetic results. The possibility of false-positive/negative results from cfDNA testing was discarded. Thus, cfDNA results would be positive in common aneuploidies or del22q11.2 and negative in normal diagnostic genetic testing results or other genetic conditions. The rate of genetic causes that were undetectable by cfDNA test was estimated for all cases as well as for CHD subgroups.Results: Of 302 cases, 98 (34.8%) had a type of genetic abnormalities, with 67 having common aneuploidies or del22q11.2 and 31 having other genetic conditions. The rate of genetic causes that were undetectable by cfDNA test in CHD cases was 13.2% among those with assumingly negative cfDNA screen results and 10.3% among the entire study population. These rates were similar between CHD subgroups (p > .05). The rate of genetic causes that were undetectable by cfDNA test was higher in the non-isolated cases than in the isolated ones among those with assumingly negative-screen results (20.5% and 9.9%, respectively, p = .025).Conclusion: In prenatally diagnosed CDH cases, a significant number of chromosomal abnormalities are still identified after diagnostic testing even if cfDNA screen is negative, and thus it is important to extensively counsel patients with negative cfDNA screen carrying a CHD-affected fetus.
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Affiliation(s)
- Mehmet Resit Asoglu
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Elizabeth M Cutting
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Halis Ozdemir
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Amanda S Higgs
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Ozhan M Turan
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sifa Turan
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
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Asoglu MR, Turan OM, Seger L, Kochan M, Turan S. Middle cerebral artery pulsatility index as possible predictive marker for neonatal death in fetuses with tricuspid valve malformation. Ultrasound Obstet Gynecol 2020; 55:552-554. [PMID: 31483895 DOI: 10.1002/uog.20862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/21/2019] [Accepted: 08/23/2019] [Indexed: 06/10/2023]
Affiliation(s)
- M R Asoglu
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - O M Turan
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - L Seger
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - M Kochan
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - S Turan
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
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Ayaz R, Asoglu MR. Neural tube defects in eastern Turkey; Is low folate status or vitamin B12 deficiency or both associated with a high rate of NTDs? J Matern Fetal Neonatal Med 2019; 33:3835-3840. [PMID: 31122096 DOI: 10.1080/14767058.2019.1623778] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Objective: The aim of this study was to compare the rates of low folate status and vitB12 deficiency between pregnancies with a NTD-affected fetus and those with a structurally normal fetus in a low-income population residing in eastern Turkey.Study design: It was a retrospective cohort study conducted in our perinatology unit in eastern Turkey between 2016 and 2018. The inclusion criterion for the study group was pregnancies with an NTD-affected fetus. The control group was pregnancies who met the following criteria; no prior history of pregnancy with a NTD-affected fetus, spontaneous abortion or stillbirth, no fetal growth problems or structural abnormality in the present pregnancy, and matching by gestational age. Venous blood samples of these women were obtained at the time of ultrasound examination and serum folate and vitB12 levels were measured by chemiluminescence method using ECLIA immunologic test (Roche, cobas e601/602 analyzers) at our laboratory.Results: The rate of NTDs was 130 per 10 000 (151/11 552). VitB12 deficiency was found in 62.9% of the study group and 36.4% of the control group (p < .001). The rate of low folate status was also different between the groups, with 42.3 and 15.2%, respectively (p < .001). Of the NTDs cases, 12.5% had only low folate status, 33.7% had only vitB12 deficiency, and 29.8% had both together. The rate of low folate status together with vitB12 deficiency was significantly different between the groups (p < .001).Conclusion: Low folate status coupled with B12 deficiency seems to be strongly associated with NTDs. Thus, simultaneous correction of their levels may be the best reasonable approach for the prevention of NTDs in low-income regions. This strategy can reduce the rate of NTDs in low-income regions, improve overall population health and mitigate the economic burden of NTDs on health care system.
