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Öğe Age-specific probability of live birth with oocyte cryopreservation: an individual patient data meta-analysis(Elsevier Science Inc, 2013) Cil, Aylin Pelin; Bang, Heejung; Oktay, KutlukObjective: To estimate age-specific probabilities of live birth with oocyte cryopreservation in nondonor (ND) egg cycles. Design: Individual patient data meta-analysis. Setting: Assisted reproduction centers. Patient(s): Infertile patients undergoing ND mature oocyte cryopreservation. Intervention(s): PubMed was searched for clinical studies on oocyte cryopreservation from January 1996 through July 2011. Randomized and nonrandomized studies that used ND frozen-thawed mature oocytes with pregnancy outcomes were included. Authors of eligible studies were contacted to obtain individual patient data. Main Outcome Measure(s): Live birth probabilities based on age, cryopreservation method, and the number of oocytes thawed, injected, or embryos transferred. Result(s): Original data from 10 studies including 2,265 cycles from 1,805 patients were obtained. Live birth success rates declined with age regardless of the freezing technique. Despite this age-induced compromise, live births continued to occur as late as ages 42 and 44 years with slowly frozen and vitrified oocytes, respectively. Estimated probabilities of live birth for vitrified oocytes were higher than those for slowly frozen. Conclusion(s): The live birth probabilities we calculated would enable more accurate counseling and informed decisions for infertile women considering oocyte cryopreservation. Given the success probabilities, we suggest that policy makers should consider oocyte freezing as an integral part of prevention and treatment of infertility. (C) 2013 by American Society for Reproductive Medicine.Öğe Assessment of ovarian reserve and Doppler characteristics in patients with multiple sclerosis using immunomodulating drugs(Galenos Yayincilik, 2009) Cil, Aylin Pelin; Leventoglu, Alev; Sonmezer, Murat; Soylukoc, Rabia; Oktay, KutlukObjective: There is limited data about fertility in multiple sclerosis (MS) patients using immunomodulating drugs and no data exists regarding the ovarian reserve of these patients. Therefore, we aimed to evaluate,the ovarian reserve and doppler characteristics of MS patients using irnmunomodulating drugs. Material and Methods: MS patients using immunomodulating drugs (interferon (1M) beta and glatiramer acetate) and age-matched healthy controls were included in the study. Subjects were examined in the early follicular phase of the menstrual cycle with transvaginal ultrasound to evaluate ovarian volume, antral follicle count (AFC) and ovarian stromal artery Doppler. On the same da blood was taken for determining serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) levels. A subgroup analysis was also carried out between MS patients using only IFN p and controls to compare the same parameters. Results: Mean ovarian volume and total AFC were lower in MS patients using immunomodulating drugs than in the controls. FSH and E2 levels did not show any differences between the groups, but LH levels were, significantly higher in MS patients. All the Doppler parameters of the ovarian stromal artery were higher in MS patients but not significantly. In the subgroup analysis, the same significant differences were found for ovarian volume, AFC and LH levels. In addition, MS patients showed significantly higher mean pulsatility index measurement than the controls. Conclusion: The findings of this study demonstrated diminished ovarian volume and follicular reserve in MS patients using immunomodulating drugs compared to age matched healthy controls. However, further studies are required to elucidate whether compromised ovarian reserve in MS patients is due to drugs or the disease itself.