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Öğe Comparing the success rate of natural cycle and modified natural cycle protocols for frozen-thawed embryo transfer(TAYLOR & FRANCIS LTD, 2022) Aydın, Turgut; Kalem, Müberra Namlı; Bakırarar, Batuhan; Aygün, Elif Ganime; Kalem, ZiyaObjective: The aim of the present study is to compare the effects of Natural Cycle and modified Natural Cycle protocols for frozen-thawed embryo transfer on clinical pregnancy rate and live birth rate. Methods: This prospective randomized controlled trial comprised 145 patients scheduled for frozen-thawed embryo transfer and was conducted at a university hospital between 2019 and 2021. The Natural Cycle protocol was administered to 73 patients and the modified Natural Cycle protocol to 72 patients and the clinical outcome was compared between the groups. The main outcome measure was live birth rate. Results: Baseline characteristics and cycle parameters were similar in both groups. There was no difference in clinical pregnancy rate (58.9% and 54.2%, respectively; p = .565) and live birth rate between the Natural Cycle and modified Natural Cycle groups (49.3% and 48.6% respectively; p = .932). Conclusion: This study established that clinical pregnancy and live birth rates were not affected by natural cycle ovulation being spontaneous or hCG-triggered among patients undergoing frozen-thawed embryo transfer. Thus, the protocol for natural cycle frozen-thawed embryo transfers should be chosen according to the priorities of the patient and the physician.Öğe Comparıson of cumulus cells and follıcular fluıd obtaıned from ınfertile ındıvıduals dıagnosed wıth polycystıc ovary syndrome (PCOS) and endomethrıosıs wıth samples obtaıned from healthy ındıvıduals(2023) Gürgan, Timur; Ruso, Halil; Tural, Rabia; Dinçel, Aylin Sepici; Dayanır, Duygu; Kalem, Ziya; Sarıbaş, SanemAim: Investigating the relationship between Growth differentiation factor-9 (GDF-9), Bone morphogenetic protein-15 (BMP-15) markers, apoptosis levels in cumulus cells and total oxidant (TOS)/ anti-oxidant (TAS) stress levels, inflammation parameters (interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha)) in follicular fluid belonging to patients with polycystic ovary syndrome (PCOS), endometriosis (END) and male factor (MF) (control) groups. Material and Methods: GDF-9 and BMP-15 markers are determined by immunohistochemical methods, apoptosis levels are studied with TUNEL. TOS and TAS statuses are investigated with spectrophotometry, IL-6 and TNF – alpha levels are examined by Enzyme-Linked Immuno Sorbent Assay (ELISA). Results: According to the data obtained in the study; GDF-9 and BMP-15 levels are found to be lower in PCOS and END groups and apoptosis levels of cumulus cells were significantly higher at these groups . TOS levels were significantly higher in PCOS and END groups whereas follicular fluid TAS levels were not statistically significant for these groups. IL-6 and TNF – alpha levels of follicular fluid was significantly higher in PCOS. These parameters were also higher for END group, however the difference was not found to be significant. Conclusion: Our results imply that correlation between GDF-9, BMP-15 markers, apotosis levels, oxidative status, inflammation levels may be interpreted with improper environment for oocyte maturation for patients diagnosed with PCOS or END. The need for further studies on subject proceeds. However, if similar datas are obtained in further studies, it is thought that evaluation of cumulus cell properties together with especially follicular fluid oxidative stress levels will contribute to the selection of the best oocyte.Öğe Enhancement of folliculogenesis by fresh onion juice in a rat model(Bentham Science Publishers, 2021) Yılmaz, Nafiye; Yorgancı, Ayçağ; İnal, Hasan Ali; Seven, Banu Yüksel; Timur, Hakan; Kalem, ZiyaAim: To evaluate the effects of fresh onion juice on female infertility. Background: Onion contains several antioxidants and has been used for the subfertile woman to achieve pregnancy by herbalists. Objective: This study was carried out to investigate the effects of fresh onion juice on ovarian folliculogenesis and implantation in rats. Methods: Female albino rats were divided into two groups: 5-day (one estrus cycle) and 10-day treatment (two estrus cycles) groups. The animals in the two groups were then divided into subgroups of the control group, 1 cc onion juice and 2 cc onion juice, each containing seven rats. At the end of the 5th and 10th days, ovarian volume and weight were measured, and the primordial, antral, and atretic follicles, and corpus lutea were counted. Vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOS) were evaluated both in the ovaries and in the endometrium immunohistochemically. Results: In the 5-day treatment group, ovarian weight and the antral follicle count were significantly higher in the 2 cc onion juice subgroup than the control group (p<0.05). In the 10-day treatment group, the antral follicle count was significantly higher both in 1cc and 2cc onion juice subgroups than the control group (p<0.05). There was also increased ovarian stromal VEGF in the 10-day 1cc onion juice subgroup (p<0.05). Conclusion: The results of our study showed that fresh onion juice could increase the number of antral follicles, which is an indicator of enhanced folliculogenesis. © 2021 Bentham Science Publishers.