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Objective Epithelial ovarian cancer (EOC) is rarely detected at stage 1a. Most of the patients have a good prognosis and there are limited factors that affect their survival. In the present study, we evaluated the p16 and p53 gene expressions of stage 1a EOC patients. Prognostic effects of these gene expressions, as well as those of other factors on short term survival were analyzed. Methods Our study included 29 patients. The specimens of the ovary with cancer were stained for p16 and p53. Gene expressions and other prognostic factors were evaluated. Results The median age of the patients was 51 years (27–84). The mean numbers of dissected pelvic and paraaortic lymph nodes were 27 and 12, respectively. The mean follow-up time was 33.7±18.9 months. During this period, recurrence occurred in two patients. One of the patients had grade 2 mucinous carcinoma and died of the disease at month 12 after the recurrence occurred at month 7. The second patient had clear cell carcinoma and recurrence occurred at month 34. p16 and p53 gene expressions or other factors were not associated with overall survival (OS) or disease-free survival in the short term. The lower p16 positivity rate in the non-clear cell group was found to be statistically significant (P=0.003). Both p53 and p16 positivity rates were higher in the high-grade carcinoma. Conclusion The levels of none of the common prognostic factors, including those of p16 and p53 gene expression, were associated with the progression-free survival or OS of stage 1a in the short term. Appropriate surgical staging and non-omission of subclinical metastases seem to be of central importance.

ObjectiveEpithelial ovarian cancer (EOC) requires an aggressive surgical approach. The important part of literature on ovarian cancer surgery emphasize residual tumor and survival analyses. Morbidity issue keeps in background. Therefore, we aimed to report on morbidity of cytoreductive surgery for EOC in this study.MethodsEOC patients who underwent primary debulking were evaluated. Intraoperative and postoperative complications that occurred within 30 days after the surgery and factors that affect morbidity were considered.ResultsThe study involved 359 patients. Forty-six intraoperative complications occurred in 42 (11.6%) patients. Advanced stage and cancer antigen level of 125 were independently and significantly associated with operative complications (hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.01–2,73; P=0.044, and HR, 1.47; 95% CI, 1.05–2.06; P=0.025, respectively). The need for intensive care unit admission was significantly higher in patients with intraoperative complications (28.6% vs. 8.8%, P=0.001). Intraoperative and postoperative complication rates were significantly higher in extended surgery than in standard surgery (18.9%vs. 8.5%, P=0.005 and 38.7% vs. 10.9%, P

OBJECTIVE: To assess the prevalence of syphilis among patients at a tertiary referral center in Turkey and determine the need for antenatal syphilis screening based on the results. STUDY DESIGN: A retrospective cohort study based on patient data obtained from a tertiary referral center in Turkey. Serological syphilis screening using the Venereal Disease Research Laboratory (VDRL) was performed on all pregnant women as a part of routine antenatal care at their first hospital visit during pregnancy. Treponema pallidum hemagglutination assay (TPHA) was used to confirm positive screening results for syphilis. RESULTS: Patients’ mean age was 27.4 years. The incidence of positive syphilis serology was 0.013% (one patient), which was supported by a positive confirmatory test (0.013%).The TPHA-positive pregnant woman diagnosed with syphilis was treated with benzathine penicillin, and she gave birth to normal infants without any signs of congenital syphilis. CONCLUSION: Syphilis prevalence should be determined in each developing country with population-based studies. According to the prevalence of syphilis, each country should determine its own syphilis antenatal screening policies.