Öğe Assessment of the Relationship Between Serum High Molecular Weight Adiponectin Hormone Levels and Insulin Resistance in Patients with Polycystic Ovary Syndrome(Georg Thieme Verlag Kg, 2019) Pekcan, Meryem Kuru; Tokmak, Aytekin; Akkaya, Hatice; Pekcan, Gultekin; Onur, Andac; Kisa, Ucler; Cil, Aylin PelinThe purpose of this study was to assess the rate of insulin resistance (IR) and the relationship between IR and high-molecular weight adiponectin (HMWA) in patients with polycystic ovary syndrome (PCOS). A cross sectional study involving 43 women with PCOS and 39 normal women was carried out over a period of nine months. Fasting glucose and insulin levels, lipid parameters and androgen levels were measured in all serum samples. HMWA was determined by enzyme-linked immunosorbent assay and IR was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR) index. The IR was more prevalent in the PCOS group than in the controls (p = 0.002). Dehydroepiandrosterone sulfate, sex hormone binding globulin, free androgen index, total testosterone, insulin, and HOMA-IR levels were significantly higher in the PCOS group as compared to the control group (all p < 0.05). Moreover, HMWA was significantly lower and negatively correlated with the clinical and biochemical hyperandrogenism in the PCOS group. HMWA and HOMA-IR were also associated with triglyceride, body mass index, and fat mass in this group. ROC curve analyses demonstrated that the AUC, indicative of the HMWA value for discriminating PCOS with IR, was 0.725, with a confidence interval of 0.615-0.835 (p = 0.001). The serum HMWA levels are lower in patients with PCOS, which suggest that HMWA might be involved in the pathogenesis of PCOS. We also conclude that HMWA might be a strong determinant of IR in PCOS patients.Öğe Diagnosis and management of vaginal mullerian cyst in a virgin patient(Springer London Ltd, 2008) Cil, Aylin Pelin; Basar, M. Murad; Kara, Simay Altan; Atasoy, PinarBenign cystic lesions of the vagina are uncommon and may become symptomatic. We describe two symptomatic anterior vaginal wall cysts in a virgin patient and the usefulness of imaging modalities. A 36-year-old virgin woman presented with a complaint of vaginal bulging and pelvic pressure. Pelvic examination revealed a cystic mass protruding from the vagina surrounded by the intact hymen. The initial abdominopelvic ultrasound showed a hypoechoic cystic mass measuring 42 x 20 mm in the vagina. She then had a pelvic magnetic resonance imaging (MRI) that revealed two anterior vaginal wall cysts with no communication with the urethra or bladder. The cysts were excised and histologic examination with mucicarmine revealed mucin-secreting tall columnar cells consistent with a diagnosis of mullerian cyst. While both ultrasonographic examination and MRI are helpful in localizing vaginal cysts, MRI is superior in showing multiple cystic lesions of the vagina and their communication with the surrounding structures.Öğe Effects of hormone replacement therapy on renal artery Doppler indices in women with natural menopause(Galenos Yayincilik, 2006) Yucel, Aykan; Kara, Simay Altan; Noyan, Volkan; Sagsoz, Nevin; Cil, Aylin PelinObjective: The aim of our study was to evaluate the effects of three different hormone replacement therapy (HRT) regimens on renal vasculature determined by renal artery Doppler ultrasonography indices in natural menopause. Design: Thirty three postmenopausal women were randomly assigned to receive 0.625 mg conjugated equine estrogen (CEE) + 5 mg medroxyprogesterone acetate (MPA) (Group I), 2 mg estradiol valerate (Group II) or 2.5 mg Tibolon (Group III), respectively. Doppler ultrasound of the left renal interlobar artery was performed for each patient before the beginning and after 70 days of each hormone replacement therapy (HRT). Setting: Kirikkale University, School of Medicine, Department of Gynecology and Obstetrics, and Department of Radiology, Kirikkale, Turkey. Main outcome measures: Renal interlobar artery Doppler indices before and after therapy. Results: Of the thirty three patients, there were 11, 7 and 9 patients who completed the study in group I, II and III, respectively. The mean age of 27 patients who completed the study was 49.44 +/- 4.07. The baseline pulsatility index (PI) and resistivity index (RI) values of the three groups were similar. After 70 days of treatment, there were statistically significant decrease in RI values of group III (p< 0.001) and RI (p=0.047) and PI (p=0.028) values of group II while statistically significant change was not obtained in group I after treatment. Conclusion: Although we may conclude from the results of this small sample sized study that tibolon and estradiol valerate may have favorable effects on renal blood flow and MPA combined with CEE may attenuate the estrogen-induced vascular effects in natural menopause, well designed studies with more patients and long term follow-up are needed to strengthen this judgment.