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OBJECTIVE: Compression/thinning of the endometrial thickness with the effect of progesterone during the luteal phase of the menstrual cycle is defined as endometrial compaction. This study aimed to show the effect of changes in endometrial thickness in the luteal phase of intrauterine insemination cycles on pregnancy outcomes. STUDY DESIGN: Fifty-eight patients who were planned for intrauterine insemination were included in this prospective cohort study. The effect of the change between the patients' endometrial measurements on the day of trigger and the 7th day after intrauterine insemination on pregnancy outcomes were compared. Patients were divided into 3 groups according to endometrial thickness change. Those with an endometrial thickness change of less than 5% were called the no change group (n=18). The groups with endometrial thickness decreasing more than 5% (n=9) and increasing (n=31) formed the other two groups. In addition, the effect of luteal phase support on endometrial compaction was investigated. RESULTS: The highest pregnancy rate (55.6%) was observed in the group with more than 5% endometrial thinning. It was found to be 16.7% in the group without change and 19.4% in the group with an increased endometrial thickness (p=0.045). endometrial compaction and pregnancy rates were higher in the group given oral dydrogesterone for luteal support compared to those using vaginal micronized progesterone. CONCLUSION: Endometrial compaction increases clinical pregnancy in intrauterine insemination cycles. Further studies are necessary to confirm the results of this study.

This study aimed to evaluate the efficacy and adverse effects of dienogest for the treatment of endometriomas. Dienogest (2 mg/day) was administered to patients with endometrioma continuously through the 6-month study period. The patients were prospectively examined on the efficacy and side effects at baseline, at third months, and sixth months of the treatment. Twenty-four out of 30 patients were able to complete the study. The mean volume of the endometrioma decreased significantly from 112.63 ± 161.31 cm³ at baseline to 65.47 ± 95.69 cm³ at a 6-month follow-up (-41%) (

Amaç:Bu çalışmada letrozol ve gonadotropinlerin evre 1-2 endometriozisli infertilhastalarda ovülasyon indüksiyonu üzerine etkilerinin karşılaştırılmasıamaçlanmıştır.Gereçve yöntem: Prospektif randomize olarak dizayn edilençalışmaya tanısal laparoskopi yapılan ve histolojik olarak tanı konulan evre1-2 endometriozisli 20 hasta dahil edildi. Zamanlanmış cinsel ilişki ile devametmeyi planlayan hastalar, en az üç en fazla beş ovulasyon indüksiyonu döngüsüiçin letrozol (n=10) veya gonadotropinler (n=10) olmak üzere iki tedavi grubunaardışık olarak randomize edildi.Bulgular:Ovulasyon, letrozol grubunda %82,2 (37/45 siklus) ve gonadotropin grubunda%86,4 (32/37 siklus) oranlarında gerçekleşti. İki grup arasında ovulasyonoranları istatistiksel olarak benzerdi (p=0,590). hCG uygulamasınınyapıldığı gün gonadotropin grubunda toplam folikül sayısı anlamlı olarakyüksekti (2,33±0,71 ve 3,05±0,91, p, Purpose: This study aimed to compare theeffects of letrozole and gonadotropins for ovulation induction in infertilepatients with stage 1-2 endometriosis. Materials and methods: Twenty patients who underwentdiagnostic laparoscopy and histologically diagnosed stage 1-2 endometriosiswere included in this prospective randomized study. Patients whoplanned to continue with timed sexual intercourse were randomized into twotreatment groups including letrozole (n=10) or gonadotropins (n=10) for minimumthree and maximum five treatment cycles. Results: Ovulation occurred in 37/45cycles (82.2%) in the letrozole group and 32/37 cycles (86.4%) in thegonadotropin group, without statistically significant difference (p=0.590).Total number of follicles was significantly higher in gonadotropin group on theday of hCG administration (2.33±0.71 vs. 3.05±0.91, p

Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility. However, they sustained fertility at an advanced age.

