Yigit Cakiroglu

Acıbadem Mehmet Ali Aydınlar Üniversitesi · Faculty of Medicine

STUDY QUESTION Does intraovarian platelet-rich plasma (PRP) injection increase the number of mature oocytes obtained after controlled ovarian stimulation (COS) in young women with poor ovarian response (POR) undergoing IVF? SUMMARY ANSWER Intraovarian PRP injection procedure does not improve mature oocyte yield after COS in women less than 38 year...

Background Ovarian reserve is the number of oocytes remaining in the ovary and is one of the most important aspects of a woman’s reproductive potential. Research on the association between thyroid dysfunction and ovarian reserve has yielded controversial results. In our study, we aimed to investigate the relationship between thyroid-stimulating hor...

In this study, we aimed to assess the impact of intratesticular injection of autologous platelet-rich plasma (PRP) on sperm retrieval rates and in vitro fertilization outcomes in men with non-obstructive azoospermia (NOA) who had previously undergone at least one unsuccessful microscopic testicular sperm extraction (micro-TESE) procedure. We divide...

Study question Does intraovarian injection of autologous platelet-rich plasma (PRP) improve oocyte yield in young patients with poor ovarian response (POR)? Summary answer Intra-ovarian PRP injection did not result in increased number of oocytes retrieved or improvement of any other relevant measured outcomes. What is known already POR is one of...

Background: With the introduction of the dual triggering-gonadotropin-releasing hormone (GnRH) analog and recombinant human chorionic gonadotropin (hCG) combination, women with a history of low mature oocyte proportion and empty follicle syndrome were shown to benefit from the dual trigger. Objective: To investigate whether dual triggering of oo...

Background Uterine fibroids are the most common benign smooth muscle tumors of the uterus. However, there is no con- sensus on whether myomectomy improves IVF success in women with non-cavity-distorting intramural fibroids. The aim of this study was to compare the IVF and pregnancy outcomes of women who had non-cavity-distorting intramural fibroids...

Purpose of review: Endometrial hypoproliferation refers to the failure of the endometrium to reach optimal thickness during fresh or frozen embryo transfer cycles in women undergoing infertility treatment with in-vitro fertilization (IVF). This review discusses the treatment options for endometrial hypoproliferation. Recent findings: Apart from...

Objective: This study facilitates decision-making when an antral follicle diameter >15 mm is detected at the beginning of the menstrual cycle in poor responder (POR) patients. Materials and methods: Eighty-three POR patients with at least one leading follicle with a diameter of 15 to 24 mm on the 2nd-4th days of the menstrual cycle were assessed...

Purpose In this study, we investigated whether metabolic dysfunction in women with Polycystic ovarian syndrome (PCOS) induces granulosa cell (GC) stress and activates in the endoplamatic reticulum and the mitochondria (UPRer and UPRmt, respectively). Methods Women who were diagnosed with PCOS (based on the Rotterdam criteria), were divided into tw...

Objective:To compare efficacy and safety of recombinant follicule stimulating hormone (r-FSH) and highly purified urinary FSH (HPuFSH) in polycystic ovary syndrome (PCOS) patients undergoing intracytoplasmic sperm injection (ICSI).Method:This was a prospective randomized study conducted at Kocaeli University Faculty of Medicine, Department of Obste...

The aim of the current study was to characterize ovarian reserve parameters and IVF outcomes in women with a history of poor ovarian response (POR) treated with intraovarian injection of autologous platelet rich plasma (PRP). Reproductive age women (N=510; age range 30-45yo) diagnosed with POR based on Poseidon criteria were included in the study....

We aimed to determine whether intraovarian injection of autologous platelet rich plasma (PRP) improves response to ovarian stimulation and in vitro fertilization (IVF) outcome in women with primary ovarian insufficiency (POI). Women (N=311; age 24-40) diagnosed with POI based on ESHRE criteria underwent intraovarian PRP injection. Markers of ovaria...

