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    Can leukocytosis foresee hysterectomy for placenta previa?
    (2019) Ozdemir, Ayse Zehra; Karli, Pervin
    Aim: The frequency of placenta previa (PP) is increasingly rising due to the increase in caesarean ratio. The aim of this study is to investigate the role of the white blood cell (WBC) in the preoperatively taken complete blood specimen in foreseeing whether hysterectomy will be performed or not in patients with placenta previa totalis.Materials and Methods:Two hundred fifty-seven (257) patients who experienced caesarean due to placenta previa totalis (PPT) in Ondokuz Mayis University between 2010 and 2018 had been surveyed retrospectively. The results of the preoperative Complete Blood Count (CBC) of the Placenta PreviaTotalis (PPT) patients in which either hysterectomy was applied or not, demographic characteristics, other follow-up and treatment results were accessed via system records and file surveys. The primary outcome is the role of preoperative White Blood Cell (WBC) levels in predicting hysterectomy, Results: WBC median values in the pre-operative complete blood specimen of the patients with placenta previa totalis demonstrate difference between the patients with hysterectomy and those without hysterectomy. While the median value was as 9.7 109/L in the patients who could be recovered with treatments apart from hysterectomy, this was obtained as 11.3109/L in the patients in which hysterectomy was applied (p=0.007).Conclusion: Increase in WBC in the pre-operative blood specimen of the patients with diagnosis of Placenta Previa Totalis may be guiding whether hysterectomy will be applied or not.Keywords: Placenta previa; hysterectomy; leukocytosis; caesarean.
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    Do inflammation and hormone parameters have effects on IVF results in patients with unexplained infertility?
    (2019) Karli, Pervin; Ozdemir, Ayse Zehra; Gulumser, Cagri
    Aim: To invastigate the inflammatory process and hormone parameters as a result of underlying cause of unexplained infertility (UI)Metarial and Methods: In total 153 patients with UI who underwent to intracytoplasmic sperm injection (ICSI) were included in the study. The blood hormones levels were obtained on the 2nd or 3rd day of the menstruation. Other blood count examinations were taken on the day of HCG administration. Relationship regarding embryo grade was also investigated.Results: Of those 153 patients, only 42 of them got pregnant. Mean maternal age was 29.08±3.5 and mean duration of the infertility was 8.19±3.1 years, respectively. There was no statistically significant difference between pregnancy rate, embriyo grade, and FSH, progesterone, fT3, fT4, TSH levels (p>0.05). Also no significant difference was found between pregnancy rate, embriyo grade and hemoglobin, hemotocrit, platelet, mean platelet volume, neutrophil, lymphocyte counts, neutrophil lymphocyte ratio and platelet lymphocyte ratio (PLR) (p>0.05). However, a significant difference was found between embriyo grade and estradiol values (p0.05). There was a negative correlation between hematocrit values and the oosit number collected with the number of embryos (p0.05). PLR was found to be 110.9 (63.6 - 313.2) in pregnant women and 110.5 (51.8 - 390) in nonpregnant patients and the correlation between the PRL measured on HCG day and pregnancy rate.was significant (p=0.002). LH median values measured on HCG day were significantly lower in pregnant group (p0.001). Conclusion: We found that inflammation does not affect on IVF result and estradiol levels significantly effects on embriyo quality. Also there was an inverse correlation between hematocrit levels and the number of oocyte- and number of embryos.Keywords: Infertility; blood cell count; inflammation; estrogen.
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    The effect of GnRH Agonist use in Frozen Cycles on pregnancy results
    (2020) Ozguvercin, Sait; Ozdemir, Ayse Zehra; Guven, Davut; Karli, Pervin
    Aim: The aim of this study was to investigate the effect of GnRH agonist use on pregnancy and abortion in the preparation of the endometrium in autologous frozen embryo transfers performed with hormone replacement therapy.Material and Methods: All autologous artificial Frozen – thawed embryo transfer (FET) between 1/2016 and 1/2018 were evaluated retrospectively in order to investigate the effect of GnRH agonist use on pregnancy and abortion rates in frozen embryo FET cycles.Results: 226 patients were included in the study. The mean age of the patients included in the study was 30.76 ± 4.72 years. Of the patients, 144 (63.7%) were diagnosed with unexplained infertility, 20 (8.8) with low ovarian reserve, and 62 (27.4) with male factor. No significant difference was found in terms of pregnancy result and abortion in patients using (N: 22) and not using GnRH agonist (p = 0.212, 1,000).Conclusion: No significant effect of GnRH agonist use on pregnancy rate or abortion was detected in autologous frozen embryo transfers performed with HRT. The prospective studies involving larger patient populations are needed to clarify this subject..
