Researcher:
Yıldız, Şule

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Şule

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Yıldız

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Yıldız, Şule
Oğuz, Şule Yıldız

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Now showing 1 - 10 of 60
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    Publication
    Role and effectiveness of progestins in pituitary suppression during ovarian stimulation for assisted reproductive technology: a systematic review and a meta-analysis
    (Edizioni Minerva Medica, 2023) Yıldız, Şule; Türkgeldi, Engin; Ata, Mustafa Barış; School of Medicine
    Introduction: despite the many unknowns about its exact mechanism, progesterone and progestins are being successfully used to prevent luteinizing hormone (lH) surge during ovarian stimulation for assisted reproductive technology (art). We will review progestin primed ovarian stimulation (PPOs) protocols in comparison with gonadotropin releasing hormone (GnrH) analogues and each other. Evidence Acquisition: MedliNe via PubMed; cochrane central register of controlled trials (ceNtral); scopus; Web of science were screened with keywords related to assisted reproductive technology, ovarian stimulation progesterone, GnrH analogue and progesterone in several combinations. search period was from the date of inception of each database until 20 May 2022. Evidence Synthesis: live birth or ongoing pregnancy rate per embryo transfer (et) was similar in PPOs and GnrH antagonist cycles (rr=1.16, 95% ci: 0.93-1.44). clinical pregnancy rate per et was likewise similar (rr=1.12, 95% ci: 0.92-1.37). Miscarriage rate per pregnancy was similar with PPOs and GnrH antagonists in autologous cycles (rr=1.01, 95% ci: 0.65-1.55). Pooled analyses showed similar live birth rate between progestins and short GnrH agonist protocols (RR=1.01, 95% CI: 0.49-2.09), however, clinical pregnancy rates per ET were significantly higher with progestins (rr=1.31, 95% ci: 1.06-1.62). Miscarriage rate per pregnancy was similar with progestins (rr=0.82, 95% ci: 0.55-1.21). Conclusions: Progestins seem to be an efficient option for pituitary suppression during ovarian suppression, providing similar outcomes for stimulation and pregnancy. They can be especially beneficial for women for whom fresh ET is not considered.
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    PublicationOpen Access
    Adenomyosis: single-cell transcriptomic analysis reveals a paracrine mesenchymal-epithelial interaction involving the WNT/SFRP pathway
    (Elsevier Science Inc, 2023) Kinali, Meric; Wei, Jian Jun; Milad, Magdy; Yin, Ping; Adli, Mazhar; Bulun, Serdar E.; Yıldız, Şule; School of Medicine
    Objective: To assess the cellular and molecular landscape of adenomyosis.Design: Single-cell analysis of genome-wide messenger RNA (mRNA) expression (single-cell RNA sequencing) of matched tissues of endometrium, adenomyosis, and myometrium using relatively large numbers of viable cells.Setting: Not applicable. Patient(s): Patients (n 1/4 3, age range 40-44 years) undergoing hysterectomy for diffuse adenomyosis. Main Outcome Measure(s): Definition of the molecular landscape of matched adenomyotic, endometrial and myometrial tissues from the same uterus using single-cell RNA sequencing and comparison of distinct cell types in these tissues to identify disease-specific cell populations, abnormal gene expression and pathway activation, and mesenchymal-epithelial interactions.Result(s): The largest cell population in the endometrium was composed of closely clustered fibroblast groups, which comprise 36% of all cells and seem to originate from pericyte progenitors differentiating to estrogen/progesterone receptor-expressing endometrial stromal-cells. In contrast, the entire fibroblast population in adenomyosis comprised a larger (50%) portion of all cells and was not linked to any pericyte progenitors. Adenomyotic fibroblasts eventually differentiate into extracellular matrix protein-expressing fibroblasts and smooth muscle cells. Hierarchical clustering of mRNA expression revealed a unique adenomyotic fibroblast population that clustered transcriptomically with endometrial fibroblasts, suggestive of an endometrial stromal cell population serving as progenitors of adenomyosis. Four other adenomyotic fibroblast clusters with disease-specific transcriptomes were distinct from those of endometrial or myometrial fibroblasts. The mRNA levels of the natural WNT inhibitors, named, secreted frizzled-related proteins 1, 2, and 4, were higher in these 4 adenomyotic fibroblast clusters than in endometrial fibroblast clusters. Moreover, we found that multiple WNTs, which originate from fibroblasts and target ciliated and unciliated epithelial cells and endothelial cells, constitute a critical paracrine signaling network in adenomyotic tissue. Compared with endometrial tissue, unciliated and ciliated epithelial cells in adenomyosis comprised a significantly smaller portion of this tissue and exhibited molecular evidence of progesterone resistance and diminished regulation of estrogen signaling.Conclusion(s): We found a high degree of heterogeneity in fibroblast-like cells in the adenomyotic uterus. The WNT signaling involving differential expression of secreted frizzled-related proteins, which act as decoy receptors for WNTs, in adenomyotic fibroblasts may have a key role in the pathophysiology of this disease.
