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Ecemis T.,Private Liv Hospital | Tasci Y.,Zekai Tahir Burak Womens Health Research Hospital | Caglar G.S.,Ufuk University
Gynecological Endocrinology | Year: 2016

Objective: To investigate the effect of co-administration of letrozole in an ovarian stimulation protocol using recombinant FSH and GnRH antagonists for ICSI in normo/high responders. Methods: Computerized data of 320 antagonist ICSI/ET cycles with or without letrozole were retrospectively analyzed. In 105 cases, letrozole (5 mg/day) was started at the second day of the cycle continued for 5 days. At the second day of letrozole, gonadotropins were added. The remaining 215 cases were stimulated with recombinant FSH only. In all cases on day 6, GnRH antagonist was started. Ovarian stimulation protocols with or without letrozole were compared for cycle outcome parameters. Results: In cycles with letrozole, significantly lower gonadotropin consumption and lower peak estradiol levels were found. In cycles with letrozole, mean number of metaphase II and fertilized oocytes retrieved were significantly higher compared to cycles without letrozole. The pregnancy and clinical pregnancy rates were similar. Conclusion: Should the number of oocytes retrieved being higher in letrozole group might indicate that letrozole might contribute to successful ovarian stimulation with a lower dosage of gonadotropins. Despite the lower peak estradiol levels, pregnancy rates being similar to other group also support the idea that letrozole can contribute to normal potential of implantation. © 2015 Taylor & Francis.


PubMed | Ufuk University, Private Liv Hospital and Zekai Tahir Burak Womens Health Research Hospital
Type: Journal Article | Journal: Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology | Year: 2016

To investigate the effect of co-administration of letrozole in an ovarian stimulation protocol using recombinant FSH and GnRH antagonists for ICSI in normo/high responders.Computerized data of 320 antagonist ICSI/ET cycles with or without letrozole were retrospectively analyzed. In 105 cases, letrozole (5mg/day) was started at the second day of the cycle continued for 5 days. At the second day of letrozole, gonadotropins were added. The remaining 215 cases were stimulated with recombinant FSH only. In all cases on day 6, GnRH antagonist was started. Ovarian stimulation protocols with or without letrozole were compared for cycle outcome parameters.In cycles with letrozole, significantly lower gonadotropin consumption and lower peak estradiol levels were found. In cycles with letrozole, mean number of metaphase II and fertilized oocytes retrieved were significantly higher compared to cycles without letrozole. The pregnancy and clinical pregnancy rates were similar.Should the number of oocytes retrieved being higher in letrozole group might indicate that letrozole might contribute to successful ovarian stimulation with a lower dosage of gonadotropins. Despite the lower peak estradiol levels, pregnancy rates being similar to other group also support the idea that letrozole can contribute to normal potential of implantation.


Deveer R.,Zekai Tahir Burak Womens Health Research Hospital | Engin-Ustun Y.,Zekai Tahir Burak Womens Health Research Hospital | Kale I.,Zekai Tahir Burak Womens Health Research Hospital | Aktulay A.,Zekai Tahir Burak Womens Health Research Hospital | And 2 more authors.
Clinical and Experimental Obstetrics and Gynecology | Year: 2010

This is a case presentation of a conjoined twin (cephalothoracopagus) pregnancy with anencaphaly and mirror-image cleft lip and palate, affecting the left side of one twin and the right side of the other twin. The pregnancy was terminated at 26 weeks. The case is discussed with information in the literature.


Deveer M.R.,Zekai Tahir Burak Womens Health Research Hospital | Deveer R.,Zekai Tahir Burak Womens Health Research Hospital | Engin-Ustun Y.,Zekai Tahir Burak Womens Health Research Hospital | Sarikaya E.,Zekai Tahir Burak Womens Health Research Hospital | And 3 more authors.
Clinical and Experimental Obstetrics and Gynecology | Year: 2012

