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Öğe A successful healthy live birth from a female patient with hypogonadotropic hypogonadism and oocytes with unusually large cytoplasmic inclusions(Soc Brasileira Reproducao Assistida-Sbra, 2016) Duvan, Candan Iltemir; Pekel, Aslihan; Ercan, Ummu Gulsum; Arikan, Yuksel OnaranThis study aimed to report the case of a successful live birth from a woman having oocytes with abnormally large cytoplasmic inclusions. The patient described in this case is a 28 year-old woman with hypogonadotropic hypogonadism (HH) with a history of two previous unsuccessful in vitro fertilization (IVF) attempts offered an antagonist protocol. Stimulation was performed with human menopausal gonadotropin 300 IU/day. The intracytoplasmic sperm injection (ICSI) procedure was performed 4-6 hours after oocyte aspiration for all mature oocytes. Six oocytes were retrieved, five of which mature (MII). All oocytes had abnormal cytoplasmic structures. Two were fertilized after ICSI and two top quality embryos were transferred on Day 2. Our case report suggests that HH patients with refractile bodies/lipofuscin in their oocytes may not have their pregnancies negatively affected. While there have been several reports of successful births from dysmorphic oocytes, no cases of successful pregnancies followed by live births from young women with HH and oocytes with large cytoplasmic inclusions had been reported to date.Öğe Effects of the etonogestrel contraceptive implant (Implanon®) on bone metabolism during lactation: a prospective study(Bmj Publishing Group, 2017) Duvan, Candan Iltemir; Onaran, Yuksel; Keskin, Esra Aktepe; Yuce, Ebru; Yanik, Burcu; Kafali, Hasan; Turhan, Nilgun OzturkAim To evaluate the effects of the etonogestrel contraceptive implant (Implanon (R)) on bone metabolism in lactating women using markers for bone formation and resorption. Study design This single-centre, prospective cohort study was conducted in Turgut Ozal University Medical Faculty Obstetrics and Gynecology Department with healthy lactating women aged between 24 and 38 years to compare the effect on bone metabolism of 6 months' use of either the implant or a non-hormonal contraceptive method. The study group (n=25) used an implant and the control group (n=25) used a non-hormonal contraceptive intrauterine device inserted 40 days' postpartum. Bone metabolism differences at the time of insertion and after 6 months were assessed quantitatively by biochemical analysis of serum and urine samples. Results At baseline, serum levels of bone metabolism parameters were similar for the two groups. In the implant group, serum alkaline phosphatase (ALP) levels decreased (p=0.004) and total protein levels increased (p=0.045) at 6 months. In the control group, serum levels of bone metabolism parameters did not change at 6 months compared to baseline. However, serum levels of phosphorus (p=0.013) and ALP (p=0.003) decreased at 6 months compared to baseline. Conclusion Six months' postpartum use of Implanon was found to have no deleterious impact on bone turnover in healthy lactating women.Öğe Electrocardiographic P-Wave Duration, QT Interval, T Peak to End Interval and Tp-e/QT Ratio in Pregnancy with Respect to Trimesters(Wiley, 2016) Tanindi, Asli; Akgun, Nilufer; Pabuccu, Emre Goksan; Gursoy, Asli Yarci; Yuce, Ebru; Tore, Hasan Fehmi; Duvan, Candan IltemirBackground: P-wave duration helps to determine the risk of atrial arrhythmia, especially atrial fibrillation. QT interval, T peak to end interval (Tp-e), and Tp-e/QT ratio are electrocardiographic indices related to ventricular repolarization which are used to determine the risk of ventricular arrhythmias. We search for any alterations in electrocardiographic indices of arrhythmia in the pregnancy period with respect to trimesters. Methods: We enrolled 154 pregnant and 62 nonpregnant, healthy women into this cross-sectional study. Maximum and minimum P-wave durations (Pmax, Pmin), and QT intervals (QTmax, QTmin) were measured from 12 leads. QT measurements were corrected