Aim The aim of this study was to assess the results of conservative treatment of cervical ectopic pregnancy (CEP). Methods We retrospectively reviewed all cervical ectopic pregnancies diagnosed at the present department between January 2010 and July 2015. Patients with CEP who were treated with either systemic or intra-amniotic methotrexate (MTX) injection were included in the study. Results Ten CEP patients were identified. Median maternal age was 33 years (range, 23–40 years). Median gestational age at diagnosis was 47 days (range, 44–58 days). Before treatment, overall mean serum beta-human chorionic gonadotrophin (β-hCG) was 29 706.9 ± 19 695.2 mIU/mL. Mean gestational sac size was 29.0 ± 6.24 mm. Eight patients had viable fetuses with detected cardiac activity. Six patients were treated primarily with systemic MTX, and four were treated with local MTX injection. One patient in the systemic MTX injection group was switched to local MTX treatment due to severe oral ulceration and increasing β-hCG titers after the fourth dose. One patient in the local treatment group had severe hemorrhage 7 days after local MTX. Three of six women achieved spontaneous pregnancy and gave birth to term, healthy infants after treatment. Conclusion Conservative treatment of CEP with both systemic and local MTX is generally successful with regard to maternal morbidity and reproductive function, but these patients must be closely followed due to the small but real risk of late hemorrhage.

Objective Acne is not solely a cosmetic problem. The clinical importance of acne in the estimation of androgen excess disorders is controversial. Recently, the Amsterdam ESHRE/ASRM-sponsored third PCOS Consensus Workshop Group suggested that acne is not commonly associated with hyperandrogenemia and therefore should not be regarded as evidence of hyperandrogenemia. Our aim was to investigate whether acne is a sign of androgen excess disorder or not. Study design This is a cross sectional study that was performed in a university hospital involving 207 women, aged between 18 and 45 years, suffering mainly from acne. The women were assigned as polycystic ovary syndrome (PCOS), idiopathic hirsutism (IH), idiopathic hyperandrogenemia (IHA). Women with acne associated with any of the androgen excess disorders mentioned above were named as hyperandrogenemia associated acne (HAA). Women with acne but without hirsutism and hyperandrogenemia and having ovulatory cycles were named as “isolated acne”. Serum luteinizing hormone, follicle stimulating hormone, estradiol, progesterone, 17-hydroxyprogesterone, dehydroepiandrosterone-sulfate (DHEAS), androstenedione, total testosterone and lipid levels were measured. Results Acne score was similar between the women with isolated acne and HAA. The most common cause for acne was PCOS and only 28% of the women had isolated acne. 114 (55%) women had at least one raised serum androgen level. Conclusions In this study, 72% of acneic women had clinical and/or biochemical hyperandrogenemia. In contrast to the suggestion of ESHRE/ASRM-sponsored third PCOS Consensus Workshop Group, our data indicate that the presence of androgen excess disorders should be evaluated in women presenting with acne.

OBJECTIVE: To compare the result of intracytoplasmic sperm injection cycles using gonadotrophins with those of using gonadotrophins combined with letrozole in infertile woman with biopsy-proven endometriosis. STUDY DESIGN: This prospective randomized study was performed at the department of Obstetrics and Gynecology Reproductive Center, in Erciyes University. Thirty- three women undergoing intracytoplasmic sperm injection (ICSI) with gonadotropin or combination of gonadotropin with letrozole were accepted. The patients were grouped as: gonadotropin group (Group 1), and gonadotropin plus letrozole (Group 2). Total and clinical pregnancy ratios, length of cycles, and doses of gonadotropin used were compared. RESULTS: Total doses of gonadotrophins used in group 1, and group 2 were 2700 (1800- 3600) IU and 2100 (1575- 3475) IU, respectively. Total dose of gonadotropin used in group 2 was found to be lower than that of group one and this difference was statistically significant (p= 0.002). Stimulation times in group 1 and 2 were 10 (9- 12) day, and (7- 12) day, respectively, and the difference was statistically significant (p=0.048). Number of the retrieved oocytes were higher in group 2 than Group 1(p=0.027). There was no statistically significant difference between groups with regard to numbers of embryos, total and clinical pregnancy ratio. CONCLUSIONS: Letrozole has no effect on the results of ICSI success in infertile women with biopsy proven- endometriosis. However, it reduces the gonadotropin dose used, stimulation time and, cost of the therapy.