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Affiliation(s)
- Reyhan Ayaz
- Division of Obstetrics and Gynecology, Van Regional Training and Research Hospital, Van, Turkey
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Asoglu MR, Celik C, Karakis LS, Findikli N, Gultomruk M, Bahceci M. Comparison of daily vaginal progesterone gel plus weekly intramuscular progesterone with daily intramuscular progesterone for luteal phase support in single, autologous euploid frozen-thawed embryo transfers. J Assist Reprod Genet 2019; 36:1481-1487. [PMID: 31104292 DOI: 10.1007/s10815-019-01482-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 05/05/2019] [Accepted: 05/07/2019] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To compare outcomes between daily intramuscular progesterone (IMP) and daily vaginal progesterone (VP) gel plus weekly intramuscular hydroxyprogesterone caproate (IMHPC) for luteal phase support (LPS) in single, autologous euploid frozen-thawed blastocyst transfers (FBTs) following artificial endometrial preparation (EP). METHODS The retrospective cohort study included 767 single, autologous FBTs from 731 patients between January 2015 and March 2018. LPS was performed either with IMP (100 mg/day) or with VP gel (90 mg, twice daily) plus IMHPC (250 mg/week). Oral estrogen was prescribed in combination of both regimes. Oral estrogen was discontinued following the visualization of fetal cardiac activity on ultrasound and progesterone at 10 weeks of gestation. The primary outcome was live birth rate. The secondary outcomes included implantation, clinical pregnancy, and multiple pregnancy rates. RESULTS Patient characteristics did not differ in LPS regimes. Of 767 FBTs, 608 had IMP (100 mg/day) for LPS and 159 had VP gel (90 mg, twice daily) plus IMHPC (250 mg/week) for LPS. The live birth rate was 51.8% and 50.3%, respectively (p = 0.737, OR 0.94, 95%CI 0.66-1.33). The implantation rate was 62.7% and 64.2%, respectively (p = 0.730, OR 1.06, 95%CI 0.74-1.53). The clinical pregnancy rates were also similar in both groups (59.5% vs. 61.6%, respectively, p = 0.631, OR 1.09, 95%CI 0.76-1.56). CONCLUSIONS We did not observe significant differences in the rates of live birth, implantation, and clinical pregnancy between daily IMP and daily VP gel plus weekly IMHPC for LPS in single, autologous euploid FBTs after artificial EP.
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Affiliation(s)
- Mehmet Resit Asoglu
- Bahceci Fulya Assisted Reproduction Center, Hakki Yeten St. No:11, Sisli, 34394, Istanbul, Turkey.
| | - Cem Celik
- Bahceci Umut Assisted Reproduction Center, Mahir Iz st. No: 31, Uskudar, 34662, Istanbul, Turkey
| | - Lale Susan Karakis
- Bahceci Fulya Assisted Reproduction Center, Hakki Yeten St. No:11, Sisli, 34394, Istanbul, Turkey
| | - Necati Findikli
- Bahceci Umut Assisted Reproduction Center, Mahir Iz st. No: 31, Uskudar, 34662, Istanbul, Turkey
| | - Meral Gultomruk
- Bahceci Fulya Assisted Reproduction Center, Hakki Yeten St. No:11, Sisli, 34394, Istanbul, Turkey
| | - Mustafa Bahceci
- Bahceci Fulya Assisted Reproduction Center, Hakki Yeten St. No:11, Sisli, 34394, Istanbul, Turkey
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Asoglu MR, Yao R, Seger L, Turan OM, Turan S. Applicability of Standardized Early Fetal Heart Examination in the Obese Population. J Ultrasound Med 2019; 38:1269-1277. [PMID: 30251391 DOI: 10.1002/jum.14807] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE This study aimed to evaluate the impact of obesity on early evaluation of fetal cardiac landmarks using a standardized examination method at the time of nuchal translucency scan. METHODS This was a cross-sectional study of an ongoing prospective cohort at high risk for congenital heart defects. We used a standardized examination protocol using 2-dimensional sonography with power Doppler in the evaluation of fetal cardiac landmarks consisting of 4-chamber view, outflow tract relationship, and transverse arches view. The study population was stratified based on maternal body mass index into nonobese (<30 kg/m2 ) and obese (≥30 kg/m2 ). Groups were compared in terms of satisfactory evaluation of fetal cardiac landmarks, transvaginal sonography use, and scan times required for the evaluations. Subanalysis was performed by further categorizing obesity into nonmorbid obesity (30.0-39.9 kg/m2 ) and morbid obesity (≥40 kg/m2 ). RESULTS A total of 190 patients were evaluated. Of these, 48.4% (n = 92) were obese. The most common indication for fetal cardiac assessment was maternal pregestational diabetes mellitus (42.6%). Transvaginal sonography was utilized in one nonobese woman (1.4%) and 11 obese women (12%) (P = .002). The satisfactory evaluation of 4-chamber view, outflow tract relationship, transverse arches view, and all views were not significantly different between groups (P > .05). The scan time was about 5 minutes longer in the obese group compared with nonobese group (P = .020). CONCLUSIONS Obesity does not hamper early evaluation of fetal cardiac landmarks around the time of nuchal translucency scan. However, obese patients are more likely to require transvaginal examinations.
