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    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, Kutluk
    Objective: 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.
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    Assesment of ovarian reserve in patients with behcet's disease
    (Elsevier Science Inc, 2010) Çil, Aylin Pelin; Sönmezer, Murat; Koçak, Mihrican; Karabulut, A. A.; Akbıyık, Filiz; Oktay, Kutluk
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    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, Kutluk
    Objective: 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.
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    Breast cancer diagnosis following ovarian stimulation: Are the tumours different?
    (Reproductive Healthcare Ltd, 2010) Sönmezer, Murat; Çil, Aylin Pelin; Öktem, Özgür; Oktay, Kutluk
    Demographic data and tumour characteristics of 18 patients (study group) diagnosed with breast cancer within 24 months of undergoing ovarian stimulation with either gonadotrophins or clomiphene citrate were evaluated and compared with similar 102 age-matched women diagnosed with breast cancer without prior infertility treatment (control group). Eight out of 17 (47.1%) patients in the study group and 35/95 (36.8%) patients in the control group had positive family history for breast cancer. Median tumour size was similar in the study and control groups (both 1.3 cm). Both groups were comparable regarding tumour histological types and oestrogen receptor, progesterone receptor and Her2/Neu expression status. Albeit not significant, stage 0 tumours were more prevalent in the study group compared with the control group (22.2% versus 10.5%), and there were no stage III tumours in the study group as opposed to 7/95 in the control group. In conclusion, breast cancer diagnosed within the first 2 years following infertility treatment is similar in tumour characteristics compared with those occurring in patients without prior infertility treatment. (C) 2010, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
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    Ongoing pregnancies from early retrieval of prematurely developing antral follicles after DHEA supplementation
    (Elsevier Sci Ltd, 2009) Soenmezer, Murat; Cil, Aylin Pelin; Oktay, Kutluk
    Two 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.
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    Who is the best candidate for oocyte cryopreservation research?
    (Elsevier Science Inc, 2010) Oktay, Kutluk; Cil, Aylin Pelin; Zhang, John
    Clinical 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.)