Objective To investigate whether there is any relation between oxidative stress and the antioxidant system in the development of polycystic ovary syndrome (PCOS) by measuring serum nitric oxide (NO) levels and xanthine oxidase (XO) activity (a generator of reactive oxygen species) and antioxidant status by measuring serum thiol levels and glutathione peroxidase (GSHPx) and paraoxonase 1 (PON1) activities. Design Prospective case-control study. Setting University hospital in Turkey. Sample Thirty women with polycystic ovary syndrome and 20 age- and sex-matched healthy control subjects were included. Methods Serum XO, PON1 and GSHPx activity and NO and thiol levels were determined by spectrophotometric methods. Main outcome measures Activity of serum XO, PON1 and GSH, as well as NO and thiol levels. Results Serum XO activities were higher in women with PCOS than in the control women (p 0.05). Serum PON1 activities were negatively correlated with serum XO activities and NO levels. Conclusion Increased oxidant XO activity and decreased lipid antioxidant PON1 activity, along with the observed negative correlation between these parameters, suggests that women with PCOS are under oxidative stress and that there is XO-mediated lipid peroxidation, which may be related to increased atherosclerosis seen in later life in such women.

This study was conducted to study poststerilization menstrual changes. For this purpose, 60 rats were divided into 2 groups. In the first group, rats underwent bilateral uterine horn ligation with Pomeroy method, and one ovary of each rat was excised and weighed. The other ligated ovary was left intact. In the second group, only unilateral oophorectomy was performed. Histopathological studies revealed the presence of primary, secondary, and tertiary follicles in the ovaries of all the rats at the beginning of the study. Such follicles were found in 20 of the 22 rats in the first group and 23 of the 26 rats in the second group at the end of the study. Poststerilization ovarian weight remained unchanged in both groups. There was no difference in terms of histologic examination between pre- and post-ligation. These findings suggest that tubal ligation in the rats performed using surgical method does not cause any alteration in the ovarian morphology.

Objective: To investigate the relationship between results of maternal thyroid function tests and endothelin levels in preeclamptic or eclamptic women. Methods: Thyroid hormones, TSH, and endothelin were measured in plasma or serum from 37 proteinuric, preeclamptic or eclamptic women and 20 normotensive, nonlaboring, pregnant women. Subjects were subdivided into four groups according to hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and birth weights of infants with respect to gestational age. Results: A significant decrease in concentrations of total thyroxine (T4) (13.76 ± 1.84 μg/dL versus 10.00 ± 1.48 μg/dL, P < .05), total triiodothyronine (T3) (180.58 ± 30.84 ng/dL versus 141.16 ± 27.31 ng/dL, P < .01), free T4 (1.45 ± 0.27 ng/dL versus 1.10 ± 0.21 ng/dL, P < .01) and free T3 (3.32 ± 0.56 pg/mL versus 2.41 ± 0.60 pg/mL, P < .01) and a significant increase in TSH (1.55 ± 0.89 μIU/mL versus 2.96 ± 1.07 μIU/mL, P < .05) and endothelin (2.31 ± 0.61 pg/mL versus 6.11 ± 1.41 pg/mL, P < .001) levels were observed in the preeclamptic-eclamptic group compared with the normotensive group. Also, women without HELLP syndrome and without small-for-gestational-age infants had elevated levels of thyroid hormones and decreased levels of TSH and endothelin compared with other subgroups, but stastical significance was reached only in total T4 (P < .05), TSH (P < .05), and endothelin (P < .001). Birth weights of infants born to preeclamptic or eclamptic women correlated positively with total T4 (P < .01) and total T3 (P < .01) and negatively with TSH (P < .01) levels. A more significant negative correlation was found in preeclamptic-eclamptics (P < .001) between birth weight and endothelin levels than in control subjects (P < .05). Endothelin levels in preeclamptic or eclamptic women correlated negatively with total T4 (P < .01), total T3 (P < .05), free T4 (P < .05), and free T3 (P < .05) and positively with TSH levels (P < .01) compared with control subjects. Conclusion: Moderate decreases in thyroid hormones with concomitant increases in TSH levels in maternal serum correlated with severity of preeclampsia or eclampsia and high levels of endothelin. Changes in results of thyroid function tests induced by preeclampsia or eclampsia might be consequences of the dysfunction in the hypothalamic-pituitary-thyroid axis, secondary to the disease itself.