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Affiliation(s)
- Mehmet Resit Asoglu
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ruofan Yao
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Lindsey Seger
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ozhan Mehmet Turan
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Sifa Turan
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Turan OM, Asoglu MR, Harman C. Modified fetoscopic laser surgery in twin-to-twin transfusion syndrome with proximate cord insertions: a report of two cases and literature review. J Matern Fetal Neonatal Med 2019; 34:163-166. [PMID: 30651014 DOI: 10.1080/14767058.2019.1571578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Proximate cord insertions (PxCIs) are a variant of umbilical cord insertions (CIs) that can be identified in monochorionic (MC) twins, making fetoscopic laser photocoagulation for twin-to-twin transfusion syndrome (TTTS) technically challenging. The existing literature is controversial for successful fetoscopic laser photocoagulation in TTTS cases with PxCIs. We presented two cases with TTTS complicated by PxCIs that underwent a successful laser ablation using our proposed technique.
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Affiliation(s)
- Ozhan Mehmet Turan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mehmet Resit Asoglu
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Christopher Harman
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
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Asoglu MR, Bears B, Turan S, Harman C, Turan OM. The factors associated with mode of delivery in fetuses with congenital heart defects. J Matern Fetal Neonatal Med 2018; 33:816-824. [PMID: 30153755 DOI: 10.1080/14767058.2018.1505855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: It is not evident whether the mode of delivery (MOD) should be modified in pregnancies complicated by fetal congenital heart defects (CHDs). The question as to whether MOD of CHD infants has a significant impact on neonatal outcome remains elusive. The aim of this study was to evaluate factors associated with MOD and its impact on immediate neonatal outcomes in a cohort of late preterm or term fetuses with CHDs born in a tertiary center.Methods: This retrospective study comprised of singleton pregnancies with known fetal CHDs who delivered after 34 0/7 weeks of gestation over a 7-year period. Fetuses with chromosomal abnormality or stillbirths were excluded. Obstetric risk factors were classified as maternal medical, maternal surgical or fetal comorbidities. MOD was classified as elective cesarean delivery (CD) or attempted vaginal delivery (VD). The latter was further categorized as successful VD or intrapartum CD. The study population was stratified into four categories based on the severity of cardiac abnormalities diagnosed by fetal echocardiography. Immediate neonatal outcomes included Apgar scores and umbilical cord artery pH.Results: Of a total of 222 patients, 79.8% underwent attempted VD and 20.2% had elective CD. Of the attempted VD group, 80.2% had successful VD and 19.8% had intrapartum CD. The frequencies of maternal medical, maternal surgical and fetal comorbidities were higher in the elective CD group than in the attempted VD group and also were higher in the intrapartum CD group than in the successful VD group (p < .05 for all). Multivariate logistic regression models revealed that maternal surgical or fetal comorbidities increased the chance of elective CD and maternal medical or fetal comorbidities decreased the chance of successful VD. The severity of CHDs was not an independent factor that affected MOD. Elective or intrapartum CD did not improve immediate neonatal outcomes.Conclusion: Our results demonstrated that preexisting obstetric comorbidities were significant variables that affected the MOD in fetuses with CHD. Vaginal delivery should be attempted unless obstetric and medical contraindications accompany index pregnancy.
