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Öğe Correlations of maternal neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with birth weight(Taylor & Francis Ltd, 2017) Akgun, Nilufer; Kalem, Muberra Namli; Yuce, Ebru; Kalem, Ziya; Aktas, HaticeObjective: The aim of this study is to investigate the possible correlation of hemogram parameters including neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with birth weight and gestational week.Materials and methods: This prospective study has been conducted with 783 patients. The maternal age, parity, gestational age, type of delivery, values of complete blood count (CBC) variables and the weight of newborn were recorded. We analyzed the statistical differences between the NLR, PLR, hemoglobin (HGB), platelet distribution width (PDW), red cell distribution width (RDW), mean platelet volume (MPV), platelet, neutrophil, lymphocyte and white blood cells (WBC) in terms of the birth weight.Results: There was no statistically significant difference in the NLR in terms of the birth weight (p=0.097), whereas there was a statistically significant difference in the PLR (p<0.001). In correlation analyses, a linear, negative, weak and statistically significant correlation was detected between NLR and PLR with the birth weight of infant and gestational week (p=0.011 and p<0.001, respectively).Conclusion: This prospective study is the first in the literature which investigates the correlation of NLR and PLR with the week of birth and birth weight of the infant. Our study suggested that the maternal NLR and PLR are negatively correlated with the week of birth and birth weight of the infant.Öğe Effect of body mass index and age on in vitro fertilization in polycystic ovary syndrome(Galenos Yayincilik, 2016) Kalem, Muberra Namli; Kalem, Ziya; Sari, Tamer; Ates, Can; Gurgan, TimurObjective: The aim of this study was to investigate age-related variations in the effect of body mass index (BMI) on in vitro fertilization (IVF) outcomes. Material and Methods: This was a cohort study conducted by retrospectively investigating the IVF cycles of 653 polycystic ovary syndrome (PCOS) patients under the age of 40 years who were diagnosed based on the Rotterdam criteria in a private IVF clinic between 2005 and 2015. The study included data from 653 IVF cycles of PCOS patients. The patients were classified into three groups based on their BMI, i.e., normal weight (n=299), overweight (n=208), and obese (n=146). The patients were also grouped by age: 562 patients were under the age of 35 years and 91 patients were above the age of 35 years. Then, BMI- and age-related variations in the IVF cycle parameters and clinical pregnancy rates of patients with PCOS were investigated. The Mantel-Haenszel Chi-square statistical assessment method was used to determine whether the effect of BMI on IVF outcomes varies with age. