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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/3

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    Demographic distributions and clinical results of assisted reproduction techniques in Turkey in 2019: a descriptive survey
    (Galenos Publ House, 2024) Aydin, Yunus; Bahceci, Mustafa; Baltaci, Volkan; Bulgurcuoglu, Sibel; Demir, Ahmet; Dilbaz, Serdar; Ergin, Elif; Findikli, Necati; Celik, Hale Goksever; Guler, Ismail; Isikoglu, Mete; Mumusoglu, Sezcan; Ozekinci, Murat; Ozornek, Hakan; Simsek, Erhan; Sukur, Yavuz Emre; Uncu, Gurkan; Urman, Buelent; Vicdan, Kubilay; Yarah, Hakan; Balaban, Basak; Benlioğlu, Can; Ata, Mustafa Barış; Graduate School of Health Sciences; School of Medicine
    Objective: The aim of this study was to describe characteristics and outcomes of assisted reproductive technology (ART) cycles performed in 2019 in Turkey. Material and Methods: One-hundred and sixty-five ART centers in Turkey were invited to submit data. The survey was sent to center directors via e-mail with anonymous links by Qualtrics'". The survey involved questions about their patient characteristics, clinical practices, and outcomes. Results: Forty-one (24.8%) centers responded to e-mails, and data gathered from 25 centers was included in the analyses. In 25 centers, 18,127 fresh or frozen transfers were carried out during the study period, of which 7796 (43.0%) were fresh and the rest were either frozen (45.2%) or embryo transfers (ET) with preimplantation genetic testing (PGT) (11.8%). The live birth rate per ET was as 30.6%, 40.1%, and 50.7% in fresh, frozen and PGT cycles, respectively. A single embryo was transferred in 65.3% of all transfers and singleton live births comprised 86.1% of all deliveries. For cycles with intrauterine insemination, 1407 were started in 2019, and 195 clinical pregnancies, 150 live births with 19 multiple pregnancies occurred. A total of 1513 ART cycles were initiated for foreign patients. Russia (29.6%), Germany (7.4%), Iraq (4.6%), Uzbekistan (3.1%), and Syria (1.4%) were the top five countries with most patients coming to Turkey for ART. Conclusion: The survey results are in parallel with the reports of international institutions and organizations. With repeated editions, the data collected with annual surveys can be used to inform ART practices in the coming years. (J Turk Ger Gynecol Assoc 2024; 25: 18-23)
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    Oral iron versus intravenous ferric carboxymaltose in the treatment of iron deficiency anemia in pregnancy: a retrospective study
    (Perinatal Tıp Vaktı, 2021) Yıldız, Şule; Faculty Member; School of Medicine; 134205
    Objective: Pregnant women with iron deficiency and severe anemia are at increased risk of preterm delivery, prematurity, and small for gestational age. Increased iron requirement necessitates iron replacement during pregnancy. While oral iron supplements are the common first choice, up to two-thirds of women experience doselimiting gastrointestinal side effects. Hence, intravenous iron can be an alternative method for iron replacement. We aimed to compare women who were given oral iron with women who received ferric carboxymaltose during pregnancy with regard to change in hemoglobin (Hb) and hematocrit (Hct) levels, mean