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Affiliation(s)
- Mehmet Resit Asoglu
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Breanne Bears
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sifa Turan
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Christopher Harman
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ozhan M Turan
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
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Asoglu MR, Higgs A, Esin S, Kaplan J, Turan S. The importance of prenatal 3-dimensional sonography in a case of a segmental overgrowth syndrome with unclear chromosomal microarray results. J Clin Ultrasound 2018; 46:351-354. [PMID: 29023778 DOI: 10.1002/jcu.22545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 06/29/2017] [Accepted: 07/10/2017] [Indexed: 06/07/2023]
Abstract
PIK3CA-related overgrowth spectrum, caused by mosaic mutations in the PIK3CA gene, is associated with regional or generalized asymmetric overgrowth of the body or a body part in addition to other clinical findings. Three-dimensional ultrasonography (3-D US) has the capability to display structural abnormalities in soft tissues or other organs, thereby facilitating identification of segmental overgrowth lesions. We present a case suspected of having a segmental overgrowth disorder based on 3-D US, whose chromosomal microarray result was abnormal, but apparently was not the cause of the majority of the fetus's clinical features.
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Affiliation(s)
- Mehmet Resit Asoglu
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Amanda Higgs
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Sertac Esin
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland
| | - Julie Kaplan
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Sifa Turan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland
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Takmaz O, Asoglu MR, Gungor M. Patient positioning for robot-assisted laparoscopic benign gynecologic surgery: A review. Eur J Obstet Gynecol Reprod Biol 2018; 223:8-13. [PMID: 29428480 DOI: 10.1016/j.ejogrb.2018.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/01/2018] [Accepted: 02/05/2018] [Indexed: 12/13/2022]
Abstract
Robotic surgical platforms are now in widespread use in the practice of gynecology all over the world. The introduction of robotic surgery has required some modifications of patient positioning when compared to standard laparoscopic surgery. Optimal patient positioning is likely to be the most essential step of robotic surgery as it provides the technical feasibility to have adequate access to the pelvic structures for performing the surgery. It is prudent to pay attention to preventing patient shifting in Trendelenburg position because of tendency of sliding down toward the direction of the head. Inappropriate patient positioning is associated with inadequate exposure of the operative field as well as detrimental complications that may lead to long-term side effects. These issues can be reduced with use of proper or strategic positioning technique. The purpose of this review is to highlight important points to properly position patient for robot-assisted laparoscopic benign gynecologic surgery and protect patient from position-related injuries.
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Affiliation(s)
- Ozguc Takmaz
- Acibadem Maslak Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey; Acibadem Mehmet Ali Aydinlar University, Department of Obstetrics and Gynecology, Division of Minimally Invasive Surgery, Istanbul, Turkey.