Objective:The basic aim of this study is to compare the pregnancy outcomes in cases with uterine fibroids located at the anterior and posterior uterine walls. Materials and methods: A total of 84 pregnant women with a diagnosis of uterine myoma larger than 30 millimeter (mm) in diameter were included in the study to determine the obstetric outcomes. In 64 (76.20%) patients,myomaswere detected at the anterior uterine wall (group 1),while20 (23.80%) were detected at the posterior uterine wall (group 2). All patients were followed monthly until the end of pregnancy. Demographic and obstetric characteristics were compared between the two groups. Results: There were no significant differences in age, gravida, parity,andmyoma size between the two groups. A significant difference existed between the groups with regard to pelvic pain. Posterior located fibroids were associated with more pelvic pain (p = 0.001). No difference was observed between the two groups with regard to the rates of preterm delivery,bleedingin early pregnancy,infantswith small for gestational age,andhospitalization period during pregnancy. Women with posterior located myomas had significantly higher miscarriage rates. Conclusion: Our findings suggest that pregnancies with uterine fibroids are at increased risk for complications. Posterior located fibroids larger than 30 mm in diameter are associated with severe pelvic pain compared to anterior located fibroids.


Kilic S.,Zekai Tahir Burak Womens Health Research Hospital | Yilmaz N.,Zekai Tahir Burak Womens Health Research Hospital | Zulfikaroglu E.,Zekai Tahir Burak Womens Health Research Hospital | Erdogan G.,Zekai Tahir Burak Womens Health Research Hospital | And 2 more authors.
Gynecological Endocrinology | Year: 2011

Our aim was to evaluate the optimal treatment strategy addressing cardiovascular risk in obese and nonobese patients with polycystic ovary syndrome (PCOS). We planned a prospective randomized clinical study. Normoandrogenemic and oligoamenorrheic women with PCOS and impaired glucose tolerance (n = 96) were enrolled in the study. Six months of treatment with metformin HCL or oral contraceptive pills (OCPs) were given to the patients. Group 1 were obese and receiving metformin. Group 2 were obese and receiving OCPs. Group 3 were nonobese and receiving metformin, and Group 4 were nonobese receiving OCPs. ADMA, homocysteine, high sensitive C-reactive protein (hs-CRP) and homeostasis model assessment estimate of insulin resistance (HOMA-IR) were investigated. ADMA, homocysteine, hs-CRP and HOMA-IR were similar in obese and nonobese groups before the treatment. After 6 months of treatment, a significant decrease was observed in ADMA, homocysteine and HOMA-IR levels in Groups 1 and 3. An increase in ADMA and hs-CRP levels was observed in Groups 2 and 4. In this study, metformin treatment leads to improvement in hormonal and metabolic parameters and decreases ADMA and homocysteine levels possibly independent of BMI. However, the use of oral contraceptives in obese and nonobese patients with PCOS with impaired glucose tolerance increases ADMA and hs-CRP levels and creates an increase in the metabolic risk. © 2011 Informa UK, Ltd.


Erdogan G.,Zekai Tahir Burak Womens Health Research Hospital | Aydin M.,Fatih University | Tasdemir N.,Zekai Tahir Burak Womens Health Research Hospital | Doganay M.,Zekai Tahir Burak Womens Health Research Hospital | Batioglu S.,Zekai Tahir Burak Womens Health Research Hospital
Climacteric | Year: 2010

ObjectivePostmenopausal women are at an increased risk of cardiovascular disease and metabolic syndrome as many risk factors are aggravated by menopause. Elevated levels of homocysteine, triglyceride and asymmetric dimethylarginine (ADMA) have been recognized as risk factors for metabolic syndrome. The present study aimed to investigate the effect of transdermal estrogen treatment on serum levels of atherogenic amino acids, homocysteine, triglyceride, high density lipoprotein (HDL) cholesterol and ADMA in women with surgical menopause. MethodsA prospective study was conducted in 85 surgically menopausal Turkish women at the Department of Menopause of Dr Zekai Tahir Burak Women's Health Research and Education Hospital between March 2007 and March 2008. Subjects were divided into two groups: a treatment group (Group 1) and control (Group 2). Group 1 (n46) received transdermal estrogen while Group 2 (n39) received no treatment. Body mass index (BMI) and levels of serum homocysteine, ADMA, triglyceride and HDL cholesterol were analyzed postoperatively at the first visit (baseline) and 6th months. ResultsThe two groups did not differ in age, baseline BMI and levels of ADMA, homocysteine and triglyceride. In Group 1, values of serum ADMA, homocysteine, triglyceride and HDL cholesterol levels were not different at baseline and at the 6-month visit (p0.996, p0.564, p0.113 and p0.173, respectively). On the other hand, the baseline and the 6th month measurements of serum ADMA, homocysteine and HDL cholesterol levels were significantly different in Group 2 (p0.001, p0.001, and p0.023, respectively). ConclusionTransdermal estrogen treatment has a protective effect against the risk factors of metabolic syndrome (homocysteine, ADMA, HDL cholesterol) in surgically menopausal patients who have undergone surgery in the early premenopausal period. © 2010 International Menopause Society.