The aim of the study was to determine, whether bladder weight changes in the menopause and whether there is any correlation between lower urinary tract symptoms and bladder weight or the duration of menopause. A total of 94 women (30 without gynecologic or obstetric complaints, 31 with menopause less than 5 years and 33 menopause of 5 years or longer) were entered into the study. Bladder weights were determined ultrasonographically. The International Prostate Symptom Score questionnaire was used to evaluate lower urinary tract symptoms. A negative correlation was found between bladder weight and the duration of menopause. There was no significant difference between the three groups in terms of overall symptom scores. However, urgency incontinence score was the highest in the early postmenopausal period. In addition, the postmenopausal women had a significant negative correlation between the duration of menopause and frequent voiding scores. It was concluded that, ultrasonographically measured bladder weight decreases with the duration of menopause. Detailed studies with larger numbers of older women are needed to determine clearly whether this decrease in bladder weight has more significant effects on lower urinary tract symptoms.

Although estrogen replacement therapy (ERT) is known to be protective against the development of cardiovascular disease in patients with surgical menopause, the effects of ERT on blood lipids when started late after the operation is not yet clear. In this prospective study, blood lipid and lipoprotein levels were measured within a 2 year period, in Group I (n = 28 patients) and in Group II (n = 21 patients), who had total abdominal hysterectomy and bilateral salphingo-oophorectomy 10-16 or 55-65 months ago, respectively. Each patient received 0.625 mg conjugated equine estrogen once daily. Blood levels of total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and very low density lipoprotein (VLDL) were measured at the beginning of the study as well as 12 and 24 months after ERT, was commenced. When the levels obtained after 12 and 24 months of ERT were compared to the baseline levels, LDL levels were decreased, whereas HDL levels were increased in Group I (p0.05); however, only the TC levels were significantly lower in Group II (p0.05). In conclusion, our results show that ERT is more effective on blood lipid changes when initiated within one year of oophorectomy compared with ERT initiated 5 years after the menopause.

A 28-year-old woman in whom a copper-T 280-A intra-uterine device (IUD) had been placed 6 months previously, presented complaining of urinary system infection and lower abdominal pain. Intra-vesical migration of IUD was confirmed by radiography and cystoscopy. Since 1966, 17 other cases of calculus formation among 41 cases of intra-vesical migration have been reported. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.

The objective of the study was to compare intracytoplasmic sperm injection (ICSI) outcome and gonadotropin doses between obese women with PCOS and non-obese patients with PCOS. This follow-up study represents ICSI outcomes in obese women with PCOS (BMI ≥ 30 kg/m(2)) compared with non-obese women with PCOS (BMI 30 kg/m(2)). Obese (n = 18) and non-obese (n = 26) women with PCOS underwent long protocol pituitary suppression, ovarian stimulation and ICSI with fresh embryo transfer. Obese patients with PCOS required higher doses of gonadotropin (2994 IU vs 1719 IU; p 0.001). Miscarriage rate was significantly higher in obese women compared with the non-obese women with PCOS (60% vs 6.7%, p = 0.002). Our results are valuable for counselling couples before initiation of assisted reproduction techniques (ART).

Summary Objective There are conflicting data regarding the effects of metformin in lean women with polycystic ovary syndrome (PCOS). Thus, our aim was to evaluate the effects of 6 months of metformin therapy on various metabolic and cardiovascular risk factors in lean women with PCOS. Design This was a prospective clinical study performed in a University hospital. Patients Twenty nonobese PCOS women and 20 age- and BMI-matched healthy women were included in the study. Metformin (2550 mg/day) was administered for 6 months in women with PCOS. The hormonal and metabolic parameters were evaluated before and after metformin treatment. Measurements The main outcome measures were serum androgens, FSH, LH, oestradiol, 17-hydroxyprogesterone, glucose, insulin, lipid profile, lipoprotein(a) [Lp(a)] and homocysteine levels. In addition 24-h ambulatory blood pressure monitoring (ABPM) and carotid intima-media thickness (IMT) were taken. Results After 6 months of metformin therapy, women with PCOS had decreased LH, total testosterone, free androgen index and slightly increased SHBG levels. Metformin treatment resulted in resumption of regular menses in 12 (60%) patients, and in 8 (40%) of them serum progesterone level was compatible with ovulation. Glucose and insulin responses to oral glucose tolerance test (OGTT) and homeostasis model assessment of insulin resistance (HOMA-IR) did not improve after the metformin therapy. There were no significant changes in terms of cardiovascular risk factors such as lipids and homocysteine, IMT and ABPM. Conclusion Metformin may have beneficial effects in lean PCOS women in terms of resumption of menses without any remarkable effect on metabolic and cardiovascular risk factors.