| | - Mehmet Resit Asoglu
- Acibadem Maslak Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Mete Gungor
- Acibadem Maslak Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey; Acibadem Mehmet Ali Aydinlar University, Department of Obstetrics and Gynecology, Division of Minimally Invasive Surgery, Istanbul, Turkey
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Gurbuz N, Asoglu MR, Ashour AA, Salama S, Kilic GS, Ozpolat B. A selective serotonin 5-HT 1B receptor inhibition suppresses cells proliferation and induces apoptosis in human uterine leiomyoma cells. Eur J Obstet Gynecol Reprod Biol 2016; 206:114-119. [DOI: 10.1016/j.ejogrb.2016.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 07/25/2016] [Accepted: 08/01/2016] [Indexed: 02/07/2023]
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Selcuk S, Cam C, Asoglu MR, Kucukbas M, Arinkan A, Cikman MS, Karateke A. Effect of simple and radical hysterectomy on quality of life – analysis of all aspects of pelvic floor dysfunction. Eur J Obstet Gynecol Reprod Biol 2016; 198:84-88. [DOI: 10.1016/j.ejogrb.2016.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 11/10/2015] [Accepted: 01/01/2016] [Indexed: 10/22/2022]
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20
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Serhat E, Cogendez E, Selcuk S, Asoglu MR, Arioglu PF, Eren S. Is there a relationship between endometrial polyps and obesity, diabetes mellitus, hypertension? Arch Gynecol Obstet 2014; 290:937-41. [PMID: 24858564 DOI: 10.1007/s00404-014-3279-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 05/02/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of our study was to evaluate the relationship between endometrial polyps and obesity, diabetes mellitus (DM) and hypertension (HT). MATERIALS AND METHODS 202 patients who applied to our gynecology clinic with complaints of infertility, recurrent pregnancy loss and abnormal uterine bleeding, diagnosed to have endometrial polyps by hysteroscopy, were compared with 79 patients without polyps, retrospectively. The relationships between risk factors and presence of a polyp and polyp size were analyzed. RESULTS The mean age of cases with endometrial polyps was significantly greater than the controls. The mean body mass index (BMI) of the cases with polyps was also significantly greater than the controls. There was no significant difference between groups with respect to prevalence of DM or HT. CONCLUSION This study suggests that obesity is an independent risk factor in the development of endometrial polyps. Clinicians should be aware in terms of endometrial polyps in the assessment of patients with BMI ≥30. There was no relationship between HT or DM with presence of polyps.
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Affiliation(s)
- Esra Serhat
- Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children's Education and Research Hospital, Istanbul, Turkey
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Asoglu MR, Selcuk S, Cam C, Cogendez E, Karateke A. Effects of urinary incontinence subtypes on women's quality of life (including sexual life) and psychosocial state. Eur J Obstet Gynecol Reprod Biol 2014; 176:187-90. [PMID: 24630299 DOI: 10.1016/j.ejogrb.2014.02.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 01/11/2014] [Accepted: 02/02/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Our aim was to investigate the effects of urinary incontinence subtypes on women's quality of life (including sexual life) and psychosocial state. STUDY DESIGN The patients, who applied to our clinic from March 2011 to August 2011, were identified and stratified into three groups: those with stress incontinence proved urodynamically (USI), those with urge incontinence (UI), and those with mixed incontinence urge incontinence (UI) proved by urodynamic and clinic evaluation. Scores on the Beck anxiety inventory (BAI), pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12), urogenital distress inventory (UDI-6), and incontinence impact questionnaire (IIQ-7) were compared between the urinary incontinence subtypes. RESULTS According to urodynamic and clinical examination of 111 women with urinary incontinence, 59 (53%) had USI, 35 (32%) had UI, and 17 (15%) had MI. BAI-scores significantly differed between the USI and UI groups (p=0.030) and between the USI and MI groups (p=0.011) not between the UI and MI groups (p=0.597). UDI-6 scores did not significantly differ between the three groups (p=0.845). IIQ-7 scores significantly differed between the USI and MI groups (p=0.003) and between the UI and MI groups (p=0.006) but not between the USI and UI groups. Patients with USI had significantly lower PISQ-12 scores than those with UI (p=0.015). CONCLUSIONS These differences in the effects of incontinence subtypes should be kept in mind in the evaluation of patients with urinary incontinence. Psychiatric assessment may improve the management of incontinence in women, especially UI and MI.