PubMed | Zekai Tahir Burak Womens Health Research Hospital
Type: Journal Article | Journal: Climacteric : the journal of the International Menopause Society | Year: 2010

Postmenopausal women are at an increased risk of cardiovascular disease and metabolic syndrome as many risk factors are aggravated by menopause. Elevated levels of homocysteine, triglyceride and asymmetric dimethylarginine (ADMA) have been recognized as risk factors for metabolic syndrome. The present study aimed to investigate the effect of transdermal estrogen treatment on serum levels of atherogenic amino acids, homocysteine, triglyceride, high density lipoprotein (HDL) cholesterol and ADMA in women with surgical menopause.A prospective study was conducted in 85 surgically menopausal Turkish women at the Department of Menopause of Dr Zekai Tahir Burak Womens Health Research and Education Hospital between March 2007 and March 2008. Subjects were divided into two groups: a treatment group (Group 1) and control (Group 2). Group 1 (n = 46) received transdermal estrogen while Group 2 (n = 39) received no treatment. Body mass index (BMI) and levels of serum homocysteine, ADMA, triglyceride and HDL cholesterol were analyzed postoperatively at the first visit (baseline) and 6th months.The two groups did not differ in age, baseline BMI and levels of ADMA, homocysteine and triglyceride. In Group 1, values of serum ADMA, homocysteine, triglyceride and HDL cholesterol levels were not different at baseline and at the 6-month visit (p = 0.996, p = 0.564, p = 0.113 and p = 0.173, respectively). On the other hand, the baseline and the 6th month measurements of serum ADMA, homocysteine and HDL cholesterol levels were significantly different in Group 2 (p = 0.001, p = 0.001, and p = 0.023, respectively).Transdermal estrogen treatment has a protective effect against the risk factors of metabolic syndrome (homocysteine, ADMA, HDL cholesterol) in surgically menopausal patients who have undergone surgery in the early premenopausal period.


PubMed | Zekai Tahir Burak Womens Health Research Hospital
Type: Comparative Study | Journal: Clinical and experimental obstetrics & gynecology | Year: 2013

The basic aim of this study is to compare the pregnancy outcomes in cases with uterine fibroids located at the anterior and posterior uterine walls.A total of 84 pregnant women with a diagnosis of uterine myoma larger than 30 millimeter (mm) in diameter were included in the study to determine the obstetric outcomes. In 64 (76.20%) patients, myomas were detected at the anterior uterine wall (group 1), while 20 (23.80%) were detected at the posterior uterine wall (group 2). All patients were followed monthly until the end of pregnancy. Demographic and obstetric characteristics were compared between the two groups.There were no significant differences in age, gravida, parity, and myoma size between the two groups. A significant difference existed between the groups with regard to pelvic pain. Posterior located fibroids were associated with more pelvic pain (p = 0.001). No difference was observed between the two groups with regard to the rates of preterm delivery, bleeding in early pregnancy, infants with small for gestational age, and hospitalization period during pregnancy. Women with posterior located myomas had significantly higher miscarriage rates.Our findings suggest that pregnancies with uterine fibroids are at increased risk for complications. Posterior located fibroids larger than 30 mm in diameter are associated with severe pelvic pain compared to anterior located fibroids.


PubMed | Zekai Tahir Burak Womens Health Research Hospital
Type: Case Reports | Journal: Clinical and experimental obstetrics & gynecology | Year: 2010

This is a case presentation of a conjoined twin (cephalothoracopagus) pregnancy with anencaphaly and mirror-image cleft lip and palate, affecting the left side of one twin and the right side of the other twin. The pregnancy was terminated at 26 weeks. The case is discussed with information in the literature.

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