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    PublicationOpen Access
    Endometriosis and adenomyosis: shared pathophysiology
    (Elsevier Science Inc, 2023) Bulun, Serdar E.; Adli, Mazhar; Chakravarti, Debabrata; Parker, James Brandon; Milad, Magdy; Yang, Linda; Chaudhari, Angela; Tsai, Susan; Wei, Jian Jun; Yin, Ping; Yıldız, Şule; School of Medicine
    Endometriosis and adenomyosis are closely related disorders. Their pathophysiologies are extremely similar. Both tissues originate from the eutopically located intracavitary endometrium. Oligoclones of endometrial glandular epithelial cells with somatic mutations and attached stromal cells may give rise to endometriosis if they travel to peritoneal surfaces or the ovary via retrograde menstruation and/or may be entrapped in the myometrium to give rise to adenomyosis. In both instances, the endometrial cell populations possess survival and growth capabilities conferred by somatic epithelial mutations and epigenetic abnormalities in stromal cells. Activating mutations of KRAS are the most commonly found genetic variant in endometriotic epithelial cells, whereas the adenomyotic epithelial cells almost exclusively bear KRAS mutations. Epigenetic abnormalities in the stromal cells of endometriosis and adenomyosis are very similar and involve an abnormal expression pattern of nuclear receptors, including the steroid receptors. These epigenetic defects give rise to excessive local estrogen biosynthesis by aromatase and abnormal estrogen action via estrogen receptor-b. Deficient progesterone receptor expression results in progesterone resistance in both endometriosis and adenomyosis.
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    Publication
    Advancements in three-dimensional bioprinting for reproductive medicine: a systematic review
    (Elsevier Sci Ltd, 2024) Aydın, Serdar; Yaşlı, Mert; Yıldız, Şule; Urman, Cumhur Bülent; School of Medicine; Koç University Hospital
    Reproductive failure due to age, genetics and disease necessitates innovative solutions. While reproductive tissue transplantation has advanced, ongoing research seeks superior approaches. Biomaterials, bioengineering and additive manufacturing, such as three-dimensional (3D) bioprinting, are harnessed to restore reproductive function. 3D bioprinting uses materials, cells and growth factors to mimic natural tissues, proving popular for tissue engineering, notably in complex scaffold creation with cell distribution. The versatility which is brought to reproductive medicine by 3D bioprinting allows more accurate and on-site applicability to various problems that are encountered in the field. However, in the literature, there is a lack of studies encompassing the valuable applications of 3D bioprinting in reproductive medicine. This systematic review aims to improve understanding, and focuses on applications in several branches of reproductive medicine. Advancements span the restoration of untapped potential in reproductive medicine.
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    Publication
    Should the trigger to oocyte retrieval interval be different in progestin-primed ovarian stimulation cycles?
    (Reproductive BioMedicine Online, 2023) Ata, Mustafa Barış; Çakar, Aysu; Türkgeldi, Engin; Yıldız, Şule; Keleş, İpek; Kalafat, Erkan; School of Medicine; Koç University Hospital
    Research question: Does the trigger to oocyte retrieval interval (TORI) affect oocyte maturation rates differently in progestinprimed ovarian stimulation (PPOS) and gonadotrophin-releasing hormone (GnRH) antagonist cycles? Design: This was a retrospective cohort study. The interaction between the stimulation protocol and TORI was assessed in a linear mixed effects multivariable regression analysis with oocyte maturation rate as the dependent variable, and stimulation protocol (GnRH antagonist or PPOS), age (continuous), gonadotrophin type (FSH or human menopausal gonadotrophin), trigger (human chorionic gonadotrophin [HCG] or GnRH agonist), TORI (continuous) and days of stimulation (continuous) as the independent variables. Oocyte maturation rate was defined as number of metaphase II oocytes/number of cumulus oocyte complexes retrieved. The maturation rate was calculated per cycle and treated as a continuous variable. Results: A total of 473 GnRH antagonist and 205 PPOS cycles (121 conventional PPOS and 84 flexible PPOS) were analysed. The median (quartiles) female age was 36 (32 40) years. Of these cycles, 493 were triggered with HCG and 185 with a GnRH agonist. The TORIranged between 33.6 and 39.1 h, with a median (quartiles) of 36.2 (36 36.4) hours. Maturation rates were similar between fixed PPOS, flexible PPOS and antagonist cycles (median 80%, 75% and 75%, respectively, P=0.15). There was no significant interaction between the stimulation protocols and TORI for oocyte maturation. Conclusions: PPOS cycles do not seem to require a longer TORI than GnRH antagonist cycles.