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Affiliation(s)
- Mehmet Resit Asoglu
- The University of Texas-Houston MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
| | - Selcuk Selcuk
- Zeynep Kamil Training and Education Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Cetin Cam
- Zeynep Kamil Training and Education Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Ebru Cogendez
- Zeynep Kamil Training and Education Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Ates Karateke
- Zeynep Kamil Training and Education Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey
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Sariibrahim B, Cogendez E, Kayatas S, Asoglu MR, Koleli I, Bakir L. Does Kruger's strict criteria have prognostic value in predicting ICSI clinical results? CLIN EXP OBSTET GYN 2013; 40:257-260. [PMID: 23971254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The purpose of this study was to compare clinical results of ICSI for different sperm morphology subgroups divided according to Kruger's classification system. MATERIALS AND METHODS This retrospectively study was conducted at Zeynep Kamil Training and Researching Hospital in Istanbul (Turkey). The study included 332 intracytoplasmic sperm injection (ICSI) cycles. The patients were under 37 years of age with primary infertility who were admitted to the Department of Reproductive Endocrinology and Infertility, from January 2005 to June 2009. The patients were divided in three groups based on Kruger's strict criteria. Normal sperm morphology was less than 4% in group 1, between 4-14% in group 2, and greater than 14% in group 3. All patients underwent ICSI and embryo transfer (ET) following controlled ovarian hyperstimulation (COH). The groups were compared to the rates of fertilization, implantation, clinical pregnancy, abortion, and live birth. RESULTS Pregnancy occurred in 132 (39.7%) of all ICSI cycles. There was no statistically significant difference between regarding groups regarding the rates of fertilization, implantation, clinical pregnancy, biochemical pregnancy, abortion, and live birth. CONCLUSION The authors concluded that the normal sperm morphology defined by Kruger's strict criteria and sperm motility will not be able to predict prognosis of ICSI cycles.
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Affiliation(s)
- B Sariibrahim
- Siverek State Hospital, Department of Obstetrics and Gynecology, Sanliurfa, Turkey.
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Sahinoglu Z, Cerrah Celayir A, Resit Asoglu M, Özcan N. Type IV Sacrococcygeal Teratoma Associated with Urogenital Sinus: Difficulties in the Prenatal Differential Diagnosis. J Neonatal Surg 2013; 2:9. [PMID: 26023429 PMCID: PMC4420355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 08/27/2012] [Indexed: 11/10/2022] Open
Abstract
Sacrococcygeal teratoma (SCT) is being more often detected due to availability of prenatal ultrasonography. Type IV SCT could be misdiagnosed as cloacal abnormalities due to the pelvic midline cystic mass associated with renal malformations and obstructive uropathy during the pregnancy. We discuss difficulties in the prenatal differential diagnosis of SCT and urogenital sinus in a 26-year-old pregnant woman, admitted to our prenatal diagnosis centre for a detailed US for a pre-sacral mass.
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Affiliation(s)
- Zeki Sahinoglu
- Department of Obstetrics and Gynecology, Zeynep Kamil Women and Child Diseases Education and Research Hospital Istanbul, Turkey.
| | - Aysenur Cerrah Celayir
- Department of Pediatric Surgery, Zeynep Kamil Women and Child Diseases Education and Research Hospital Istanbul, Turkey.
| | - Mehmet Resit Asoglu
- Department of Obstetrics and Gynecology, Zeynep Kamil Women and Child Diseases Education and Research Hospital Istanbul, Turkey.
| | - Nahit Özcan
- Sonomed Medical Imaging Center, Istanbul, Turkey.
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Asoglu MR, Selcuk S, Cam C, Ayaz R, Tug N, Karateke A. Colpocleisis, patient satisfaction and quality of life. J Turk Ger Gynecol Assoc 2012. [DOI: 10.5152/jtgga.2012.40] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Sahinoglu Z, Cerrah Celayir A, Resit Asoglu M, Özcan N. Diagnostic difficulties in a case of persistent cloaca with hydrocolpos. J Neonatal Surg 2012; 1:55. [PMID: 26023414 PMCID: PMC4420364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Accepted: 08/28/2012] [Indexed: 11/30/2022] Open
Abstract
Pelvic midline cystic mass associated with renal malformation represents typical imaging features of a cloacal anomaly. We report a case of persistent cloaca that was diagnosed antenatally with fetal ultrasonography and MRI.