Purpose of review: Recurrent implantation failure (RIF) refers to the absence of implantation after repeated transfer of good embryos into a normal uterus. This review discusses the diagnostic criteria and cause of RIF. Recent findings: Regardless of the advancements in IVF practice, RIF is still a challenge that has to be solved. Exact definiti...

Obesity may have negative effects on fertility early onset of obesity in women; menstrual irregularities, chronic oligo-anovulation and infertility in adulthood can be seen. Obesity in women may increase the risk of miscarriage and may adversely affect the outcome of pregnancy achieved with assisted reproductive technologies. The aim of this study...

Methotrexate is a commonly used agent in the treatment of an un-ruptured ectopic pregnancy. Thromboembolic events are rarely seen side effects of such a medicine. We report the case of the 22-year-old woman who underwent Methotrexate therapy for an un-ruptured ectopic pregnancy without any history of thromboembolic risk factors. A second dose (50 m...

Objective To compare HOXA-10 gene expression in eutopic endometrium samples, between fertile and infertile endometriosis patients and the fertile control cases, and in endometrium and endometrioma specimens, between severe and moderate endometriosis cases. Study Design Prospective clinical study included women without infertility and endometriosis...

Background: Mycoplasma hominis is often present in the amniotic cavity with microbial invasion associated with spontaneous preterm labor. Conventional culture method is the gold standard for detection of Mycoplasmas, but real-time polymerase chain reaction (real-time PCR) has revolutionized the diagnosis of M. hominis. Objective: The purpose of...

Purpose: The purpose of this study was to determine the efficacy of low- and large-volume techniques of intrauterine insemination (IUI) on pregnancy rates in unexplained infertility couples. Materials and Methods: This retrospective study was performed in a single center over a 33-month period which included a total of 272 couples that underwent 27...

Endometriosis is an estrogen-dependent disease in which progesterone resistance and inflammation have been found to be major mechanisms responsible for its development and progression. When compared to eutopic endometrium, key molecules have been found to be differentially expressed, which contribute to these mechanisms. One pathway that is aberran...

OBJECTIVE To examine effects of body mass index (BMI) and insulin resistance (IR) on the in vitro fertilization (IVF) outcomes in women with polycystic ovary syndrome (PCOS). METHODS A total of 106 women with PCOS who underwent intracytoplasmic sperm injection were investigated. The patients were stratified into groups according to their BMI [heal...

OBJECTIVE: To collect the IVF outcomes from patients with endometriomas who were not treated surgically and compare the results with those of women who were treated surgically for uni/bilateral endometriomas. STUDY DESIGN: The records of 114 patients with a diagnosis of endometriosis were classified into 4 groups: no surgery for unilateral endomet...

We report a rare case of pregnancy with concomitant pancreatic cancer. At 28 weeks' gestation, the patient was diagnosed with a large tumoral mass in the head of the pancreas. She had a cesarean section at 32 weeks' gestation due to premature labor and underwent surgery for pancreatic cancer in her third month postpartum.

Good anatomic outcomes have been achieved with transvaginal synthetic materials in pelvic organ prolapse, but mesh-related complications are a major health concern. Therefore, developing new synthetic or biological materials with increased tissue strength and decreased complications are major challenges. This paper presents preliminary pilot series...

Background/aims: Data on the timing of catheter removal technique following embryo transfer (ET) are quite limited. We aimed to compare the reproductive outcomes of intracytoplasmic sperm injection (ICSI)/ET cycles in which the transfer catheter was removed immediately with those in which the catheter was removed after a delay period and hereby to...

Objective: To investigate whether amnioreduction has any impact on emergency cervical cerclage outcome. Materials and methods: Data of women who underwent emergency cervical cerclage for advanced cervical dilatation and protruding membranes were analyzed retrospectively. Results: During the study interval, a total of 56 women who were underwen...

