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    Alarin: A new predictive marker in infertile women with polycystic ovary syndrome: A case-control study
    (Wiley, 2022) Gorkem, Umit; Yildirim, Engin
    Aim There is scant evidence concerning the relationship of alarin concentrations for polycystic ovary syndrome (PCOS) status in the existing literature. Therefore, we aimed to reveal the relationship about predictive value of serum alarin concentrations for PCOS risk in infertile women. Methods This prospective case-control study included a total of 151 infertile women who met eligibility criteria of the study. Infertile women diagnosed with PCOS formed the study group (n = 80). Women with diagnoses of unexplained infertility constituted the control group (n = 71). The biochemical analyses of serum concentrations of lipid profiles, estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-Mullerian hormone (AMH) and alarin were performed. Results There were no differences for the study parameters, including age, body mass index, fasting glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total triglyceride, E2, and FSH levels in either group. Serum LH, AMH, alarin concentrations, and antral follicle counts had higher values in the PCOS group compared with the controls. Correlation analysis revealed that serum alarin levels were significantly positively correlated with LH and AMH levels, only in the PCOS group. Multivariate binary logistic regression analysis demonstrated that infertile women with high alarin concentrations were significantly more likely to develop PCOS (OR = 1.77, 95% CI = 0.095-0.332, p < 0.001). Conclusion Higher serum concentrations of alarin and a positive correlation with serum LH levels were found in infertile women with PCOS. This evidence supported that high alarin concentrations might play a role in the development of PCOS.
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    The circulating alarin level was elevated in infertile women with poor ovarian reserve
    (Taylor & Francis Ltd, 2021) Yildirim, Engin; Gorkem, Umit
    Objective We aimed to reveal the association of serum alarin level with POR status of the infertile women in the present study. Methods The eligibility criteria for this prospective cross-sectional study included a total of 92 infertile women attending the Hitit University Hospital, and all participant women were categorized into two main groups of ovarian reserve: (i) Poor ovarian reserve (POR) group (n = 40) based on ESHRE consensus and (ii) Control group (NOR) (n = 52). Results The mean adjusted-ages and BMI values of the NOR and POR groups were statistically comparable (p = .057 and p = .600, respectively). The mean E2, FSH, and LH levels were elevated in the POR group (p < .001, for all). The mean AFC and AMH concentration were significantly reduced in the POR group (p < .001, for both). In addition, there was a significant increase in the serum alarin level in the POR group (p < .001). Pearson's analysis revealed that the mean BMI value of the POR group had a weak and negative correlation (r = 0.318, p = .046). Also, there was no correlation between serum alarin with E2 and FSH levels in both study groups. A weak and positive correlation was found between serum alarin and LH concentration only in the POR group (r = 0.318, p = .045). The mean AMH and AFC values were not significantly correlated with serum alarin levels. Conclusion The circulating alarin level was significantly elevated in infertile women with POR patterns. In addition, the alarin level was significantly correlated with the serum LH concentration in the POR pattern.
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    Copeptin: A potential marker for the prediction of poor ovarian reserve in the infertile women
    (Galenos Publ House, 2022) Gorkem, Umit; Yildirim, Engin
    Objective: There is actually no evidence regarding the physiological effects of copeptin in infertile women with different ovarian reserve types. This study aimed to investigate the relationship of serum copeptin level with poor ovarian reserve (POR) and to reveal the predictive value of copeptin for POR development in the infertile women. Materials and Methods: All participant women were classified as the control group (n=77) included the women with diagnosis of unexplained infertility and the POR group (n=61) was composed of the women who met the European Society of Human Reproduction and Embryology consensus on POR [serum anti-Mullerian hormone (AMH) concentrations below 1.1 ng/mL]. The biochemical tests, including estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone, AMH and copeptin were analysed. The analyses of serum copeptin concentrations were measured by the means of competitive enzyme immunoassay. Results: A significant increase in the serum copeptin level existed only in the POR group. There was a significant positive correlation between serum copeptin with E2 and FSH levels in the POR group. Significant negative correlations between copeptin and AMH concentrations (r=-0.310, p=0.015) and between copeptin concentration and antral follicle counts (r=-0.284, p=0.027) were detected only in the POR group. The estimated areas under receiver operating characteristic curves for serum concentration were found to be statistically significant with a cut-off value of 3.52 (95% confidence interval 0.519-0.709), sensitivity 0.90 and specificity 0.72. Conclusion: This study confirmed that there was an elevated serum copeptin concentration in the infertile women with POR and that serum copeptin concentration may have a predictive value for POR diagnosis.
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    The hazardous impacts of multiple repeated cesarean deliveries on adhesion formation and obstetric outcomes
    (2020) Kan, Ozgur; Gorkem, Umit; Cakir, Caner; Aykilic, Aysegul; Kocak, Ozgur; Yildirim, Engin
    Aim: The aim of this study was to determine whether the impact of repeat cesarean deliveries (CD) and abdominal adhesions on maternal and fetal complications exists in patients with a history of one previous CD and ones with three or more prior CD.Material and Methods: A total of one hundred-one pregnant women with a history of at least one previous CD were included in this prospective observational study. Participants were divided into two groups, patients with a single CD were added to the control group (n=56) and patients with a history of three or more CD were included in the study group (n=45). Preoperative scar characteristics and hemoglobin levels, intraoperative adhesion severity and grade were evaluated by using Linsky and Nair classifications for adhesion. In addition, duration of surgery, maternal complications and fetal status by using APGAR scoring system was analyzed, respectively.Results: Demographic features were comparable between the groups. The differences among the groups were found to be statistically significant in terms of adhesion intensity and grade (1.13 vs 0.42, p0.01 and 1.80 vs 0.89, p0.01, respectively), hemoglobin change (1.42 vs 0.83 mg/dL, p=0.011) and operation duration (47.60 vs 36.82 min, p0.01). In addition, APGAR scores were significantly lower in the multiple repeat cesarean group (1.min; 8.31 vs 8.64, p=0.02 and 5.min 9.37 vs 9.64, p=0.04, respectively).Conclusion: Multiple repeat CD was associated with poor obstetric outcomes and complications. Careful preoperative evaluation and preparation might be useful in reducing complications, especially in patients with a history of three or more CD.
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    The relationship between oxidative stress markers and endometrial hyperplasia: A case-control study
    (Galenos Yayincilik, 2021) Yildirim, Engin; Turkler, Can; Gorkem, Umit; Simsek, Omer Yavuz; Yilmaz, Ercan; Aladag, Hulya
    Objective: Endometrial hyperplasia (EH) is considered an endometrial cancer precursor. This study aimed to determine the role of oxidative stress and thiol groups with antioxidant properties in EH pathogenesis. Materials and Methods: In our prospective case-control study, participants were washed with 5 mL of saline before the endometrial biopsy. Endometrial washing fluid was taken into microtubules, and thiol and disulfide levels were analyzed using the Ellman reagent. Results: A total of 108 patients were in the EH group and 84 patients in the control group. The total and native thiol levels were higher values in the control group (p<0.001, for both). Disulfide levels were higher in the EH group (p<0.001). Native/total thiol ratio and disulfide/total thiol ratio were higher in the EH group (p<0.001, for both). The analysis performed in the control group revealed a significant positive correlation between estradiol and disulfide levels (r=0.322, p=0.033). No significant correlation was found between estradiol and disulfide in the EH group. Conclusion: Oxidative stress level was higher in the washing fluids of patients with EH and this stress plays a role in the EH etiology.