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Antalya, Turkey

Berkkanoglu M.,Antalya IVF | Bulut H.,Antalya IVF | Coetzee K.,Vitale | Ozgur K.,Antalya IVF
Middle East Fertility Society Journal | Year: 2015

Objective In this study, we reviewed the reproductive outcomes following ICSI in 5 couples where the male partners had undergone renal transplantations. Chronic renal failure and dialysis may adversely affect male reproductive function resulting in severely depressed semen parameters or even azoospermia, which maybe further adversely affected by the immunosuppression taken from after transplantation. Study design Case report. Setting A private fertility clinic. Patients The study included five infertile couples where the male partners were the recipients of renal transplants, 3-15 years prior to having ICSI treatment. All couples suffered from male factor infertility, with diagnoses of; azoospermia, asthenoteratozoospermia, oligoasthenoteratozoopsermia. Results In the 5 case reports 5 ICSI and 3 FET treatment procedures were completed. In all but one of the cases grade 1 quality embryos were obtained and transferred. From the 8 embryo transfers performed 4 pregnancies were obtained, one miscarried at 8 weeks and 3 resulted in live births. Conclusions In this study, we showed that pregnancy and normal live birth were possible following ICSI treatment for male factor infertility, where male partners had had renal transplants and were under immunosuppressive therapy. © 2014 The Authors. Source


Ozgur K.,Antalya IVF | Bulut H.,Antalya IVF | Berkkanoglu M.,Antalya IVF | Humaidan P.,University of Aarhus | Coetzee K.,Antalya IVF
Reproductive BioMedicine Online | Year: 2016

In this matched-controlled study (n = 300), the effect of hysteroscopic surgery performed concurrently with oocyte retrieval on the reproductive outcomes of intracytoplasmic sperm injection (ICSI) freeze-all cycles was investigated in patients screened for intrauterine anomalies. Conventionally, hysterscopic surgery is performed in a different cycle from IVF, delaying treatment completion and increasing patient anxiety. One hundred and fifty patients who had hysteroscopic surgery concurrently with oocyte retrieval (hysteroscopy group) in ICSI freeze-all cycles were matched according to age and oocyte number with 150 ICSI freeze-all cycles, in which the patients required no hysteroscopy (control group). In the hysteroscopy group, hysteroscopy was performed for diagnostic (n = 5) and therapeutic (n = 145) purposes. Blastocyst culture and Cryotop vitrification was performed in both groups. Frozen embryo transfer (FET) was successfully performed in the hysteroscopy group from 35 days after oocyte retrieval. No significant differences were observed for implantation, pregnancy, clinical pregnancy and early pregnancy loss rates in the hysteroscopy and control groups (48.9%, 72.0%, 61.3% and 14.8% versus 48.3%, 75.3%, 64.7% and 14.3%, respectively). Performing hysteroscopic surgery concurrently with oocyte retrieval in a segmented-IVF programme has no negative impact on reproductive outcomes, increases efficiency, and provides patients with low-risk treatment. © 2016 Reproductive Healthcare Ltd. Source


Ozgur K.,Antalya IVF | Bulut H.,Antalya IVF | Berkkanoglu M.,Antalya IVF | Coetzee K.,Vitale
Journal of Assisted Reproduction and Genetics | Year: 2015

Purpose: To investigate the perinatal outcomes of patients with clinical pregnancies from ICSI treatments who had previously undergone hysteroscopic surgery to correct partial intrauterine septa and compare them to outcomes of patients with no intrauterine anomalies. Method: A retrospective observational analysis of 2024 ultrasound confirmed pregnancies from ICSI treatments performed between January 2005 and June 2012. The patients were grouped according to their intrauterine status, and sub-grouped according to the number of fetal hearts observed; singleton control (n = 1128), twin control (n = 566), singleton septum (n = 217) and twin septum (n = 113). The primary outcomes analyzed were miscarriage, preterm, very preterm, stillbirth, vanishing twin and live delivery rates, as well as low birth weight and very low birth weight rates. Result(s): The live birth rate (89,9 %) in the singleton control subgroup was non-significantly higher than the live birth rate (85,3 %) in the septum subgroup, with a RR of 1,05 (p = 0,0583, 95 % CI 0,9943–1,1182) for live birth. In contrast the live birth rate (91,3 %) in twin control subgroup was significantly higher than the live birth rate (84,1 %) in the septum subgroup, with a RR 1,09 (p = 0,0282, 95 % CI 0,9988–1,1819). Non-significantly, higher miscarriage and stillbirth rates were the main contributors to the reduced live birth rates. The singleton and twin septum subgroups also had higher rates of premature and very premature delivery and LBWs and vLBW, especially in the singleton septum subgroup. Conclusion(s): The hysteroscopic correction of intrauterine septa may not eliminate all risks for premature delivery. © 2015, Springer Science+Business Media New York. Source