Purpose The aim of this study is to investigate the association of perifollicular blood flow (PFBF) with follicular fluid EG-VEGF, inhibin-a, and insulin-like growth factor-1 (IGF-1) concentrations, endometrial vascularity, and IVF outcomes. Methods Forty women with tubal factor infertility were included in a prospective cohort study. Each woman un...

Objective: To determine whether natural killer cell (NK) concentrations in the mid-secretory endometrial tissue of women with unexplained infertility differ from those in the mid-secretory endometrial tissue of fertile women. Methods: This study was conducted with 22 patients with unexplained infertility caused by unsuccessful ovulation induced...

Study Question: Does retraction of embryo transfer (ET) catheter following a 30-second waiting period at the end of ET process affect pregnancy and clinical pregnancy rates in ICSI/ET cycles? Summary Answer: The retraction of ET catheter following a 30-second waiting period inside the uterus has no positive effect on the rates in ICSI/ET cycles. W...

Aim: The aim of this study was to review our exogenous cesarean scar pregnancy (CSP) cases that were managed through transabdominal ultrasound (TAUS)-guided suction curettage either alone or with a concomitant additional therapeutic modality. The study was carried out over a 6-year period and we compared clinical outcomes, success rates and compli...

Objective: To investigate the inflammatory markers in polycystic ovary syndrome (PCOS) and associations of these markers with obesity and in vitro fertilization (IVF) outcomes. Methods: A total of 292 women underwent IVF procedure either with PCOS (n = 146) or without PCOS (n = 146, age, and body mass index (BMI) matched controls) were included...

Objective: The purposes of this study were to present an endometrial cancer case with a first sign of bone metastasis, and to reveal factors affecting survival and the appropriate treatment methods for bone metastases. Materials and methods: A total of 101 case reports that presented with bone metastasis of endometrial cancer were reviewed in th...

Mullerian adenosarcoma following tamoxifen therapy is a rare condition. Our aim was to report the youngest patient in the literature with uterine mullerian adenosarcoma who was undergoing tamoxifen therapy for breast cancer. A premenopausal woman aged 38 years who was undergoing tamoxifen therapy for breast cancer, was admitted with symptoms of low...

Objective: To compare perinatal outcomes between patients with and without abnormal Doppler findings and lactate peak in the fetal brain detected by magnetic resonance spectroscopy (¹HMRS) and to assess the feasibility of fetal brain lactate in the prediction of adverse obstetric outcomes in growth-restricted fetuses. Methods: Pregnancies with FGR...

Turner's syndrome (TS) is depicted as a total or partial absence of one X chromosome that results in ovarian dysgenesis. Chances of spontaneous pregnancy in TS are rare and the outcome of the pregnancies is known to be poor with an increased risk of miscarriage and stillbirths. Our aim is to evaluate reproductive and obstetric outcomes of natural c...

Objective To determine whether interactions between coital frequency, cervical length, and urogenital infection affect obstetric outcomes. Materials and Methods A total of 268 unselected pregnant women were recruited in the study. The study population consisted of four groups of women: group 1 (n=203) screened negative for bacterial vaginosis (BV)...

We report the case of a benign mesenchymal spindle-cell tumor located on fetal neck, diagnosed during prenatal ultrasound and magnetic resonance investigation. A 30-year-old woman (gravida 2, para 1) was referred to our perinatology unit for evaluation of a fetal neck mass that had been identified on ultrasonography at 29 weeks gestation. A right l...

Objective: To evaluate whether symptoms and recurrence would differ with and without Cu-IUD removal in patients with concomitant biofilm forming Candida spp. Methods: The data of 270 consecutive patients wearing TCu380A Cu-IUD were evaluated. Among these patients, 100/270 were found to have Candida spp. isolated from the tail of Cu-IUD or vagina...

Objective The aim of this study is to investigate the effect of first chromosome long arm duplication (dup(1q)) in cases with endometrial carcinoma detected with array based comperative genomic hybridization (aCGH) on survival from the cancer. Materials and Methods A total of 53 patients with the diagnosis of endometrial carcinom due to endometria...