Objective To compare the effectiveness of oral and vaginal misoprostol for preoperative cervical ripening in premenopausal women before hysteroscopic surgery. Design Placebo-controlled, double blind, randomized trial. Setting University hospital. Patient(s) Eighty-six premenopausal women eligible for operative hysteroscopy were recruited. Nine women were excluded from the study. Intervention(s) Patients were randomly assigned to receive 400 μg of misoprostol orally (n = 39) or vaginally (n = 38), 10–12 hours before operative hysteroscopy. Main Outcome Measure(s) Extent of initial cervical width, percentage of patients requiring cervical dilatation, duration of cervical dilatation and surgical procedure, complications during procedure, and associated side effects. Result(s) Mean cervical widths in the vaginal and oral misoprostol groups after treatment were 7.3 ± 1.6 mm and 6.0 ± 1.5 mm, respectively, which was a statistically significant difference. Time required for cervical dilatation (98.6 ± 88.7 s vs. 49.1 ± 34.9 s) and duration of surgery (14.5 ± 6 vs. 7.7 ± 4.0 min) was statistically significantly shorter in the vaginal misoprostol group. The percentage of women with an initial cervical width of 9 mm was statistically significantly higher in the vaginal misoprostol group (36.8% vs. 5.1%). Uterine perforation occurred in two patients in the oral misoprostol group and in none in the vaginal misoprostol group. Side effects were comparable between the two treatment groups. Conclusion(s) Vaginal administration of misoprostol is more effective than the oral route for preoperative cervical ripening in premenopausal women.

Vulvovaginal candidiasis is one of the most frequent infections of the female genital tract with a high incidence. Although numerous antimycotical agents are available for treatment of yeast vaginitis, there are few comparative data on the in vivo and in vitro activity of these drugs. The aim of this open, randomized, and comparative study was to determine in vivo and in vitro effectiveness of the 3 systemic antifungal agents: terbinafine and 2 azoles (itraconazole and fluconazole) in the treatment of patients with Vulvovaginal candidiasis. A total of 44 patients who had signs and symptoms of Vulvovaginal candidiasis were recruited for the study. Patients were randomly assigned to 3 groups: terbinafine 500 mg/d orally was used for 7 days, itraconazole 200 mg/d orally was used for 7 days, and fluconazole 150 mg orally was used as a single dose. Both clinical and mycologic examinations were performed for posttreatment assessment at week 4. This study revealed a clinical cure rate 33.3% for terbinafine, 60% for itraconazole, and 66.6% for fluconazole (P0.05). Mycologic cure rates were 33.3%, 10%, and 66.6% respectively (P0.05). Overall cure rates were 33.3%, 10%, and 53.3% (P0.05). Terbinafine could be an alternative treatment option in Vulvovaginal candidiasis because there were no significant differences in the clinical and overall cure rates among 3 antifungal agents. However, terbinafine could not be suggested as a first-line treatment in Vulvovaginal candidiasis. Systemic use of terbinafine in larger numbers of cases may give more information about the effectiveness of this drug in the treatment of patients with vulvovaginal candidiasis.

