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OBJECTIVE: This study was designed to compare the serum vaspin levels between patients with primary ovarian insufficiency (POI) and healthy fertile women. STUDY DESIGN: Sixty-nine patients diagnosed with idiopathic POI and 70 age-matched healthy fertile women were included in this case-control study. General gynecological and physical examination findings and serum basal hormone levels were recorded. Vaspin levels in serum samples were determined using the Enyzme-Linked ImmunoSorbent Assay (ELISA) method. RESULTS: The mean age of the patients with POI was 31.9±5.4 years, while it was 31.2±3.8 years in the control group. There were no statistically significant differences in body mass index, gravidity, parity, and cigarette consumption between the groups. However, the mean follicle-stimulating hormone level in POI patients was 55.4±25.1 IU/L, significantly higher than the 6.2±1.8 IU/L observed in the control group. Luteinizing hormone levels were also significantly higher in POI patients, while estradiol and anti-Mullerian hormone values were significantly lower. Furthermore, the mean serum vaspin level in POI patients was 0.79±0.56 ng/mL, compared to 1.08±0.64 ng/mL in the control group (p<0.001). CONCLUSIONS: Serum vaspin levels were found to be decreased in women with POI. Therefore, monitoring the serum vaspin levels in women with POI may help in the early identification of patients with POI. [ABSTRACT FROM AUTHOR]

Ovarian response to stimulation mainly determines the length of stimulation. However, there is no clarity in the literature regarding the optimal duration required to achieve oocyte maturity in patients with the poor ovarian response (POR) defined by Bologna criteria. Therefore, a total of 267 cycles that fulfilled the inclusion criteria were selected retrospectively. Group A constitute of patients with a stimulation period < 9 d (n = 70); and group B included patients with a stimulation period ≥ 9 d (n = 133). The results showed that antral follicle count (5.72 ± 1.82 vs. 5.10 ± 1.78, p = 0.023), serum oestradiol level on hCG day (1286.88 ± 778.18 pg/mL vs. 820.14 ± 479.04 pg/mL, p = 0.001), and total gonadotropin dose used (2949.53 ± 727.92 IU vs 2020.94 ± 415.17 IU, p = 0.0001) were higher in group B when compared to group A. Although the number of total (5.47 ± 3.32 vs 3.86 ± 2.15, p = 0.0001) and mature oocytes retrieved (4.34 ± 2.88 vs 2.84 ± 1.67, p = 0.0001) were higher in group B, no significant difference was observed in the pregnancy rates between groups (25.6 vs 15.7%, p > 0.05). In conclusion, no deleterious effect of a shorter duration of stimulation on cycle outcome was seen in patients with POR. [ABSTRACT FROM AUTHOR]

To assess the effect of cabergoline on endometrial vascular endothelial growth factor receptor-2 (VEGFR-2) immunoexpression in an ovarian hyperstimulation syndrome (OHSS) rat model. Twenty-one immature female Wistar rats were assigned into three groups: group 1, the control group; group 2, stimulated with gonadotropins to mimic OHSS; and group 3, in which an OHSS protocol was induced and thereafter treated with cabergoline (100 μg/kg/day). Body weight, ovarian volume, corpora lutea numbers, and endometrial VEGFR-2 expression were compared between the groups. Weight gain and ovarian volume were highest in the OHSS-placebo group, while cabergoline administration significantly reversed those effects (p = 0.001 and p = 0.001, respectively). VEGFR-2 stained cells were significantly lower in groups 2 and 3 compared to group 1 (p = 0.002). Although VEGFR-2 expression was lowest in group 3, the difference was not statistically significant. Corpora lutea numbers were also similar (p = 0.465). While successful implantation requires a vascularized receptive endometrium, impaired expression of VEGFR-2 and disrupted endometrial angiogenesis due to cabergoline administration may be associated with IVF failure in fresh OHSS cycles. The insignificant decrease in endometrial VEGFR-2 expression observed in this research needs to be investigated by further studies involving additional techniques such as immunoblotting and/or RT-PCR analyses. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome is the most common endocrine problem affecting about 5-18% of women of reproductive age and can lead to infertility due to anovulation. Lifestyle change and weight loss are the first-line approaches in infertility treatment. The first-line treatment approach in medical treatments is ovulation induction (Ol) with Clomiphene Citrate (CC), and in recent years, recommendations and findings have been reported for the use of aromatase inhibitors (Al) in first-line treatment. Despite repeated use of CC, there may be no response to CC at a rate of 25%, this group of patients is defined as a CC-resistant PCOS group. In these patients, second-line treatment approaches are applied to increase ovulation rates. Second-line treatment approaches can be Ol with Gonadotropin, as well as surgical treatments such as Ovarian Drilling (OD). In this article, past and current practices on OD will be presented. [ABSTRACT FROM AUTHOR]