Öğe Ongoing pregnancies from early retrieval of prematurely developing antral follicles after DHEA supplementation(Elsevier Sci Ltd, 2009) Soenmezer, Murat; Cil, Aylin Pelin; Oktay, KutlukTwo patients with severely diminished ovarian reserve who were refractory to aggressive ovarian stimulation conceived with oocytes from prematurely developing antral follicles after dehydroepiandrosterone supplementation. The first patient had 11 and 14.5 mm, and the second patient had 13 mm antral follicles on cycle days 2 and 3 respectively. In the first case, no ovarian Stimulation was performed, while the second case received one dose of gonadotrophins with a gonadotrophin-releasing hormone antagonist. Following very early human chorionic gonadotrophin (HCG) triggering on cycle day 5, when antral follicles reached 15 and 18.5 mm in the first case, and 19 mm in the second case, IVF intracytoplasmic sperm injection treatment resulted in pregnancies in both cases, which are currently ongoing at 35 and 14 weeks of gestation. The results in these patients show that pregnancy can be achieved in poor responder patients with prematurely developing antral follicles following early HCG triggering based on follicle size rather than cycle day, with no or minimal stimulation. Whether DHEA Supplementation had any impact on the success of these cycles remains to be determined.Öğe Progranulin and tumor necrosis factor-alpha in lean polycystic ovary syndrome patients(Taylor & Francis Ltd, 2021) Uzdogan, Andac; Pekcan, Meryem Kuru; Cil, Aylin Pelin; Kisa, Ucler; Akbiyik, FilizObjective In this study, levels of progranulin (PGRN) and tumor necrosis factor-alpha (TNF-alpha) were measured to detect the presence of inflammation in lean polycystic ovary (PCOS) patients. Methods 40 lean PCOS patients were assessed by Rotterdam criteria. Forty healthy women with regular menstrual cycles and without biochemical and clinical hyperandrogenism were involved in our study. Blood samples were taken from the patient and control groups for the measurement of progranulin (PGRN), tumor necrosis factor-alpha (TNF-alpha), lipid parameters, glucose, insulin, and other hormones. Results Serum PGRN and TNF-alpha levels were significantly higher in patients with lean PCOS, compared with the control group (p = .037, p = .041). PGRN levels were positively correlated with TNF-alpha levels in lean PCOS patients. Conclusion PGRN is known as a ligand for the TNF-alpha receptor. PGRN level increase in lean PCOS patients may be due to inhibiting the inflammatory effects of TNF-alpha. To observe the PGRN and TNF-alpha connection in obesity, further study is needed in obese PCOS patients and obese control groups.Öğe A rare cause of acute abdominal pain in children: Isolated tubal torsion; a case series(Kare Publ, 2017) Gunal, Yasemin Dere; Bahadir, Gokhan Berktug; Boybeyi, Ozlem; Cil, Aylin Pelin; Aslan, Mustafa KemalIsolated tubal torsion -a rare cause of acute abdomen in children-is usually difficult to diagnose because of non-specific findings. Surgical salphingectomy is required in delayed diagnosis in most cases. Three sexual inactive adolescents diagnosed in isolated tubal torsion (ITT) were discussed for its diagnostic features and surgical management. Laboratory tests and radiological studies including ultrasonography (US), color doppler ultrasound were performed in all patients after evaluation for acute lower abdominal pain in emergency department and they underwent surgical intervention with laparotomy (n:2) and laparoscopy (n:1). One of the patients in this study had salpingectomy. Detorsion of the fallopian tube and cyst excision were performed in the remaining two patients who also had paratubal cysts. There was no recurrence in these patients during the follow-up for 3 and 2 years. The isolated tubal torsion should be kept in mind and early surgical management is essential in order to preserve fallopian tube because of its importance in fertility. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Öğe Who is the best candidate for oocyte cryopreservation research?(Elsevier Science Inc, 2010) Oktay, Kutluk; Cil, Aylin Pelin; Zhang, JohnClinical studies of oocyte cryopreservation have gained momentum within the recent years; however, no guidelines have yet been established for patient selection. This article discusses the controversial aspects of selecting candidates for oocyte cryopreservation research. (Fertil Steril(R) 2010;93:13-5. (C)2010 by American Society for Reproductive Medicine.)