This study aimed to determine whether the preliminary factor for the manifestation of lower urinary tract symptoms (LUTS) in perimenopausal women is age-dependent morphological changes in the bladder or hypoestrogenism. The bladder weights and the effects of bladder weight changes on LUTS were evaluated in three groups of women within and age range of 50-55 years: premenopausal ( n =29), short-term menopausal (less than 5 years) ( n =38) and long-term menopausal (5 years and more) ( n =31). The comparison of LUTS among the groups was made using the International Prostate Symptom Score (IPSS) questionnaire; the ultrasonographically determined bladder weights of all the women and the duration of menopause were evaluated for the presence of any correlation for their ages. The relation between the bladder weights and the symptom scores was also tested. The bladder weight of women with longer duration of menopause was found to be significantly decreased compared with that of women with shorter-duration menopause within the same age group ( p 0.05 for each). The symptom scores had no correlation with the bladder weights or the ages of patients ( p >0.05 for each). In this age group of women the duration of hypoestrogenism does not seem to cause a difference in the symptom scores. To observe a possible significant difference, it is necessary to evaluate older women or women with a longer duration of hypoestrogenism. These findings suggest the cause for the decreased bladder weight to be the higher duration of hypoestrogenism rather than the older age.

Objective(s): To evaluate the effects of metformin on insulin resistance, ovarian androgen production, and clomiphene-induced ovulation and pregnancy rates in infertile women with polycystic ovary syndrome (PCOS). Study design: Twenty-one infertile women with PCOS were selected in this prospective randomized clinical study. Basal steroid and gonadotropin levels were measured, and oral glucose tolerance test (OGTT) was performed. The patients were divided randomly into group 1 (n = 11) and group 2 (n = 10). Group 1 patients were treated with 1700 mg per day of metformin for 3 months. The basal tests and OGTT were repeated after metformin therapy. Group 2 patients did not receive metformin. The patients in both groups received 100 mg of clomiphene citrate (CC) daily for 5 days until either a pregnancy occurred, or six CC cycles were reached. Metformin administration continued during CC therapy until the day of hCG in group 1. Serum progesterone (P) level greater than or equal to5 ng/ml was considered as confirmatory of ovulation. Ovulation and pregnancy rates after six cycles were determined. Results: Serum androgens and insulin response to OGTT decreased significantly after metformin therapy. Midluteal serum P level was significantly higher in cycles treated with metformin plus CC (P < 0.05). The ovulation (38 of 51 cycles, 74.4% versus 34 of 55 cycles, 61.8%) and pregnancy rates (5 of 11 women, 45.5% versus 3 of 10 women, 30%) were higher, but not significantly, in the metformin plus CC group than in the CC alone group. All the patients who conceived had insulin resistance in group 1 whereas non-insulin resistance in group 2. Conclusion(s): Metformin improves insulin resistance and reduces androgen levels. Metformin did not increase significantly the ovulation and pregnancy rates. (C) 2003 Elsevier Ireland Ltd. All rights reserved.

Objective: To determine the long-term effects of estrogen replacement therapy on sex hormone binding globuline (SHBG) and free testosterone (fT) levels in surgical postmenopausal women. Study Design: Forty patients with surgical menopause were enrolled in this prospective study. The women were randomly divided into two groups. The first group received oral therapy (continuous conjugated equine estrogens (CEE) - 0.625 mg per day) and the second group received transdermal therapy (patches delivering continuous 17 beta -estradiol (E2) - 0.05 mg per day). Serum SHBG and fT levels were determined at baseline and after first and second years of treatment. Two-way repeated measures analysis of variance with Bonferroni adjusted post-hoc test and unpaired-t-test were performed for statistical analysis with SPSS program. Results: Serum SHBG levels increased significantly with oral CEE after first year of treatment (P < 0.05) and remained at this level for the next year. Transdermal therapy did not affect SHBG levels after first and second years (P < 0.05). Serum fT levels did not change significantly in either group at the end of the first or second years (P < 0.05) although there was a significant difference between the groups after 2 years (P < 0.05). Conclusion: Oral conjugated estrogens increased SHBG levels during therapy. This effect may balance the increased estrogen and androgen stimulation on breast tissue and may be more beneficial to the cardiovascular system in postmenopausal women. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

The purpose of our study was to compare the effects of cyclical versus continuous transdermal oestrogen replacement therapy on lipoprotein (a) (Lp(a)) and nitric oxide levels. The patients were randomly assigned into two groups. The first group received transdermal 17-beta oestradiol 50 mug/day for 21 days and the second group the same treatment on a continuous basis. Medroxyprogesterone acetate (10 mg/day orally) was added between the 14th and 25th days to each group. Lipoprotein (a) and nitric oxide levels were measured before the study and after six months. These values were compared using the Wilcoxon rank test within the groups and the unpaired t-test between the groups. Lipoprotein (a) levels decreased significantly in each group at the sixth month (p < 0.05). When compared between the groups, the decrease of lipoprotein (a) levels in the second group was more prominent at the sixth month (p < 0.05). Nitric oxide levels increased in each group after six months (p < 0.05). No difference in nitric oxide levels was observed between the groups before and after the therapy (p > 0,05). Continuous transdermal estradiol had a better effect on lipoprotein (a) levels than cyclical therapy The seven day pause in the 21-day administration did not affect nitric oxide levels negatively after six months.