Purpose Recurrence is a major clinical problem in patients with pulmonary embolism and can affect mortality. The decision to discontinue treatment is important for recurrence and is based on patients' clinical features as well as certain blood parameters. Our aim in this study was to evaluate whether mean platelet volume (MPV) and platelet distribution width (PDW) have utility as new predictive parameters for recurrence and mortality in pulmonary embolism. Materials and Methods A total of 440 patients with pulmonary embolism underwent computed tomography, Doppler ultrasonography, and echocardiography before and at the conclusion of treatment. Thrombocyte count, MPV, PDW, and D-dimer parameters were also evaluated at the same time points. Results MPV and PDW were significantly higher in deceased patients (8.8 ± 1.2 fl and 17.4 ± 0.8) compared to surviving patients (7.7 ± 0.9 fl and 17 ± 0.9) (p < 0.0001). Initial MPV and PDW were also significantly higher in patients with recurrence (8.4 ± 0.7 vs 7.6 ± 0.8 fl, p < 0.0001 and 17.3 ± 0.8 vs 16.9 ± 0.9, p = 0.002, respectively) than in patients without recurrence. At the end of treatment, MPV was still higher in patients with recurrence compared to patients without recurrence (8.7 ± 0.5 and 7.5 ± 0.7 fl, respectively, p < 0.0001). MPV values over 8.05 fl at the end of treatment predicted recurrence with 91% sensitivity and 77% specificity. Conclusion MPV seems to be an indicator of recurrence in pulmonary embolism and may have utility in the prediction of recurrence. Elevated MPV can also be used to predict mortality in pulmonary embolism., Author(s): Omer Araz [sup.1] [sup.2] , Fadime Sultan Albez [sup.1] , Elif Yilmazel Ucar [sup.1] , Bugra Kerget [sup.1] , Nafiye Yilmaz [sup.1] , Metin Akgun [sup.1] Author Affiliations: (1) [...]

Usually in in vitro fertilization (IVF) treatment; controlled ovarian hyperstimulation is started on the 2-3rd day of menstruation. However, in patient groups with limited time, waiting for menstruation for ovarian hyperstimulation has now been replaced by 'random start protocols'. In this case report, the ovarian stimulation responses of the same patient in the early and late follicular phases in different menstrual cycles were compared. [ABSTRACT FROM AUTHOR]

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Objective Fetuin-A is a hepatokine which is previously found related to fertility and pregnancy outcomes. We aimed to investigate if recurrent pregnancy loss (RPL) is associated with increased fetuin-A levels. Materials and methods Serum fetuin-A concentrations were measured and compared in 30 non-pregnant women with a history of unexplained recurrent miscarriage, 29 women who had a history of unexplained recurrent miscarriage and were admitted to our clinic due to miscarriage during the study period and 30 fertile women who have no history of miscarriage or any other pregnancy complications with at least two previous healthy children. Results The median serum fetuin-A levels of group I, II, and III were 59.45, 62.73, and 44.52, respectively (p=.065). Serum fetuin-A levels significantly increased in group II compared to group III (p=.011). No significant differences in the levels of fetuin-A of group I compared to either group II (p=.433) or group III (p=.268). Conclusions The etiology of RPL is still a subject that is not clarified. Fetuin-A levels may have a relationship with RPL. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The association between recurrent implantation failure and thrombophilia is still controversial depending on the published reports with conflicting results. In this study, we aimed to assess the clinical relevance of screening women with recurrent implantation failure for some thrombophilic variants including factor V H1299R (FV HR2) haplotype. STUDY DESIGN: A total of 279 women were recruited in this case-control study. 229 women with a history of recurrent implantation failure and 50 fertile control with no history of pregnancy losses were screened for eight specific gene mutations, regarding factor V G1691A gene (FV Leiden), FV HR2, factor II prothrombin G20210A, factor XIII V34L, PAI-1 4G/5G, MTHFR C677T, MTHFR A1298C and A3 haplotype of the endothelial cell protein C receptor gene. RESULTS: Recurrent implantation failure group displayed a significantly higher prevalence of FV HR2 heterozygosity than fertile controls while the frequency of FV Leiden mutation was comparable between groups (p=0.011; p=0.619). Additionally, the difference in the prevalence of other specific or total gene mutations among women with recurrent implantation failure was also insignificant. DISCUSSION: The primer outcome of this study was the co-existence of the higher prevalence of FV HR2 haplotype and the insignificant percentage of FV Leiden mutation in women with recurrent implantation failure. Thus, we emphasize that the HR2 haplotype may be associated with recurrent implantation failure particularly in non-carriers for FV Leiden mutation. In the necessity of screening for thrombophilia in recurrent implantation failure, HR2 haplotype should be involved in the searched gene panel particularly in the absence of FV Leiden mutation. Further large-scale prospective studies are needed to investigate whether screening or treatment for HR2 haplotype has any detrimental impact on implantation success in cases of recurrent implantation failure. [ABSTRACT FROM AUTHOR]

This study was designed to investigate serum telomerase levels of occult primary ovarian insufficiency (POI) and the relationship between in vitro fertilisation (IVF) results of these patients and serum telomerase levels. A cross-sectional case-control study was conducted between May and October 2017 including 78 patients at University of Health Science, Turkey. Occult POI was defined as women with a history of follicle-stimulating hormone (FSH) elevation between 12 and 25 IU/L and low ovarian reserve before initiation of IVF (n = 39). The control group were patients attending the hospital for contraception, with no history of infertility, having at least one healthy child (n = 39). Telomerase levels in serum samples were determined using enzyme-linked immunosorbent assay method. There was no statistically significant difference in serum telomerase levels in occult POI patients when compared with the control group.Impact statementWhat is already known on this subject? Clinical studies investigating the role of telomerase on reproductive function and in vitro fertilisation (IVF) outcomes in occult primary ovarian insufficiency (POI) patients are limited with no clear consensus and in all these studies polymerase chain reaction technique was used to evaluate telomere length. Regarding our knowledge, this is the first study in the literature investigating the role of serum telomerase levels in occult POI patients.What do the results of this study add? In contrast to the previous studies, in this study no statistically significant difference was found in serum telomerase levels in occult POI patients when compared with the fertile control patients.What are the implications of these findings for clinical practice and/or further research? The occult POI patients examined in this study are overlooked until they apply with infertility. Serum telomerase measurement is not useful to support the diagnosis of occult POI. Nevertheless, in order to confirm these findings, further studies in larger populations are needed. [ABSTRACT FROM AUTHOR]