Objective To evaluate preopertive accuracy of endometrial thickness for assesment of histologic grade and stage of endometrial carcinoma and also determining a cut-off value for the determination of grade of endometrial carcinoma. Materials and Methods Clinical data of 105 patients who underwent surgical staging with endometrial carcinoma were rev...

The effects of childhood cancer therapy on ovarian reserve tests and on pubertal development within 5 years were compared with a control group. The study group was composed of 41 patients who underwent chemotherapy during pre-menarche (subgroup A; n = 15) and after menarche (subgroup B; n = 26); the control group was composed of 44 patients admitte...

AimThe aim of this study was to demonstrate the effects of tubal surgery and antituberculosis treatments in patients with genital tuberculosis.Material and MethodsA total of 38 infertile women who had been diagnosed with pelvic tuberculosis and who had had laparoscopy and hysteroscopy were recruited into the study. All women with female genital tub...

Aim: The aim of study is to compare maternal and fetal outcomes of pregnancies in which cerclage was placed following the loss of first fetus with those without cerclage placement in multiple pregnancies for delayed interval delivery. Methods: Records of pregnancies in which the first fetus was lost between 13-26 weeks and delayed delivery exper...

Pentalogy of Cantrell is a rare malformation described in the literature. We report a case of pentalogy of Cantrell associated with left limb deficiency in a twin pregnancy. The fetus with multiple anomalies revealed kyphosis, ectopia cordis, and a large defect with protruding liver and bowel loops at 12 weeks and 3 days of gestational age on ultra...

Success rates of any artificial reproduction techniques depend on a correct protocol for ovarian stimulation. This can be decided only by proper assessment of ovarian reserve before commencing ovarian stimulation. This study has been conducted to investigate the role of hormonal and functional biomarkers in the prediction of ovarian response. A tot...

To investigate the biochemical markers such as nitric oxide (NO), malondialdehyde (MDA) and reduced glutathione (GSH), indicators of the oxidative status of the follicle, to predict the outcome of in vitro fertilization. Follicular aspirates of dominant follicles were collected during oocyte retrieval. Biochemical analyses of NO, MDA and GSH were p...

Objective: To compare microdose GnRH agonist (MDL) protocol with GnRH antagonist/letrazole (AL) protocol in patients with poor ovarian response. Design: Randomised clinical trial. Setting: Kocaeli University Assisted Reproductive Centre Interventions: POR was diagnosed according to ESHRE Bologna criteria in case of presence of 2 out of 3 criteri...

Previous reports suggest that maternal exposure to acute stress related to earthquakes affects the sex ratio at birth. Our aim was to examine the change in sex ratio at birth after Eastern Marmara earthquake disasters. This study was performed using the official birth statistics from January 1997 to December 2002 - before and after 17 August 1999,...

To describe menstrual abnormalities and intrauterine adhesions within 5 years after a transuterine compression suture and uterine devascularization with hypogastric ligation. Prospective clinical follow-up was conducted on 56 patients who underwent uterine devascularization with hypogastric ligation and transuterine suture. The main outcomes were t...

Diastematomyelia is a rare malformation characterized by division of the spinal cord into two columns by a cartilaginous or osseus spur. Even though anomalies of the vertebral column have been reported with diastematomyelia, a case associated with Dandy Walker malformation has not been reported before in the literature review. In this report, we de...

Purpose: Polycystic ovary syndrome (PCOS) is considered as the most common endocrinopathy among women of reproductive age. Oral contraceptives (OCs) and metformin are one of the main drug groups in the long-term treatment of PCOS. This study was undertaken to investigate the effects of drospirenone-ethinyl estradiol and drospirenone-ethinyl estrad...