Öğe Factors that affect survival in vaginal cancer: A seer analysis(Taylor and Francis, 2022) Bakırarar, Batuhan; Kalem, Müberra Namlı; Kalem, ZiyaThis study aimed to investigate the factors that affect survival in vaginal cancer by means of a large population-based database that had been monitored over a 42 year period (1975–2017). It was investigated which factors were most predictive in survival. This study evaluated the factors that affect survival in primary vaginal cancer as one of the rarest gynaecological cancers. Relationships were explored between survival and age and race of patient, in situ/invasive behaviour of tumour, histological type, stage, grade, surgical treatment, and year of diagnosis. Survival rate was found to be higher at younger ages and earlier stages, in in situ and squamous cell carcinomas, in the presence of previous surgery, and diagnosis from 2000 onward. It was shown that other causes were more predictive of mortality in older patients and that mortality due to other causes decreased in patients diagnosed from 2000 onward. Mortalities due to cancer were found to be lower in the patients who had underwent surgery. At the end of this study, an estimation model was developed for 10-year survival in vaginal cancer and software was created for the model. IMPACT STATEMENT What is already known on this subject? Primary vaginal cancer is very rare, accounting for 2% of female genital tract malignancies. Due to its low incidence and difficulty of its final diagnosis, vaginal cancer has the least amount of data among all female genital tract malignancies. It is difficult for clinicians to estimate the survival with already limited data on vaginal cancer in the literature. What do the results of this study add? Survival rate was found to be higher at younger ages and earlier stages, in in situ and squamous cell carcinomas, in the presence of previous surgery, and diagnosis from 2000 onward. It was shown that other causes were more effective in mortality with older age and that mortality due to other causes decreased in patients diagnosed from 2000 onward. Mortalities due to cancer were found to be lower in the patients who had underwent surgery. What are the implications of these findings for clinical practice and/or further research? It is anticipated that such studies will contribute to the transformation of societal data collection methods into a prospective nature and lead the way for stronger survival estimation models to be developed in days to come.Öğe Fresh versus frozen-thawed blastocyst transfer in high responders(Via Medica, 2018) Kalem, Ziya; Namlı Kalem, Müberra; Ruso, Halil; Bakirarar, Batuhan; Gurgan, TimurObjectives:This study aimed to investigate and compare the pregnancy and live birth rates in IVF cycles of frozen-thawed embryo transfers and fresh embryo transfers in a group of women with a high risk of Ovarian hyperstimulation syndrome (OHSS). Material and methods: The study group consisted of 254 women with a high level of response to controlled ovarian hyperstimulation. The patients who received fresh cycle embryo transfers with calcium infusions are referred to as the Fresh Ca+ group, and those without the calcium therapy are called the Fresh Ca- group; and we used correspondingly similar terminology for the Frozen group. Results: We observed no statistically significant differences between the cycles of fresh and frozen-thawed embryo transfers in patients with a high risk of OHSS in terms of implantation, clinical pregnancy, and live birth rates. Furthermore, these implantation, clinical pregnancy and live birth rates were not different in the cycles with or without calcium treatment. There was no statistical difference in the OHSS rates between the fresh and frozen-thawed cycles; although, the OHSS rates were less in the two calcium infusion groups (Fresh Ca+ and Frozen-thawed Ca+) than in the without-calcium group.There was no OHSS development in the subjects of the Frozen-thawed Ca+ group. Conclusions: Our study results suggest that fresh and frozen-thawed embryo transfers have similar IVF results in patients with a high risk of OHSS. Calcium infusion is beneficial in preventing OHSS without altering pregnancy rates. Both IVF protocols with calcium infusion can safely be applied in high-responder patients without lowering success rates.Öğe A rat study on the PTEN expression in ovarian tissue in PCOS and folliculogenesis(Nature Portfolio, 2023) Namli Kalem, Muberra; Anadol, Elvan; Kalem, Ziya; Sezginer, Perihan Yalcinkaya; Elmas, Cigdem; Yilmaz, Canan; Bakirarar, BatuhanThe objective of this investigation was to examine alterations in PTEN expression within ovarian tissue in a rat model of polycystic ovary syndrome (PCOS). The analysis also encompassed the examination of PTEN alterations in the ovarian tissue throughout the process of folliculogenesis in rats with normal ovulatory cycles. The study involved 12 adult female Sprague-Dawley rats randomly assigned to the letrozole-induced polycystic ovary syndrome (PCOS) group as part of an animal-based research endeavour. The sections derived from the ovaries were subjected to immunohistochemical staining for PTEN. The evaluation of PTEN staining levels in ovarian tissues was conducted using electron microscopy. Follicle counts, as well as hormonal and biochemical analyses (serum luteinising hormone (LH), follicle-stimulating hormone (FSH), anti-Mullerian hormone (AMH), testosterone, oestradiol levels and serum glucose, triglyceride, HDL and LDL-cholesterol levels), were conducted to provide evidence of the manifestation of polycystic ovary syndrome (PCOS) in rats. The number of primordial and Graafian follicles in the PCOS group decreased significantly, and the number of primary, secondary and antral follicles increased significantly. PTEN expression was found to be significantly higher in the PCOS group than in the control group in the primordial follicle oocyte cytoplasm, primordial follicle granulosa cells, primary follicle oocyte cytoplasm, primary follicle granulosa cells, antral follicle oocyte cytoplasm, antral follicle granulosa cells, and corpus luteum (p = 0.007, p = 0.001, p = 0.001, p = 0.001, p = 0.001, p = 0.002, and p = 0.018, respectively). In the non-PCOS group, a time-dependent comparison of the amount of oocyte cytoplasm and PTEN staining in granulosa cells of the oocytes at different stages of development was performed. While the follicles were developing from the primordial follicle to the primary and antral follicle, the amount of PTEN staining in the oocyte cytoplasm decreased, whereas the PTEN activity in the granulosa cells increased as the oocyte developed (p = 0.001 and p = 0.001, respectively). The current investigation demonstrated changes in PTEN expression in ovarian tissue throughout the course of normal folliculogenesis, as well as in instances of disrupted folliculogenesis, with a focus on rats with PCOS.