corpuscular volume (MCV), weight gain during pregnancy, gestational age at birth, delivery method and birthweight. Methods: A total of 120 pregnant women, 60 in the oral iron group and 60 in the ferric carboxymaltose group were included in this retrospective study. All pregnant women underwent a baseline measurement for Hb, MCV, and Hct levels at their first antepartum care visit in the first trimester. Women in the oral iron group were started supplementation between the 16 and 20 weeks of gestation. Women in the ferric carboxymaltose group underwent 1000 mg of iron infusion between 20 and 28 weeks of gestation. Results: Women in the oral iron group have shown a significant decrease in Hb levels which was 12.2 (range: 11.5–13) g/dL at baseline and 12.1 (range: 11.2–12.5) g/dL before delivery (p=0.034). However, ferric carboxymaltose group did not show any difference between baseline Hb levels and Hb levels before delivery (p=0.60). Likewise, Hct levels have shown a significant decrease in the oral iron group which were 36.7 (range: 34–39) and 35.8 (range: 34–38) at baseline and before delivery, respectively (p=0.006). There was no significant difference between Hct levels in the ferric carboxymaltose group. Conclusion: Intravenous ferric carboxymaltose administration seems an effective, easy-to-use option for iron supplementation during pregnancy. / Amaç: Demir eksikliği ve şiddetli anemisi olan gebeler, preterm doğum, prematürite ve gebelik haftasına göre küçük olma yönünden artmış risk altındadır. Artmış demir gereksinimi, gebelikte demir replasmanını gerekli kılmaktadır. Oral demir takviyeleri yaygın ilk tercihken, kadınların üçte ikisine kadar olan kısmı doz sınırlayıcı gastrointestinal yan etkiler yaşamaktadır. Bu nedenle, demir replasmanı için intravenöz demir alternatif bir yöntem olabilir. Çalışmamızda, hemoglobin (Hb) ve hematokrit (Hct) seviyelerinde değişim, ortalama eritrosit hacmi (MCV), gebelikte kilo alma, doğumda gestasyonel yaş, doğum yöntemi ve doğum ağırlığı yönünden gebelik süresince oral demir alan kadınlarla ferrik karboksimaltoz alan kadınları karşılaştırmayı amaçladık. Yöntem: Bu retrospektif çalışmaya, altmışı oral demir grubu ve altmışı ferrik karboksimaltoz grubunda olmak üzere toplam 120 gebe dahil edildi. Tüm gebelere, birinci trimesterdeki ilk antepartum bakım ziyaretlerinde Hb, MCV ve Hct seviyeleri için referans ölçümü yapıldı. Oral demir grubundaki kadınlara 16. ve 20. gebelik haftaları arasında takviye başlandı. Ferrik karboksimaltoz grubundaki kadınlara 20. ve 28. gebelik haftaları arasında 100 mg demir infüzyonu uygulandı. Bulgular: Oral demir grubundaki kadınlarda Hb seviyelerinde anlamlı bir azalma görüldü; referans ölçümünde 12.2 (aral›k: 11.5–13) g/dL ve doğumdan önce 12.1 (aralık: 11.2–12.5) g/dL idi. Ancak ferrik karboksimaltoz grubunda referans Hb seviyeleri ile doğumdan önceki Hb seviyeleri arasında herhangi bir fark görülmedi (p=0.60). Benzer şekilde Hct seviyelerinde de oral demir grubunda anlamlı azalma görüldü; referans ölçümünde ve doğumdan önce sırasıyla 36.7 (aralık: 34–39) ve 35.8 (aralık: 34–38) idi (p=0.006). Ferrik karboksimaltoz grubunda Hct seviyeleri arasında anlamlı fark yoktu. Sonuç: intravenöz ferrik karboksimaltoz uygulamasının, gebelik süresince demir takviyesi olarak verimli ve kullanımı kolay bir seçenek olduğu görülmektedir.