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    Publication
    Can endometrial compaction predict live birth rates in assisted reproductive technology cycles? a systematic review and meta-analysis
    (Springer/Plenum Publishers, 2023) Türkgeldi, Engin; Yıldız, Şule; Kalafat, Erkan; Keleş, İpek; Ata, Mustafa Barış; Bozdağ, Gürkan; School of Medicine; Koç University Hospital
    Purpose: Endometrial compaction (EC) is defined as the difference in endometrial thickness from the end of the follicular phase to the day of embryo transfer (ET). We aimed to determine the role of EC in predicting assisted reproductive technology (ART) success by conducting a meta-analysis of studies reporting the association between EC and clinical outcomes of ART. Methods: MEDLINE via PubMed, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from the date of inception to May 19, 2023. The primary outcome was live birth rate (LBR) per ET. Secondary outcomes were live birth or ongoing pregnancy per ET, ongoing pregnancy per ET, clinical pregnancy per ET, and miscarriage per clinical pregnancy. Results:Fifteen studies were included. When data from all studies reporting live birth were pooled, overall LBR rates were comparable in cycles showing EC or not [RR = 0.97, 95%CI = 0.92 to 1.02;10 studies, 11,710 transfer cycles]. In a subgroup of studies that included euploid ET cycles, a similar LBR for patients with and without EC was noted [RR = 0.99, 95%CI = 0.86 to 1.13, 4 studies, 1172 cycles]. The miscarriage rate did not seem to be affected by the presence or absence of EC [RR = 1.06, 95%CI = 0.90 to 1.24;12 studies]. Conclusion: The predictive value of EC in determining LBR is limited, and assessment of EC may no longer be necessary, given these findings. Trial registration: PROSPERO CRD42023410389
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    Can endometrial compaction predict live birth/ongoing pregnancy rates in assisted reproductive technology cycles? A systematic review and meta-analysis
    (Oxford University Press, 2023)  ; Türkgeldi, Engin; Kalafat, Erkan; Yıldız, Şule; Keleş, İpek; Ata, Mustafa Barış; Bozdağ, Gürkan;  ; School of Medicine; Koç University Hospital
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    Effect of trigger-to-oocyte collection interval on collected oocyte count in progestin-primed ovarian stimulation (PPOS) and GnRH antagonist cycles
    (Elsevier, 2023) Çakar, Aysu; Yıldız, Şule; Türkgeldi, Engin; Keleş, İpek; Bozdağ, Gürkan; Kalafat, Erkan; Ata, Mustafa Barış; School of Medicine; Koç University Hospital
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    Utilization of the Bologna criteria: a promise unfulfilled? A review of published and unpublished/ongoing trials
    (Elsevier, 2018) Boza, Ayşen; N/A; Yıldız, Şule; Mısırlıoğlu, Selim; Yakın, Kayhan; Urman, Cumhur Bülent; Faculty Member; Doctor; Faculty Member; Faculty Member; School of Medicine; N/A; School of Medicine; School of Medicine; N/A; Koç University Hospital; N/A; N/A; 134205; N/A; 106822; 12147
    Objective: To study the use of the Bologna criteria (BC) for the definition of poor ovarian responders (POR) in clinical practice and research. Design: Systematic review of published and unpublished/ongoing trials between January 2012 and August 2017 on POR. Setting: Not applicable. Patient(s): Not applicable. Intervention(s): The databases were searched using the relevant medical subject headings including all subheadings. The search was limited to humans and English language. The references of the included studies were cross-searched for possibly missed articles. Only clinical trials providing an evidence level >= III were included. Case reports, review, letters, and hypothetical articles were excluded. Main Outcome Measure(s): Extracted studies were divided into two groups: studies in which the BC were used or not. Result(s): One hundred nine published clinical studies analyzing a total of 30,540 women and 112 unpublished/ongoing trials were identified. The BC were used to define POR in 56 (51%) of the published and 44 (39%) of the unpublished trials. The use of the BC gradually increased from 29% to 53% from 2012 to 2017. Asian researchers were more likely to use the BC compared with European and North American researchers (65%, 49%, and 23%, respectively). Neither the design of the study nor the impact factor of the publishing journal was correlated with the use of the BC. Conclusion(s): There is still reluctance to use the BC for the definition of POR, which makes it difficult to combine data from small studies and reach a meaningful conclusion. (C) 2017 by American Society for Reproductive Medicine.
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    Progestins vs gonadotropin releasing hormone analogues for pituitary suppression during ovarian stimulation for assisted reproductive technology, a systematic review and meta-analysis
    (Oxford Univ Press, 2020) Yıldız, Şule; Alexandru, Polexa; Çekiç, Sebile Güler; Türkgeldi, Engin; Ata, Mustafa Barış; Faculty Member; N/A; Doctor; Faculty Member; Faculty Member; Koç University Hospital; School of Medicine; N/A; N/A; School of Medicine; School of Medicine; 134205; N/A; N/A; 329649; 182910
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