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Affiliation(s)
- Zeki Sahinoglu
- Department of Obstetrics and Gynecology, Zeynep Kamil Women and Child Diseases Education and Research Hospital Istanbul, Turkey.
| | - Aysenur Cerrah Celayir
- Department of Pediatric Surgery, Zeynep Kamil Women and Child Diseases Education and Research Hospital Istanbul, Turkey.
| | - Mehmet Resit Asoglu
- Department of Obstetrics and Gynecology, Zeynep Kamil Women and Child Diseases Education and Research Hospital Istanbul, Turkey.
| | - Nahit Özcan
- Sonomed Medical Imaging Center, Istanbul, Turkey.
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Soguktas S, Cogendez E, Eser Kayatas S, Asoglu MR, Selcuk S, Ertekin A. Comparison of saline infusion sonohysterography and hysteroscopy in diagnosis of premenopausal women with abnormal uterine bleeding. Eur J Obstet Gynecol Reprod Biol 2012; 161:66-70. [DOI: 10.1016/j.ejogrb.2011.11.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 10/13/2011] [Accepted: 11/13/2011] [Indexed: 11/27/2022]
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Karateke A, Selcuk S, Asoglu MR, Namazov A, Tug N, Cam C, Cakir S. Endometrium kanserinde sa�kal�m� etkileyen prognostik fakt�rler. Turk J Obstet Gynecol 2012. [DOI: 10.5505/tjod.2012.83435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kayatas S, Asoglu MR, Selcuk S, Sargin MA. Pregnancy in a patient with Wegener's granulomatosis: a case report. Bull NYU Hosp Jt Dis 2012; 70:127-129. [PMID: 22892004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Pregnancy in patients with Wegener's granulamotosis (WG) is rare, and differential diagnosis of WG flare and preeclampsia is difficult. CASE A pregnant 35 year old with WG was referred with diagnosis of severe preeclampsia; caesarean section was performed. Intubation of the patient was difficult due to subglottic stenosis. Because of the clinical symptom, the case was considered preeclampsia, but p-ANCA of the patient was positive. In pregnancies with WG, differential diagnosis of WG flare-ups from preeclampsia should be made from clinical symptoms and laboratory findings. Serum ANCA titers are not useful in the differential diagnosis of WG flare-ups and preeclampsia because it may be positive in preeclampsia. CONCLUSION Differential diagnosis of WG flare-up and preeclampsia should be made by clinical features. In the patients with subglottic stenosis, general anesthesia should not be preferred due to the probability of difficult intubation.
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Affiliation(s)
- Semra Kayatas
- Department of Obstetrics and Gynecology, Zeynep Kamil Hospital, Istanbul, Turkey
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Cam C, Asoglu MR, Selcuk S, Aran T, Tug N, Karateke A. Does mediolateral episiotomy decrease central defects of the anterior vaginal wall? Arch Gynecol Obstet 2011; 285:411-5. [PMID: 21735189 DOI: 10.1007/s00404-011-1965-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 06/20/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This retrospective study investigates the effects of mediolateral episiotomy on the pelvic floor. METHODS Premenopausal women suffering from urinary incontinence/genital prolapse who delivered only by vaginal route were enrolled into the study. History of diabetes, morbid obesity (BMI > 40 kg/m(2)), vacuum/forceps extraction, perineal lacerations that warranted repair during labor and any pelvic surgery were the exclusion criteria. Evaluation of the patients included pelvic organ prolapse quantification scores, presence of stress incontinence, urethral hypermobility, and questionnaires were obtained for overactive bladder and anal incontinence symptoms. These data obtained from patients with the history of mediolateral episiotomy were compared with those of patients with no episiotomy or any other pelvic injury that warranted surgical repair. RESULTS Groups were identical by means of demographic data, POP-Q findings, signs and symptoms of the pelvic floor. However, in the MLE group, central defects on the anterior vaginal wall were less frequent. CONCLUSION According to the results of this retrospective study, MLE seems to prevent central defects on the anterior vaginal wall. Prospective randomized studies are needed to draw a sufficient conclusion.