Ozgur K.,Antalya IVF | Bulut H.,Antalya IVF | Berkkanoglu M.,Antalya IVF | Coetzee K.,Vitale | Ay S.,Sinanpasa Family Health Center
Middle East Fertility Society Journal | Year: 2015

Objective To investigate the use of an oocyte M-Index as a measure of the reproductive competence of oocyte cohorts collected following COS for ICSI. Design A retrospective analysis of 3135 autologous ICSI cycles. Setting A private IVF clinic. Materials and methods Oocytes were denuded immediately after oocyte collection and the in vivo oocyte M-Index was calculated for the oocyte cohort collected (number of normal metaphase II oocytes per total number of normal oocytes collected). The measured outcomes were analyzed according to the M-Index (0-20%, 21-40%, 41-60%, 61-80%, and 81-100%) and female age (20-30, 31-40 years). Main outcomes Clinical pregnancy. Results 60,955 oocytes were collected from the 3135 ICSI cycles, 57,214 (93.9%) were normal and 39,364 (68.8%) of these were metaphase II oocytes. 71.6% of metaphase I oocytes reached nuclear maturity by the time of the ICSI procedure. Trend analyses of fertilization and clinical pregnancy to M-Index showed that fertilization increased significantly (p < 0.0001) with an increasing M-Index, from 64.0% (M-Index 0-20%) to 78.1% (M-Index 81-100%) as well as clinical pregnancy (p < 0.001) from 23.3% to 48.1%. No predictive threshold value could be determined from the data using ROC analysis. Analyzing the data across a 40% M-Index cut-point, both embryology and clinical pregnancy outcomes were significantly higher for cycles with an M-Index of >40%. Conclusion Our analysis shows that a simple maturation index calculated at the time of oocyte collection in a given ICSI cycle provides important prognostic information with regard to potential pregnancy outcomes and may reflect the importance of cytoplasmic maturation in oocyte competence. © 2014 Production and hosting by Elsevier B.V. on behalf of Middle East Fertility Society. Source


Ozgur K.,Antalya IVF | Berkkanoglu M.,Antalya IVF | Bulut H.,Antalya IVF | Humaidan P.,University of Aarhus | Coetzee K.,Antalya IVF
Fertility and Sterility | Year: 2015

Objective To investigate the possible effect of controlled ovarian stimulation on the perinatal outcomes of assisted reproductive technology pregnancies, by comparing the outcomes from fresh ET with frozen ET (FET) with blastocysts of similar quality. Design Retrospective observational study. Setting Private fertility center. Patient(s) Seven hundred eighty-four fresh transfers and 382 vitrified-warmed double blastocyst transfers. Intervention(s) None. Main Outcome Measure(s) Miscarriage, perinatal mortality, preterm delivery, live birth, live-birth weights, and gestational age of live births. Result(s) FET resulted in higher implantation rates (51.5% vs. 40.6%), higher live-birth rates per transfer (56.8% vs. 44.3%), and lower ectopic pregnancy rates (0.32% vs. 1.80%). FET pregnancies also had higher day 14 βhCG levels per implantation (148.2 vs. 176.2 IU/L) and higher infant birth weights (singletons Δ109.4 g, twins Δ124 g). Female infants benefitted the most in terms of birth weight. Miscarriage, premature delivery, perinatal morbidity, and live birth per pregnancy were all nonsignificantly different between fresh ET and FET. Conclusion(s) Clinically significant differences between the peri-implantation and perinatal outcomes of fresh ET and FET suggest better endometrial receptivity and placentation in FET cycles. © 2015 American Society for Reproductive Medicine. Source

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