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    Placental apoptosis in preeclampsia
    (Turkish Society of Obstetrics and Gynecology, 2013) Kotiloğlu, Esin; Şan, Tangül; Kavak, Zehra Neşe; N/A; Öktem, Özgür; Urman, Cumhur Bülent; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 102627; 12147
    Objective: We aimed in this study to determine if trophoblastic apoptosis is increased in placentas from preeclamptic women compared to healthy term control placentas. Patients and methods: 28 preeclamptic and 10 healthy control placentas were used for the study. Apoptosis in the trophoblasts were analyzed using TUNEL method and electron microscopy techniques. Results: Both groups were comparable in terms of age and parity. However, mean gestational week was significantly lower (33.2(3.2 vs. 39.1(0.5 p<0.0001 respectively), and apoptotic rate in the trophoblasts were significantly higher (40.7(17.9 vs. 25.2(10.6, p<0.05, respectively) in the preeclamptic group compared to controls. Conclusion: These results suggest that trophoblast apoptosis is increased in the preeclamptic placentas and that this form of apoptosis is different from that occurring with placental aging as a consequence of cell turnover. / Amaç: Preeklampsi ile komplike olmuş gebeliklerde plasental örneklerde trofoblast apoptozisinin araştırılması Gereç ve yöntemler: Bu çalışma da 28 preeklampsi hastası ile 10 sağlıklı term tekil gebeden olmak üzere toplam 38 plasental örnekte trofoblastlarda TUNEL metodu ve elektron mikroskopisi ile apoptozis araştırılmıştır. Sonuç: Her iki grup yaş ve parite açısından farklılık göstermezken, kontrol grubuna ortalama gebelik haftası preeklamptik grupta anlamlı daha düşük (33.2(3.2 vs. 39.1(0.5 p<0.0001), buna karşın trofoblastlarda apoptotik indeks anlamlı oranda daha yüksek bulunmuştur (40.7(17.9 vs. 25.2(10.6, p<0.05). Değerlendirme: Bu sonuçlar preeklampsi ile komplike olmuş gebeliklerde trofoblastlarda apoptozisde bir artış olduğunu ve bu artışın plasental yaşlanma ile gelişen apoptozisden farklı olduğu görüşünü desteklemektedir.
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    Oocyte in vitro maturation: a sytematic review
    (Galenos Yayincilik, 2018) Hatirnaz, Safak; Hatirnaz, Ebru Saynur; Dahan, Michael Haim; Tannus, Samer; Tan, Justin; Tan, Seang Lin; N/A; Ata, Mustafa Barış; Faculty Member; School of Medicine; 182910
    In vitro maturation (IVM) is one of the most controversial aspects of assisted reproductive technology. Although it has been studied extensively, it is still not a conventional treatment option and is accepted as an alternative treatment. However, studies have shown that IVM can be used in almost all areas where in vitro fertilization (IVF) is used and it has a strong place in fertility protection and Ovarian Hyperstimulation syndrome management. The aim of this systematic review was to address all aspects of the current knowledge of IVM treatment together with the evolution of IVM and IVF.
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    Diagnosis and treatment of iron deficiency anemia during pregnancy and the postpartum period: iron deficiency anemia working group consensus report
    (Galenos Yayınevi, 2015) Api, Olus; Breyman, Christian; Demir, Cansun; Ecder, Tevfik; Çetiner, Mustafa; Faculty Member; School of Medicine; N/A
    According to the World Health Organization (WHO), anemia is the most common disease, affecting >1.5 billion people worldwide. Furthermore, iron deficiency anemia (IDA) accounts for 50% of cases of anemia. IDA is common during pregnancy and the postpartum period, and can lead to serious maternal and fetal complications. The aim of this report was to present the experiences of a multidisciplinary expert group, and to establish reference guidelines for the optimal diagnosis and treatment of IDA during pregnancy and the postpartum period. Studies and guidelines on the diagnosis and treatment of IDA published in Turkish and international journals were reviewed. Conclusive recommendations were made by an expert panel aiming for a scientific consensus. Measurement of serum ferritin has the highest sensitivity and specificity for diagnosis of IDA unless there is a concurrent inflammatory condition. The lower threshold value for hemoglobin (Hb) in pregnant women is <11 g/dL during the 1st and 3rd trimesters, and <10.5 g/dL during the 2nd trimester. In postpartum period a Hb concentration <10 g/dL indicates clinically significant anemia. Oral iron therapy is given as the first-line treatment for IDA. Although current data are limited, intravenous (IV) iron therapy is an alternative therapeutic option in patients who do not respond to oral iron therapy, have adverse reactions, do not comply with oral iron treatment, have a very low Hb concentration, and require rapid iron repletion. IV iron preparations can be safely used for the treatment of IDA during pregnancy and the postpartum period, and are more beneficial than oral iron preparations in specific indications.