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Affiliation(s)
- Cetin Cam
- Department of Obstetrics and Gynecology, Zeynep Kamil Hospital, Burhanettin Ustunel C., No:20, Uskudar, 34668 Istanbul, Turkey
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Karateke A, Tug N, Cam C, Selcuk S, Asoglu MR. Concomitant surgical correction of occult stress urinary incontinence by TOT in patients with pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol 2011; 154:105-7. [DOI: 10.1016/j.ejogrb.2010.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 07/01/2010] [Accepted: 08/02/2010] [Indexed: 12/01/2022]
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Karateke A, Tug N, Cam C, Selcuk S, Asoglu MR, Cakir S. Discrepancy of pre- and postoperative grades of patients with endometrial carcinoma. EUR J GYNAECOL ONCOL 2011; 32:283-285. [PMID: 21797117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE To investigate the diagnostic accuracy of endometrial curettage in patients with endometrial carcinoma. In this retrospective study, pre- and postoperative histopathologic findings of patients with endometrial cancer were investigated. METHODS 168 patients with the final diagnosis of endometrial cancer were enrolled in the study. Pre- and postoperative histopathologic diagnoses and grades (according to the 1988 FIGO classification) of the patients were compared retrospectively. RESULTS 22 patients were diagnosed as having endometrial hyperplasia and the remaining 136 patients had endometrial carcinoma preoperatively. Overall discrepancy rate of grades was 39% (31% upgrade, 8% downgrade; p < 0.05). There was also 9% discrepancy between the pre- and postoperative histopathological types. CONCLUSION It has been suggested that since endometrial cancer patients with low grades according to the preoperative pathologic diagnosis have a potential to upgrade, the management of these patients if myometrial invasion is less than one-half thickness, simply by hysterectomy plus bilateral salpingo-oophorectomy (without lymph node sampling), might actually miss some patients who actually deserve surgical staging. Further studies are needed to draw a sufficient conclusion.
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Affiliation(s)
- A Karateke
- Department of Obstetrics and Gynecology, Zeynep Kamil Hospital, Istanbul, Turkey
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Cam C, Karateke A, Asoglu MR, Selcuk S, Namazov A, Aran T, Celik C, Tug N. Possible cause of failure after McCall culdoplasty. Arch Gynecol Obstet 2010; 283:791-4. [PMID: 20232205 DOI: 10.1007/s00404-010-1418-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2009] [Accepted: 03/01/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate prospectively the rate of postoperative failure of McCall culdoplasty and the presence of a history of vaginal delivery of macrosomic infants as risk factors in patients with stage III or symptomatic stage II apical prolapse without any other pelvic floor defects. MATERIALS AND METHODS Patients with pelvic organ prolapse who underwent vaginal hysterectomy and McCall culdoplasty procedures were staged according to the POP-Q system before and after the operation (n = 70). POP-Q stages, age, gravidity, parity, body mass index (BMI), and the presence of diabetes mellitus in patients with or without history of vaginal delivery of macrosomic infants were analyzed. A birth weight of ≥4,000 g was accepted as macrosomia. Operative failure was defined as a postoperative POP-Q stage ≥ stage III of the apical segment. Follow-up period was 26.5 ± 6.37 months. RESULTS Twenty-seven women had a history of macrosomic delivery and the remaining 43 did not. Postoperative failure was observed in 15 patients (44.4%) in the macrosomia group and in 3 patients (6.9%) in the control group. Postoperative failure was seen more frequently in the macrosomia group (Pearson's chi-square test, P = 0.000). No significant difference was found between the groups regarding age, gravidity, parity, BMI and the presence of diabetes mellitus. CONCLUSION Failure of McCall culdoplasty occurs more frequently in patients with history of vaginal delivery of macrosomic infants, possibly due to direct pelvic floor damage. This technique should not be used in patients with a possible history of direct pelvic floor damage.
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Affiliation(s)
- Cetin Cam
- Department of Obstetrics and Gynecology, Zeynep Kamil Hospital, No: 1, Selimiye, Uskudar, 34668 Istanbul, Turkey
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