Ratlarda lökositten zengin trombositten zengin plazmanın ve lökositten fakir trombositten zengin plazmanın siklofosfamid ile azaltılmış over rezervleri üzerine etkisinin incelenmesi
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Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İnfertilite kontraseptif yöntemler kullanmaksızın 1 yıl düzenli ilişkiye rağmen gebelik elde edilememesidir. Kadın infertilitesinin giderek artan önemli problemlerinden biri over rezervlerinin azalmasıdır. Trombositten zengin plazma (TZP) günümüzde birçok alanda kullanılmakla beraber, infertilite alanında da kullanılmaktadır. Over rezervlerine etkisi daha önce birçok çalışmada araştırılmıştır. Bu çalışmanın amacı lökositten zengin TZP ile lökositten fakir TZP'nin over rezervleri üzerine etkisinin incelenmesidir. Bu çalışmada 63 adet 200±20 gr dişi Spraque-Dawley cins rat kullanılmıştır. 15 adet rat TZP eldesi için ayrılmış ve kalan 48 adet rat her grupta 8 adet rat olacak şekilde 6 gruba randomize edilmiştir. Birinci gruba intraperitoneal %0.9 serum fizyolojik, 2. gruba intraperitoneal 75 mg/kg siklofosfamid, 3. gruba 75mg/kg intraperitoneal siklofosfamid ve 200 µl lökositten fakir trombositten zengin plazma (LF-TZP), 4. gruba 75mg/kg intraperitoneal siklofosfamid ve 200 µl lökositten zengin trombositten zengin plazma (LZ-TZP), 5.gruba intraperitoneal 200 µl LF-TZP ve 6. gruba intraperitoneal 200 µl LZ-TZP enjeksiyonları yapılmıştır. Enjeksiyonlar çalışmanın 1., 7., 15. günlerinde yapılmış ve 25.günde ratlar sakrifiye edilmiştir. Çalışmanın sonunda ratlardan FSH ve AMH düzeyleri için kan alınmış ve overler tarafsız bir patolog tarafından incelenmek üzere çıkarılmıştır. Çalışma çift kör yöntemi ile gerçekleştirilmiş, istatistiksel analizde SPSS (version 20) istatistik programı kullanılmış ve p<0,05 anlamlı kabul edilmiştir. Çalışmanın sonucunda preantral ve antral folikül sayıları lökositten zengin TZP gruplarında diğer gruplara göre anlamlı düzeyde yüksek bulunmuştur (p=0,023). FSH düzeyleri siklofosfamid grubunda anlamlı düzeyde yüksek, lökositten zengin TZP gruplarında anlamlı düzeyde düşük bulunmuştur (p<0,001). AMH düzeylerinde gruplar arasında anlamlı bir farklılık saptanmamıştır (p?0,05). Korpus luteum sayılarına bakılmış ve gruplar arasında anlamlı sonuç elde edilememiştir (p?0,05). Over korteks/medulla oranları incelenmiş ve siklofosfamid alan gruplarda korteks-medulla oranları anlamlı düzeyde düşük saptanmıştır. (p<0,001). Sonuç olarak çalışmamızda LZ-TZP'nın LF-TZP'ye oranla folikül rezervini arttırmada daha etkili olduğu gözlenmiştir. Bu bulgular infetilitenin en önemli sebeplerinden biri olan düşük over rezervi olan hastalarda özellikle lökositten zengin hazırlanan TZP'nın kullanımının daha etkin olduğunu düşündürmektedir. İnfertilitede TZP uygulamaları açısından daha kapsamlı klinik çalışmalara ihtiyaç vardır. Anahtar Sözcükler: Over, folikül, infertilite, over yetmezliği, trombositten zengin plazma, rat, siklofosfamid, anti müllerian hormon, lökositten zengin TZP, lökositten fakir TZP
Infertility is the inability to achieve pregnancy despite 1 year of regular intercourse without using contraceptive methods. One of the increasingly important problems of female infertility is the decrease in ovarian reserves. Although platelet-rich plasma is used in many areas today, it is also used in the field of infertility. Its effect on ovarian reserves has been investigated in many studies before. The aim of this study is to compare the effects of leukocyte-rich platelet rich plasma (LR-PRP) and leukocyte-poor platelet rich plasma (LP-PRP) on ovarian reserves. In this study, 63 200 ? 20 gr female Spraque-Dawley rats were used. 15 rats were allocated to obtain PRP and the remaining 48 rats were randomly divided into 6 groups with 8 rats in each group. İntraperitoneally 0.9% saline are/is injected to group 1, intraperitoneally 75 mg/kg cyclophosphamide are injected to group 2, 75 mg/kg intraperitoneal cyclophosphamide and 200 µl LP-PRP are injected to group 3, 75 mg/kg intraperitoneal cyclophosphamide and 200 µl LR-PRP are injected to group 4, 200 µl of LP-PRP intraperitoneally injected to group 5 and 200 µl of LR-PRP intraperitoneally injected to group 6. Injections were made on the 1st, 7th and 15th days of the study and the rats were sacrificed on the 25th day. At the end of the study, FSH and AMH levels were taken from the rats and the ovaries were removed