using Fridericia (QTc-Fr) and Bazett's (QTc-Bz) correction. Tp-e interval was obtained from the difference between QT interval, and QT peak interval (QTp) measured from the beginning of the QRS until the peak of the T wave. Tp-e/QT ratio was calculated using these measurements. Results: Pmax were 93.0 +/- 9.1, 93.9 +/- 8.9, 97.9 +/- 5.6, 99.0 +/- 6.1 in nonpregnant women, first, second, third trimesters of pregnancy, respectively (P = 0.001); whereas Pmin values were not significantly different. QTc-Fr max were 407.4 +/- 14.2, 408.5 +/- 16.1, 410.1 +/- 13.1, 415.1 +/- 10.1 (P = 0.007); Tp-e were 72.7 +/- 6.2, 73.2 +/- 6.5, 77.2 +/- 8.9, 87.2 +/- 9.6 (P < 0.001); and Tp-e/QT were 0.17 (0.14-0.20), 0.17 (0.14-0.20), 0.18 (0.15-0.23), 0.20 (0.16-0.25) in nonpregnant women, first, second, and third trimesters of pregnancy respectively (P < 0.001). None of the participants experienced any arrhythmic event. Conclusions: P-wave duration is prolonged in the second trimester, and resumes a plateau thereafter. Maximum QTc interval, Tp-e interval and Tp-e/QT ratio are increased in the late pregnancy. Although these indices are altered during the course of pregnancy, they all remain in the normal ranges.Öğe Is the level of maternal serum prohepcidin associated with preeclampsia?(Taylor & Francis Inc, 2015) Duvan, Candan Iltemir; Simavli, Serap; Keskin, Esra Aktepe; Onaran, Yuksel; Turhan, Nilgun Ozturk; Koca, CemileObjective: The objective of the study was to compare pro-hepcidin, hemoglobin (Hb) concentration, hematocrit (Hct), C-reactive protein (CRP), IL-6 and iron status parameters in preeclamptic (PE) and healthy pregnant women, and to examine the relationship between serum pro-hepcidin levels and iron parameters of preeclampsia (PE). Methods: In a prospective controlled study, we collected serum from women with normal pregnancy (n = 37) and from women with PE (n = 30) at the Department of Obstetrics and Gynecology at Turgut Ozal University between February 2010 and January 2013. Pro-hepcidin, hemoglobin (Hb) concentration, hematocrit (Hct), CRP, IL-6 and iron status parameters were measured in all patients and compared between groups. Results: Levels of serum prohepcidin in PE and control groups were similar and amount 69.4 +/- 19.7 and 71.9 +/- 22.1 ng/ml, respectively. The difference was not statistically significant (p: 0.694). On the other hand, the study group had a statistically lower iron binding capacity (IBC), total iron binding capacity, transferin, total protein, albumin levels (p<0.05). No significant differences were found among prohepcidin, Hb concentration, Hct, iron, ferritin, IL-6, urea and creatine in both the groups. Conclusion: In pregnancies complicated by PE with normal values of hemoglobin and hematocrit, serum prohepcidin concentrations are similar to those observed in healthy pregnant women. The analysis revealed no significant correlations between prohepcidin level and serum iron, serum ferritin or transferrin in the PE.Öğe Relationship between oxidant and antioxidant activity in hyperemesis gravidarum(Taylor & Francis Ltd, 2014) Onaran, Yuksel; Kafali, Hasan; Duvan, Candan Iltemir; Keskin, Esra; Celik, Hakim; Erel, OzcanObjective: To evaluate oxidant and antioxidant activity in patients with hyperemesis gravidarum (HG) by using serum total antioxidant activity (TAO), total free sulfhydryl (-SH), ceruloplasmin and lipid hydroperoxide (LOOH) levels. Materials and methods: In a cross-sectional trial, blood samples were collected from patients with HG (n = 25) and healthy pregnant women (n = 25) as control group. Serum TAO activities, -SH levels and LOOH levels and ceruloplasmin levels were measured. Results: Serum TAO activity was found to be significantly lower (p = 0.003) in patients with HG compared with controls. However, serum -SH levels, LOOH levels and ceruloplasmin levels did not change significantly in patients with HG compared to controls. Conclusion: Presence of oxidative stress in HG patients depends more on reduced antioxidant activities than increased oxidative stress.