The purpose of our study was to make a contribution to research in determining the least harmful progestogen dose for women who have not had their uterus removed. The study was an open comparative trial. The patients were consecutively assigned to two groups. The first group (n = 19) were given 0.625-mg conjugated equine estrogen plus 5-mg medroxyprogesterone acetate (MPA), and the second (n = 18) 0.625-mg conjugated equine estrogen plus 2.5-mg MPA. Serum total cholesterol (T-cholesterol), triglyceride, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels plus LDL-C/HDL-C values (atherogenic index) were measured before the study and again after 6 and 12 months. These values were compared with ANOVA and postANOVA tests (Scheffe) within the groups and with unpaired t-test between the two groups. The triglyceride serum levels in the first group were decreased in the 12th month compared to baseline levels. In addition, LDL-C/HDL-C values were significantly decreased in the 6th month, but these values slightly increased in the following 6 months. In the second group, T-cholesterol, triglyceride, LDL-C and atherogenic index were decreased in the 12th month when compared to baseline levels within the groups. This decrease was statistically significant (p0.05). There was no significant difference between the two groups (p0.05). Hormone replacement therapy with continuous 0.625-mg conjugated equine estrogen and 2.5-mg MPA had a better effect on lipid profiles than 0.625-mg conjugated equine estrogens and 5-mg MPA after 12 months of treatment.

Objective: To determine the effectiveness of hyaluronic acid (HA) and heparin [unfractioned heparin (UH) or low molecular weight heparin (LMWH)] combination in reducing adhesion formation in a rat uterine horn model. Study Design: Prospective, randomized, comparative study in a rat model was done in Surgical Research Laboratory, Erciyes University. A standard lesion was created by unipolar electrocautery in 120 uterine horns of total 60 female Wistar-Albino rats. Animals were then randomly assigned into four groups, each consisting of 15 animals: (1) control, no adjuvant given, (2) HA, 1 mi of 0.4% solution given onto each horn preoperatively; (3) HA, 1 ml of 0.4% solution given preoperatively plus 1 mi of UH given postoperatively; (4) HA, 1 mi of 0.4% solution given before injury plus 1 ml of LMWH given after injury. A second-look laparotomy was performed two weeks after surgery. The number of horns with adhesion was determined and a scoring system applied. Result(s): The number of horns without adhesion formation was significantly higher in HA plus UH (P

Objective: To compare the effects of continuous noncombined transdermal estradiol versus oral conjugated estrogen on serum sex hormone-binding globulin (SHBG) levels prior to and during the 10th and 22nd weeks of therapy in patients with surgical menopause. Study design: Open, comparative trial. Patients were consecutively assigned to three groups: group 1 (n=18) received continuous transdermal estradiol (0.050 mg/day), group 2 (n=18) continuous oral conjugated estrogens (0.625 mg/day), whereas group 3 (n=15) received no treatment. Serum SHBG levels were determined before treatment and after 10 and 22 weeks of treatment. Results: Serum SHBG increased significantly with oral conjugated estrogens at 10 (p0.05). Conclusion: Transdermal estrogen has no effect on SHBG, whereas oral conjugated estrogens causes a considerable increase. (C) 1997 Elsevier Science Ireland Ltd.

Hydatid cyst is a parasitic disease caused by Echinococcus. Although the first and most important site for this parasite is the liver, it can be seen in pelvic organs as well. However, primary involvement is very rare. We report and discuss a case with a primary involvement of the uterus which was operated and confirmed by microscopic studies. In conclusion, the gynecologist should be aware of the possibility of hydatid cyst when a septated cystic mass is found in the pelvis.