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    The relationship of pelvic pain symptoms with CA-125 levels in endometriosis cases
    (2019) Karli, Pervin
    Aim: This study aims to investigate the relationship between CA-125 levels and pelvic pain symptoms in patients with endometriosis.Material and Methods: This study consisted of retrospective data of 31 patients who were admitted to the outpatient clinic of Faculty of Medicine, Amasya University between 01 January 2013 and 01 January 2018 for complaints of pelvic pain, dysmenorrhea or infertility, who had a preliminary diagnosis of endometriosis by clinical and ultrasonography examination and diagnosed with endometriosis by laparoscopy or laparotomy as well as 35 patients who received diagnostic laparoscopy for any reason or laparotomy or laparoscopy for benign or tubal ligation. The study included patients aged 18 to 45 years old. Patient data were recorded via an information form which included age, presence of infertility, duration of infertility, preoperative CA-125 values, presence of dysmenorrhea and dyspareunia symptoms, previous operation for endometriosis, presence of additional gynecological pathology, disease stage, operation notes, primary complaints, preoperative TVS information, gravida, parity, abortion and living children, used medication, if any, chronical diseases, if any. Results: The blood CA-125 levels were statistically significant in the patients considering the presence of chronic pelvic pain, dysmenorrhea and infertility (p 0.05). Mean CA-125 levels were 51.43 U/ml in patients with chronic pelvic pain symptoms. Mean CA-125 levels were 45.45 (U/ml) in patients with dysmenorrhea. Mean CA-125 was 45.67 (U/ml) in infertile patients and 45.58 (U/ml) in patients with endometriosis. Mean CA-125 levels in patients with additional gynecological diseases were 38.29 (U/ml), which was not statistically significant.Conclusion: This study demonstrated that CA-125 levels were significantly associated with pelvic pain symptoms, infertility and endometriosis. In light of the results, preoperative serum CA-125 levels are a predictor and should be considered for patients with chronic pelvic pain.Keywords: Endometriosis; CA-125; pelvic pain.
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    Serum amyloid-a may be an early marker in diagnosis of preterm premature rupture of membrane and chorioamnionitis
    (2019) Kayabas, Hatice; Devran Bildircin, Fatma; Karli, Pervin; Avci, Bahattin; Alper, Tayfun; Ozdemir, Ayse Zehra
    Aim: To determine the efficiency of serum amyloid-A (SAA) in predicting preterm premature rupture of membrane (PPROM) and chorioamnionitis in risky cases. Study Design: The study consists of 20 women 26-37 weeks of pregnancy who had PPROM and 20 pregnant women without water breaks. Levels of SAA were determined in maternal venous and umbilical cord blood. Results: SAA values in cord blood and venous blood of mothers with PPROM were higher than in the control group (p0,05). SAA values in the patients with clinical chorioamnionitis (n=9) were significantly higher (p0,05) than both PPROM patients without chorioamnionitis (n=11) and the control group (n=20). Conclusion: In women at risk for PPROM in whom diagnosis cannot be established, blood SSA levels can be used as a marker. Increased SAA values in pregnant women with PPROM who were conservatively treated were considered a marker for chorioamnionitis.
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    Sexual dysfunction in in-vitro fertilization (IVF) patients and the effect of ovarian reserve on sexual dysfunction
    (2019) Karli, Pervin; Ozdemir, Ayse Zehra
    Aim: In this prospective study, we aimed to compare the patients scheduled for in vitro fertilization (IVF) with poor ovarian reserve to patients with unexplained infertility in the same age group in terms of sexual dysfunction.Material and Methods: In this prospective study, a total of 146 patients admitted to the IVF center of Ondokuz Mayıs University between June 2018 and December 2018 were included in the study. Fourty-eight of these patients had poor ovarian reserve and 98 were scheduled for IVF due to unexplained infertility. In these patients, the female sexual function index (FSFI) scores were calculated for the diagnosis of sexual dysfunction prior to treatment. In addition, ovarian reserve tests such as cyclic follicle stimulating hormone (FSH) and anti mullerian hormone (AMH) at the beginning of the menstrual cycle were recorded.Results: The mean age of the female patients in the study was 30.2+-5 years. The mean FSFI score was 22.36 +-3.31 and 22.44+-3.53 in the group with poor ovarian reserve and with unexplained infertility, respectively. The prevalence of sexual dysfunction (FSFI score 26.55) in the poor ovarian reserve group was 89.6% (n=48) compared to the unexplained infertility group, which was 93.9% (n=98). The analysis of domains revealed no statistically significant difference between the two groups (p=0,356).Conclusion: Sexual dysfunction is frequently observed in patients scheduled for IVF. Our study showed that there was no difference in sexual dysfunction between the two groups. Interestingly, it was revealed that there was a correlation between FSH levels and satisfaction and pain.It was also interesting that the rate of sexual dysfunction was extremely high in both groups.Keywords: Decreased ovarian reserve; sexual dysfunction; unexplained infertility; ovarian reserve.