for examination by a blinded pathologist. The study was performed with double-blind method, SPSS (version 20) statistical program was used for statistical analysis and p<0.05 was considered significant. As a result of the study, preantral and antral follicle counts were found to be significantly higher in leukocyte-rich PRP groups compared to other groups (p=0.023). FSH levels were found to be significantly higher in the cyclophosphamide group and significantly lower in the leukocyte-rich PRP groups (p<0.001). No significant difference was found between the groups in AMH levels (p?0.05). The corpus luteum numbers were examined and no significant difference could be obtained between the groups (p?0.05). Ovarian cortex/medulla ratios were examined and cortex-medulla ratios were significantly lower in cyclophophamide injected groups (p<0.001). In conclusion, in our study, it was observed that leukocyte-rich platelet-rich plasma was more effective in increasing follicle reserve than leukocyte-poor platelet-rich plasma. These findings suggest that the use of PRP, especially rich in leukocytes, is more effective in patients with low ovarian reserve, which is one of the most important causes of infertility. More comprehensive clinical studies are needed in terms of PRP applications in infertility. KEY WORDS: Ovary, follicul, infertility, ovarian failure, platelet rich plazma, leukocyte rich PRP, leukocyte poor PRP, anti mullerian hormone
Infertility is the inability to achieve pregnancy despite 1 year of regular intercourse without using contraceptive methods. One of the increasingly important problems of female infertility is the decrease in ovarian reserves. Although platelet-rich plasma is used in many areas today, it is also used in the field of infertility. Its effect on ovarian reserves has been investigated in many studies before. The aim of this study is to compare the effects of leukocyte-rich platelet rich plasma (LR-PRP) and leukocyte-poor platelet rich plasma (LP-PRP) on ovarian reserves. In this study, 63 200 ? 20 gr female Spraque-Dawley rats were used. 15 rats were allocated to obtain PRP and the remaining 48 rats were randomly divided into 6 groups with 8 rats in each group. İntraperitoneally 0.9% saline are/is injected to group 1, intraperitoneally 75 mg/kg cyclophosphamide are injected to group 2, 75 mg/kg intraperitoneal cyclophosphamide and 200 µl LP-PRP are injected to group 3, 75 mg/kg intraperitoneal cyclophosphamide and 200 µl LR-PRP are injected to group 4, 200 µl of LP-PRP intraperitoneally injected to group 5 and 200 µl of LR-PRP intraperitoneally injected to group 6. Injections were made on the 1st, 7th and 15th days of the study and the rats were sacrificed on the 25th day. At the end of the study, FSH and AMH levels were taken from the rats and the ovaries were removed for examination by a blinded pathologist. The study was performed with double-blind method, SPSS (version 20) statistical program was used for statistical analysis and p<0.05 was considered significant. As a result of the study, preantral and antral follicle counts were found to be significantly higher in leukocyte-rich PRP groups compared to other groups (p=0.023). FSH levels were found to be significantly higher in the cyclophosphamide group and significantly lower in the leukocyte-rich PRP groups (p<0.001). No significant difference was found between the groups in AMH levels (p?0.05). The corpus luteum numbers were examined and no significant difference could be obtained between the groups (p?0.05). Ovarian cortex/medulla ratios were examined and cortex-medulla ratios were significantly lower in cyclophophamide injected groups (p<0.001). In conclusion, in our study, it was observed that leukocyte-rich platelet-rich plasma was more effective in increasing follicle reserve than leukocyte-poor platelet-rich plasma. These findings suggest that the use of PRP, especially rich in leukocytes, is more effective in patients with low ovarian reserve, which is one of the most important causes of infertility. More comprehensive clinical studies are needed in terms of PRP applications in infertility. KEY WORDS: Ovary, follicul, infertility, ovarian failure, platelet rich plazma, leukocyte rich PRP, leukocyte poor PRP, anti mullerian hormone
Açıklama
Tıp Fakültesi, Kadın Hastalıkları ve Doğum Ana Bilim Dalı
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology
