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Background: As BMP15, GDF9, and kisspeptin all play critical roles in folliculogenesis and fertilization, investigating the possible relationship between obesity and these three factors could prove crucial in relation to understanding the role of obesity in infertility. Thus, the present study sought to determine the effects of obesity on the serum BMP15, GDF9, and kisspeptin concentrations in women of reproductive age. Methods: Ninety female participants were equally divided into three groups: class-1 obese (n=30), class-2 obese (n=30), and normal weight (control; n=30). The participants' serum BMP15, GDF9, and AMH concentrations were measured. Moreover, the serum kisspeptin concentrations were evaluated in the class-1 obese and control groups by means of the enzyme-linked immunosorbent assay (ELISA) method while the participants were in their menstrual period. Results: The serum BMP15 and kisspeptin concentrations were found to be much higher in the control group than in both obese groups (p=0.001 and p=0.01, respectively). While the GDF9 concentration exhibited a statistically significant positive correlation with age, the BMP15 concentration exhibited a positive correlation with the kisspeptin and LH concentrations in the control group. In addition, a positive correlation was identified between the BMP15 concentration and both age and the glucose level and a negative correlation with the insulin level in both the obese groups. Conclusions: Obesity appears to reduce the serum BMP15 and kisspeptin concentrations in obese women of reproductive age. This reduction may represent a milestone in reproductive dysfunction and may be used to predict the success of infertility treatment in obese women.

Background: Milk fat globule-epidermal growth factor 8 (MFG-E8) is expressed in the endometrial epithelium and its expression increases during the implantation process. Due to this knowledge, we aimed to investigate the maternal serum MFG-E8 levels on both healthy pregnant women in the first trimester and pregnant women complicated with missed abortion and threatened abortion in the first trimester., Methods: This prospective, cross-sectional study was conducted in a tertiary referral hospital, department of obstetrics between July 2020 and February 2021 after ethical committee approval. The study population was consisted of 30 healthy pregnant women (HP) in the first trimester, 30 pregnant women suffering from threatened abortion (TA) in the first trimester and 30 pregnant women suffering from missed abortion (MA) in the first trimester. Maternal serum MFG-E8 levels were analyzed with enzyme linked immunosorbent assay. Delivery and neonatal outcomes of the study population was evaluated. The continuous variables were compared among three groups with variance analysis with post hoc tests. The categorical variables were compared with chi-square and Fisher's exact tests where applicable., Results: The mean age of the study population was 29.36 ± 5.31 years. There was no significant difference among three groups for parameters of age, body mass index, parity number, and gestational week. Despite being within normal ranges, the mean neutrophil and international normalized ratio values of the three groups showed statistically significant difference (p < 0.05). The mean maternal serum MFG-E8 levels of MA, TA, and HP groups were 270 ± 152.3, 414.7 ± 236.7, and 474 ± 222.5 ng/mL, respectively (p = 0.001). It was found that mean of MFG-E8 of the MA group was statistically significantly lower than those of the other two groups (p < 0.05)., Discussion: Although maternal serum MFG-E8 level seems to be a parameter that differ between live and nonlive pregnancies, studies with large number of cases are needed to discuss our results and to determine a cut-off value for prediction.

Objective : Ovarian hyperstimulation syndrome is an iatrogenic condition that occurs in the treatment of infertility. There is no specific treatment available for OHSS. Cabergoline is a dopamine receptor 2 agonist and VEGF-VEGF2 receptor antagonist . Recently, cabergoline has been widely used to prevent the development of OHSS and reduce its severity Serotonin is known as a neurotransmitter and thought to have a role in the mechanism of angiogenesis and in signaling in endothelial cells. Serotonin is said to have similar effects to VEGF . Ondansetron is Selective Serotonin (5-HT3) Receptor Antagonist . It works by blocking the action of serotonin, a natural substance that may cause nausea and vomiting. In the clinical practice today, there is no choice other than cabergoline, to prevent occurrence and reduce severity of OHSS, and sometimes its effects are limited. Methods : In our study, we compared the effect of cabergoline and ondansetron. 32 immature rats were used and the OHSS model was created. Parameters such as hematocrit value , ovarian size, the number of follicles in the ovary, endometrial capillary congestion and thickness values were evaluated and compared. Results : As a result, in our study, it was seen that ondansetron was effective on OHSS in many parameters. It is thought to be as effective as cabergoline. When we look at the literature, this is the first study in which ondansetron was evaluated for this purpose. It would be good to show this effect of ondansetron with other studies.

Introduction: The etiopathogenesis of HG is still unclear., Aim: The aim of this study was to investigate the levels of YKL-40 protein as an inflammatory marker and evaluate the levels of IMA as an oxidative marker in hyperemesis gravidarum women., Materials and Methods: Totally 35 patients with hyperemesis gravidarum and 35 healthy pregnants were included in the study. Singleton pregnancies between 6+0 week and 13+6 weeks of gestation, with normal fetal anatomy were included in the study. Complete blood count, complete urine analyze, biochemical tests and thyroid function tests were done., Results: There was no significant difference between groups for demographical features (age, gravidity, gestational age, body mass index). Also, there was no statistically significant difference between groups for IMA levels (p>0.05). The median level of YKL-40 was higher in pregnants with hyperemesis gravidarum than normal pregnants but the difference was not statistically significance (p>0.05)., Conclusion: Further comprehensive studies with more number of patients are needed to show the efficacy of YKL-40 and IMA levels for predicting hyperemesis gravidarum and even monitoring of the treatment.

Purpose: To determine the shear bond strength (SBS) between zirconium framework and resin cements after different surface conditioner methods and after application of 10-methacryloyloxydecyl dihydrogen phosphate (MDP) based silane and a bonding agent mix., Materials and Methods: 128 disc-shaped zirconium-oxide specimens were prepared. Specimens were placed in autopolymerizing acrylic resin. The bonding surface of specimens was smoothed consecutively with 600-, 800-, and 1200-grit silicon carbide papers under water cooling. Eight groups were prepared: CJ, Co-Jet; N, Nd-YAG laser; E, Er-YAG laser; NS, Nd-YAG laser + silane; ES, Er-YAG laser + silane; CJB, Co-Jet + bonding agent; NSB, Nd-YAG laser + silane + bonding agent; ESB, Er-YAG laser + silane + bonding agent. SEM analysis was performed under 2000× magnification. Dual- and self-cured resin cements were bonded to specimens, and shear force was applied. Data were analyzed with one-way ANOVA and Tukey's multiple comparison test (p < 0.05)., Results: The SBS values differed from each other among the groups. While the CJB group showed the highest values, the N group showed the lowest. The treatment with MDP-based silane and bonding agent mix increased SBS values of each cement belonging to each group. SB values of dual-cure resin cement were higher than those of self-cure resin cements., Conclusion: Different surface conditioner methods exhibit an important effect on the SBS of resin cements to zirconium. The application of MDP-based silane and bonding agent mix enhanced SB values., (© 2017 by the American College of Prosthodontists.)

Aim: We examined body mass index (BMI) and gestational weight gain (GWG) patterns of pregnant women and investigated the impact of these factors on the urinary albumin-creatinine ratio (ACR) during pregnancy., Methods: The data of 163 women whose basal BMI and ACR were measured during the first trimester were used in this study. Body weight alone between 12-16 weeks and body weight together with ACR after 37 weeks of gestation were measured., Results: Overall, 46% of women were overweight or obese, 60.7% had excessive weight gain and 16.6% had inadequate weight gain. Only 22.7% of women gained weight within the recommended range. There was no difference in weight gain patterns with respect to BMI. ACR during the third trimester was significantly higher than during the first trimester (7.08 [0.00-1180.90] mg/g vs 4.73 [0.00-275.00] mg/g, respectively; P = 0.001). The ACR of obese women was higher than in normal weight subjects during the third trimester (16.79 mg/g [0.01-1180.90] vs 8.07 mg/g [0.10-402.14] respectively; adjusted P = 0.015). Both ACR change and third trimester ACR were weakly but significantly correlated with basal BMI (r: 0.228 P: 0.003 and r: 0.301 P < 0.001, respectively) but not with GWG or GWG rate. Basal BMI was not associated with first-trimester ACR., Conclusion: Obesity is associated with an increase in urinary albumin excretion during the course of pregnancy. Distinction of this relationship during pregnancy offers an opportunity for further research on pathophysiological mechanisms. The alarmingly high rate of non-compliance with IOM guidelines in pregnant women is a concern. Prompt measures for counseling of women before and during pregnancy in order to maintain healthy weight are needed., (© 2017 Japan Society of Obstetrics and Gynecology.)

Objective: To evaluate serum total and lipid bound sialic acid (TSA&LBSA) levels in patients with polycystic ovary syndrome (PCOS)., Material and Methods: Forty women with PCOS and 35 healthy controls were enrolled in the study. Serum TSA, LBSA, follicle stimulating hormone, lutenizing hormone, estradiol, thyroid stimulating hormone, prolactin, dehydroepiandrosterone sulphate, androstenedione, free testosterone, total testosterone, 17-OH progesterone, sex hormone binding globulin, cortisol, total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein were measured in each subject. Insulin resistance was estimated by fasting insulin level, fasting glucose: insulin ratio and 75-g glucose tolerance test for 2 hours., Results: Serum TSA levels were not significantly different between the groups. Serum LBSA levels were higher in patients with PCOS compared to the control group. TSA was correlated with androstenedione and HOMA-IR in the PCOS group. Positive correlations were found between LBSA and dehydroepiandrosterone sulphate in patients with PCOS. After correction for BMI, the only existing significant correlation was between LBSA and follicle stimulating hormone., Conclusion: Serum LBSA levels, which has previously been found to be higher in cardiovascular diseases and diabetes mellitus, are elevated in PCOS.

Objective: The aim of the study was to evaluate plasma apelin levels in patients with polycystic ovary syndrome (PCOS) and healthy controls., Material and Methods: Plasma apelin levels, serum lipid levels, serum hormone levels, and homeostasis model assessment-insulin resistance (HOMA-IR) values of 32 patients with PCOS and 31 healthy women forming the control group were checked., Results: Plasma apelin levels of the PCOS group (0.350±0.083 ng/ml) were significantly higher than those of the control group (0.246±0.045 ng/ml) (p<0.001). No significant correlation was detected between apelin levels and biochemical or clinical data in PCOS group., Conclusion: Plasma apelin levels were significantly higher in PCOS patients.

Objective: To evaluate short-term leptin and ghrelin concentrations in women with polycystic ovary syndrome (PCOS) who use low-dose oral contraceptives containing drospirenone., Design: Prospective study., Setting: Department of obstetrics and gynaecology in a university hospital., Patient(s): Twenty women with PCOS were enrolled in the study., Intervention(s): A low-dose oral contraceptive containing ethinyl estradiol and drospirenone was given for three cycles., Main Outcome Measure(s): Serum androstenedione, free T, T, dehydroepiandrosterone sulphate, sex hormone-binding globulin, FSH, LH, E(2), lipid profiles, leptin, and ghrelin levels were measured in each subject. Insulin resistance was estimated by the homeostasis model assessment-insulin resistance (HOMA-IR)., Result(s): While leptin concentrations did not change with therapy, ghrelin levels increased statistically. Baseline leptin concentrations were correlated positively with body mass index, waist-to-hip ratio, insulin, and HOMA-IR and negatively with ghrelin. After controlling for body mass index and waist-to-hip ratio in a partial correlation analysis, leptin levels were not correlated with these parameters. Ghrelin was inversely correlated with body mass index, waist-to-hip ratio, insulin, HOMA-IR, and free T., Conclusion(s): In patients with PCOS, an oral contraceptive containing ethinyl estradiol and drospirenone increases ghrelin levels but not leptin levels in a 3-month period. Ghrelin might be related to the metabolic and androgenic changes in patients with PCOS.

Analgesic techniques after c-section must be effective producing early mobilisation to enable mothers to care effort their babies. In this study, the comparison of ropivacaine 0.2% alone, with ropivacaine 0.2%+sufentanil 0.75 microg mL-1 for patient controlled epidural analgesia (PCEA) was aimed. Fifty women (ASA-I) were enrolled in the study. All patients had combined spinal-epidural anaesthesia. Infusion of analgesic solutions was started when sensory level decreased by two dermatome levels. The patients randomly assigned, into two groups (n=25). In Group-I, ropivacaine 0.2% and sufentanil 0.75 microg mL-1, in Group-II, ropivacaine 0.2% alone were applied (bolus 1.25 mL, lockout 30 min, with 2.5 mL h-1 background infusion). Pain (Visual Analog Scale), motor blockage (Bromage scale) and sedation (Four point scale) were evaluated during 24 hours after Caesarean, using the scales of visual analogue, bromage, and four-point, respectively. Haemodynamic and respiratory parameters, side effects, total drug consumption and additional analgesic need, were recorded. Statistical analysis included student-t, chi-square, and Mann Whitney U tests. There was no difference in demographic data, sedation scores, haemodynamic and respiratory parameters, between the groups. Motor block and pain scores were significantly higher in Group-II than in Group-I at 2 and 4. h. Total drug consumption was 65.24+/-4.20 mL for Group-I and 81.1+/-6.44 mL for Group-II, (P<0.05). Four patients in Group-I and 21 patients in Group-II received additional analgesic. Pruritus was observed more frequently in Group-I. The addition of sufentanil 0.75 microg mL-1 to ropivacaine 0.2% for PCEA after Caesarean led to more effective analgesia and less motor weakness when compared to ropivacaine 0.2% alone, especially during early postoperative period.

Objective: To investigate the effects of hormone therapy, estrogen therapy and tibolone on markers of apoptosis including bcl-2, and bax and cyclin D(1) expression in postmenopausal vaginal epithelium., Study Design: Thirty postmenopausal women were randomized to the treatment protocols (0.625 mg conjugated equine estrogen (CEE) + 2.5 mg medroxyprogesterone acetate (MPA); 2mg estradiol valerate; 2.5mg tibolone). After baseline vaginal biopsy, control biopsies were performed after 70 days following the initiation of the therapy. Bcl-2, bax, Bcl-2/bax ratio, cyclin D(1) measurements were performed immunohistochemically. Data were analyzed by Kruskal-Wallis, Mann-Whitney U and Wilcoxon tests., Results: After the treatment period the above-mentioned parameters were not different among the groups except for cyclin D(1) levels. Cyclin D(1) expression was found to be strong in patients with treated estradiol valerate., Conclusions: The effects of estrogen on cyclin D(1) expression were not detected with tibolone or with the addition of progesterone to estrogen in the vaginal epithelium. Cyclin D(1) appeared to have stronger effects on the estrogen related proliferation compared to apoptotic markers in vaginal epithelial cells.

Background/aims: Neopterin is a biochemical marker of activated cell-mediated immune response which increases in pathological conditions associated with cellular immune activation as well as in pregnancy where cellular immune response is predominant. The aim of this study was to determine the urinary neopterin level in each trimester of pregnancy and to determine if it can be used as a marker., Methods: 104 healthy pregnant women (mean age 22.10 +/- 4.39 years; 36 in the first, 30 in the second and 38 in the third trimester) and 16 non-pregnant healthy women (mean age 20.94 +/- 4.48 year) were included., Results: The mean urinary neopterin concentration of all pregnant women was higher than that of non-pregnant women (166.4 +/- 31.7 and 103.1 +/- 27.5 micromol/mol creatinine respectively, p < 0.01). The mean urinary neopterin levels in each trimester and non-pregnant women were 139.8 +/- 49.6, 131 +/- 40.2, 227.9 +/- 86.5 and 103.1 +/- 27.5 micromol/mol creatinine, respectively. Urinary neopterin levels were not significantly different between non-pregnant, first and second trimester groups, but were significantly higher in the third trimester than each of these groups (p < 0.05, p < 0.01 and p < 0.01 respectively)., Conclusion: Urinary neopterin levels increase significantly in the third trimester probably due to more predominated cellular immunity. The pathologies causing cellular immune activation, especially in the first two trimesters can be predicted with urinary neopterin levels., (Copyright (c) 2005 S. Karger AG, Basel.)

Objective: The aim of this study was to determine the effect of treatment on endotelin-1 concentration that is considered to have role in etiopathogenesis of eclampsia and preeclampsia., Methods: Nine patients with eclampsia and 12 patients with preeclampsia were included to the study. Endothelin-1 levels were measured before and after magnesium sulfate treatment. After the magnesium sulfate administration, if the blood pressure was still elevated, nifedipine was given., Results: Endothelin-1 levels of preeclamptic patients before and after magnesium sulfate treatment were 16.9 +/- 2.3 fmol/ml and 14.6 +/- 1.9 fmol/ml respectively (p < 0.05). The same measurements of eclamptic patients were 18.1 +/- 3.2 and 14.7 +/- 3.4 respectively (p < 0.05). The mean blood pressures of preeclamptic patients before and after magnesium sulfate were 125.8 +/- 7.3 mm-Hg, 118.2 +/- 8.7 mm-Hg respectively, and the same measurements of eclamptic patients were 136.0 +/- 12.4 mm-Hg and 123.1 +/- 10.6 mm-Hg respectively (p < 0.05, p < 0.05)., Conclusion: Treatment had been found to have negative effects on endothelin-1 levels that is considered to play an important role on etiopathogenesis of eclampsia and preeclampsia.

Background: In this prospective controlled study, the aim was to examine the effects of vitamin C, mannitol and verapamil on adnexial ischaemia-reperfusion injury in the rat ovary., Methods: Thirty-six female Wistar rats were used. In the controls (group 1), only laparotomy was performed. In group 2, ovarian ischaemia was produced and the bilateral ovaries were surgically removed 4 h later. In group 3, an ischaemic period of 4 h was followed by reperfusion for 1 h; the bilateral ovaries were then removed. In groups 4, 5 and 6, after 4 h of ischaemia, either vitamin C, mannitol or verapamil respectively was infused before reperfusion; after 1 h of reperfusion the ovaries were removed. Thiobarbituric acid reactive substance (TBARS) levels were measured in all ovary tissues., Results: TBARS levels of the reperfusion group were significantly higher than those of groups treated with vitamin C or mannitol (P = 0.013 and P = 0.045 respectively), but not of the verapamil group., Conclusions: Vitamin C and mannitol were found to be effective in reducing ischaemia-reperfusion injury of the ovary during its early stages, but verapamil was ineffective.

Objective: To evaluate short-term leptin concentrations in women who use low-dose oral contraceptives., Study Design: From 15 women without medical problems, venous blood samples were taken: basal, between days 3 and 5 of menstruation, and in the third month. The Human Leptin Radioimmunassay Kit (Linco Research, Inc., St. Charles, Missouri) was used for leptin measurement. Statistical analysis was done with the Wilcoxon test., Results: The average patient age was 30.1 +/- 6.7 years. The basal leptin concentrations and leptin concentrations at the third month were 22.17 +/- 8.85 and 23.04 +/- 6.77 ng/mL, respectively. This increase was not statistically significant., Conclusion: Oral contraceptives with low-dose estrogen and desogestrel do not affect leptin concentrations in a three-month period.