OBJECTIVE: Umbilical cord usually seems simple functionally and structurally but it's the life link between fetus and mother that was critically important for growing fetus. The aim of this study is to evaluate the effect of early umbilical cord coiling index on perinatal outcomes. STUDY DESIGN: 221 patients with singleton, alive pregnancies between 18-24 gestational weeks were included in our study and have been evaluated prospectively. Patients’ age, obstetric history, BMI before pregnancy, history of smoking was registered. Umbilical arter coiling index was also calculated. Perinatal problems such as preeclampsia, gestational diabetes mellitus (GDM), intrauterine growth restriction (IUGR), small for gestational age (SGA) and birth weight, gestational age at birth, and newborn intensive care unit need were recorded. RESULTS: There was a negative correlation between antenatal umbilical cord coiling index (aUCI) and gestational age. The birth weights were lower in patients with hypocoiled umbilical cord structure. Preeclampsia was seen in 3.93% of patients with normal aUCI, 26.09 % in hypocoiling group, and 21.05 % in hypercoiling group. The percentage of patients with normal aUCI who had GDM is 2.18, 13.04% of patients with hypercoiling and 10.53% of patients with hypocoiling had GDM. The percentage of patients with normal aUCI who had IUGR is 3.49, 21.74% of patients with hypercoiling and 5.26% of patients with hypocoiling had IUGR. According to aUCI there was a statistical difference in GDM, preeclampsia and IUGR and different from the literature, in our study, we found a statistically significant difference in hypercoiled umbilical cords in terms of preeclampsia. Newborns with hypercoiling or hypocoiling were needed more neonatal intensive care unit. CONCLUSIONS: There was measured correlation between umbilical cord diameter and aUCI between 18-24 weeks and perinatal outcome but new prospective studies about umbilical artery morphology and perinatal outcomes are also needed.

BackgroundThe serum P concentrations are suggested to have an impact on pregnancy outcome. However there is no consensus about the optimal progesterone cut-off during the luteal phase. Few studies evaluated the effectiveness of a “rescue protocol” for low serum P concentrations and most of these studies used vaginal progesterone administration. There is paucity of data on the effectiveness of rescue protocol using intramuscular progesterone (IM-P) in frozen-thawed embryo transfer (FET).MethodsThis study is a retrospective cohort study included 637 single or double blastocyst FETs with artificially prepared endometrium receiving 100 mg IM progesterone (P) after incremental estrogen treatment. Serum P concentrations were evaluated using blood samples obtained 117-119 hours after the first IM-P administration and 21 ± 2 hours after the last IM-P administration. Patients with serum P concentrations

The aim of the study is to compare the perinatal outcomes of twin pregnancies resulting from assisted reproductive technology (ART) treatment in which granulocyte colony-stimulating factor (G-CSF) was used with those in which it was not. In this retrospective study, the clinical data of 122 dichorionic diamniotic twin pregnancies were reviewed. Pregnancies were divided into two groups, G-CSF-treated and non-G-CSF treated. Maternal age, gestational week at birth, oligohydramnios, gestational hypertension, pre-eclampsia, preterm birth, first-trimester bleeding, gestational diabetes, rupture of membrane, foetal congenital anomalies, admission to the neonatal intensive care unit, birth weight (BW), small for gestational age, BW discordance, Apgar score and placental weight were compared between the groups.IMPACT STATEMENT What is already known on this subject? Granulocyte colony-stimulating factor (G-CSF) administrations increase pregnancy outcomes and do not have a negative effect on perinatal outcomes in singleton pregnancies. What the results of this study add? This study showed that the perinatal outcome of dichorionic diamniotic twin pregnancies conceived after assisted reproductive technology (ART) treatment was similar in the GSF administrated and non-GSF administrated groups. What the implications are of these findings for clinical practice and/or further research? Using G-CSF to increase the success of ART does not seem to have an adverse outcome in the dichorionic diamniotic twin pregnancies.

Introduction: Stress urinary incontinence (SUI) can adversely affect the patient's sexual function. Aim: To evaluate the sexual functions in women who underwent transobturator tape (TOT) surgery because of stress urinary incontinence and factors affecting the treatment results. Methods: The study was conducted in 2 tertiary level clinics between 2013 and 2019 and included sexually active patients with a diagnosis of SUI who underwent TOT operation. The preoperative and postoperative (6 months after surgery) Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) scores of the patients were evaluated. The patients were evaluated according to the score changes of an increased score (benefited) and the same or lower score (did not benefit). The PISQ-12 questionnaire has 3 subdomains of behavioral-emotive (Q: 1–4), physical (Q: 5–9), and partner-related (Q: 10–12). Each question is scored from 0 to 4, giving a total ranging from 0 to 48. A higher PISQ-12 score indicates better sexual function. Main Outcome Measure: PISQ-12. Results: The study included 117 patients with a median age of 52 years (range, 32–67 years), and 51.3% of the patients were postmenopausal. When the preoperative and postoperative PISQ-12 scores were evaluated in the whole group, there was a statistically significant improvement (from 24.66 to 26.52, P = .001). In the analysis of domains, there was a statistically significant improvement in physical score (from 11.68 to 13.53, P