Objective. To discuss a patient with a prenatal diagnosis of unilateral isolated femoral focal deficiency. Case. Antenatal diagnosis of unilateral isolated femoral focal deficiency was made at 20 weeks of gestation. The length of left femur was shorter than the right, and fetal femur length was below the fifth percentile. Proximal femoral focal def...

Klippel-Trenaunay-Weber syndrome is a rare cutaneous vascular disorder characterized by the presence of multiple hemangiomata, arteriovenous fistulas, and limb hypertrophy. We report the prenatal sonographic findings in a case of Klippel-Trenaunay-Weber (KTW) syndrome including fetal limb hypertrophy and large subcutaneous cystic lesions. Prenatal...

Objective. Aim of our study is to present a case of a twin pregnancy following invitro fertilization cycle complicated with hemoperitoneum at third trimester. Case. A 26-year-old nulliparous pregnant woman at 32 weeks of gestation with twin pregnancy following invitro fertilization cycle complained of abdominal pain. After 48 hours of admission, la...

Rhabdomyoma is the most common prenatally diagnosed cardiac tumor. We present two cases of fetal cardiac rhabdomyoma. In each case, fetal ultrasound assessment revealed the intracardiac tumors that were confirmed on postnatal imaging. The mother and her previous child were examined for the markers of tuberous sclerosis and diagnosis of tuberous scl...

The aim of this case report is to present two cases of heterotopic pregnancy in the light of the literature, to present the incidence of heterotopic pregnancy which has increased due to ovulation induction and assisted reproductive techniques and that might cause serious problems for the pregnant women and intrauterine pregnancy. A 33 year old woma...

To evaluate the effect of copper intrauterine device (IUD) on the expression of cyclooxygenase (COX) and inducible nitric oxide synthase (iNOS) in the luteal phase endometrium. A prospective clinical study was conducted on 30 women who were willing to use a copper IUD contraception. Endometrial biopsies and blood samples were taken before and 3 mon...

To evaluate the maternal and fetal outcome in 44 pregnancies complicated with HELLP syndrome and to investigate the role of platelet counts in its prognosis. A retrospective analysis of the medical records of 44 patients with the diagnosis of hemolysis elevated liver enzymes and low platelet count between June 1997 and January 2009 was performed. T...

The common availability of assisted reproductive techniques (ART) has brought the increase of multiple pregnancies. Usually, soon after the preterm delivery of the first fetus in multiple pregnancies, the delivery of the remaining fetus also happens. Delayed interval delivery of the remaining fetus after preterm delivery of the first one allows to...

Objective: To determine the prevalence and to assess the contributing risk factors of postpartum depression in an urban population. Material and Methods: A prospective study involving postpartum women was conducted at a tertiary medical center in order to determine the individuals with depressive symptomatology. Three different depression scales na...

Objective: To determine the effects of high dose betamethasone on post-Cesarean section HELLP syndrome outcome. Material and Methods: The study was conducted on 65 pregnant women with HELLP syndrome who were planned emergency Cesarean section with a controlled randomized prospective method. Patients were assigned to betamethasone treatment (Group I...

Objective: Troponin is an inhibitory protein complex located on the actin flament in all striated muscles. Cardiac Troponin I is found only in the heart and has been used as a sensitive and specific marker of myocardial injury. Our aim was to investigate the different percentile limits and determinants of cord blood cardiac Troponin I (Tn I) concen...

To compare the diagnostic accuracy of 2-dimensional sonography (2DUS) and real-time 3-dimensional sonography (3DUS) in the diagnosis of congenital mullerian defects (CMD) with respect to the phase of the menstrual endometrium. The accuracy of sonography was examined on 108 women by 2 gynecologists during the 1st 5 days after cessation of menstrual...

We present a case of a 40-yr-old woman diagnosed with a primary malignant struma ovarii. The patient was admitted with the complaint of pelvic pain and a large pelvic mass in the mid-portion of lower abdomen on gynecological examination. Pre-operative tumor markers and routine biochemistry were unremarkable. She was treated with total abdominal hys...

Objective: To evaluate the effect of a copper intrauterine device on the expression of mucin- 1 (MUC1) and İntegrin β1 in the luteal phase endometrium. Material and methods: 25 regularly menstruating women (25-35 years) who were willing to use copper intrauterine device contraception participated in this study. Endometrial sampling via a Pipelle...

The purpose of this study was to compare fetal oxygen saturation by fetal pulse oximetry in parturients with and without epidural labor analgesia in a prospective case control study. Fetal oxygen saturation values were compared in term pregnant women who received epidural analgesia (epidural group) with those in women who did not (control group). M...

Objective: To investigate the mothers' anxiety levels and determine its effect on fetomaternal circulation in pregnant women undergoing genetic amniocentesis. Material and methods: A prospective case-control study was conducted regarding the assessment of maternal anxiety levels by means of the Spielberger State-Trait Anxiety Inventory in 60 pre...

To integrate intermittent fetal pulse oximetry (FPO) to intrapartum fetal assessment and reduce the rate of caesarean sections. A randomised controlled trial using 37 weeks as a restriction point was conducted in 230 women induced with misoprostol. One hundred-fourteen were assessed with intermittent FPO plus fetal heart rate (FHR) monitoring (stud...

To compare the efficacy of repeated doses of 100 microg vs. 200 microg misoprostol given sublingually for induction of second trimester abortion. One hundred and sixty-two women at 15-22 weeks' gestation were randomized to receive every 2 h either 100 microg (group 1; n = 81) or 200 microg (group 2; n = 81) misoprostol sublingually. The primary out...

OBJECTIVE: To investigate the role of fetal pulse oximetry on cesarean section rates and neonatal outcomes in pregnant women with an indication of induction of labour due to intrauterine growth restriction. MATERIAL-METHOD: Pregnant women who have been planned induction of labour with 50 mcg sublingually misoprostol due to intrauterine growth rest...

To integrate cervical length measurement into antenatal screening and apply emergency cerclage when indicated to prevent spontaneous deliveries at < 34 weeks of gestation. Cervical length measurements of 400 pregnant volunteers were obtained at gestational weeks 12-14, 18-20 and 28-32. Whenever a cervical measurement < 30 mm was observed, vaginal c...

To present a case of primary malignant melanoma of the cervix. The patient was admitted with the complaint of vaginal bleeding. Gynecological examination revealed a dark, papillary mass on the posterior lip of the cervix. Histopathology showed a malignant neoplasm with increased vascularity, indicating the possibility of a primary uterine cervical...

Fryns syndrome (FS) is a rare malformation. We report a case of FS referred to our clinic at 27 weeks' gestation with a diagnosis of congenital diaphragmatic hernia. Sonographic examination of the fetus revealed a left-sided diaphragmatic hernia, pulmonary hypoplasia, and a median orofacial cleft. The diagnosis of FS was made after exclusion of chr...

To describe the first case of a leiomyoma localized in the septum of a septate uterus that had cervical duplication and a longitudinal vaginal septum. Case report. A university hospital. A 43-year-old patient with primary infertility and complaint of menorrhagia. Laparotomy, adhesiolysis, myomectomy, and resection of the vaginal septum in the first...

Paradoxical embolism via a patent foramen ovale (PFO) is a rare event in the puerperium as a cause of stroke. We report a 21-year-old, G4P3A1 woman with the symptoms of convulsion, stroke and unconsciousness 1 week after cesarean delivery. An infarction was detected in both frontal lobes, and echocardiography and MRI confirmed the PFO. Her follow-u...

Intramural pregnancy, an unusual type of ectopic pregnancy, is conception within the uterine wall, surrounded by myometrium without a connection to the endometrial cavity, fallopian tubes or the round ligament. Common complaints are vaginal spotting, pelvic pain, and a prolonged menstrual period. Before rupture, diagnosis is usually suspected by ul...