Objective Several studies have examined biological markers during the first trimester to predict the maintenance of a healthy pregnancy. One such marker is kisspeptin, which is encoded by the KISS-1 gene. We aimed to determine whether first-trimester pregnancy losses were associated with levels of placental KISS-1 expression. Methods This prospective case control study was conducted at a tertiary center. The study group included 27 and 24 patients who underwent dilation and curettage at

Objective: We aimed to compare surgical outcomes and postoperative complications among different hysterectomy approaches such as total abdominal hysterectomy, vaginal hysterectomy, multiport access laparoscopic hysterectomy, and single-port access laparoscopic hysterectomy. Study Design: This retrospective, single institution, case control study was carried out at the Obstetrics and Gynecology Department of Baskent University in Ankara, Turkey. We evaluated 86 consecutive patients who underwent hysterectomy for benign gynecological conditions. Results: A total of 86 women underwent hysterectomy: 20 (23.3%) total abdominal hysterectomy, 20 (23.3%) vaginal hysterectomy, 27 (31.3%) multiport access laparoscopic hysterectomy, and 19 (22.1%) single-port access laparoscopic hysterectomy using a transumbilical single-port system. There was no significant difference in uterine size between groups (Z=5.705; p=0.127). A statistically significant (p

Background: The current study tested the level of endocan, which is thought to have an effective role in both endothelial dysfunction and inflammation, in infertile women with endometriosis treated with in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). It is based on the hypothesis of chronic inflammation in the pathophysiology of endometriosis. Methods: This prospective case–control study included a total of 64 women who were in the IVF/ICSI program. The women were divided into two groups: endometriosis (n = 32) and non-endometriosis (n = 32). Their baseline characteristics, stimulation parameters, and IVF/ICSI outcomes (clinical pregnancy and live birth rates) were recorded. Blood samples collected at the beginning of the IVF cycle for endocan levels were analyzed with a sandwich enzyme immunoassay and the results were documented. Results: The endocan levels in the endometriosis group were significantly higher than those in the non-endometriosis group, i.e., 5010 pg/mL and 2738 pg/mL, respectively (p < 0.05). A significant weakly positive correlation was found between endocan levels and the presence of endometriosis (p < 0.05, r: 0.284). The cut-off value for endometriosis was determined as 4693 pg/mL with a sensitivity of 53.13% and a specificity of 78.12%. Clinical pregnancy was insignificantly higher in the non-endometriosis group (p = 0.079). However, live birth rates were significantly higher in the non-endometriosis group (p < 0.05). No correlation was found between clinical pregnancy and live birth rate and endocan levels (p > 0.05). Conclusion: High endocan levels were detected in women who underwent IVF/ICSI treatment for endometriosis and infertility and there was a positive correlation between them. However, there was no relationship between endocan levels and IVF/ICSI outcomes.

Objective: To determine the role of anti-Mullerian hormone (AMH) levels in predicting the response to clomiphene citrate (CC) therapy for ovulation induction in women with unexplained infertility. Materials and methods: For this retrospective study, fifty consecutive patients who responded to CC were taken as Group 1, while fifty consecutive patients who failed to show adequate ovulatory response with CC were taken as Group 2. We compared the AMH levels of the two groups and receiver operating characteristic (ROC) curve was used to determine the threshold for AMH in predicting the ovulatory response to CC therapy. Results: Mean age, body mass index, luteinizing hormone, prolactin, and thyroid-stimulating hormone values were similar in the two groups. AMH and antral follicle count (AFC) values were higher in Group 1 than in Group 2 (p = 0.001 and p = 0.001, respectively). There was a statistically significant negative correlation between FSH and AFC (r = −0.339, p = 0.001), while AFC and AMH displayed a statistically significant positive correlation (r = 0.713 and p = 0.001). AMH values and AFC were found to be predictors of the adequate ovulatory response to CC. The area under the ROC curve was 0.86 vs 0.80, respectively. At an AFC cutoff value of 14, the sensitivity and specificity for prediction of ovulation were 68% and 80%, respectively. Conclusion: The AMH and AFC cut-off values for the prediction of positive ovarian response to CC in patients with unexplained infertility were 2.78 ng/mL and 14, respectively. If further prospective and randomized studies confirm our results, these thresholds may be useful to predict successful ovulation induction and reduce the unresponsive cycles. Keywords: Anti-Mullerian hormone, Clomiphene citrate, Ovulation induction, Unexplained fertility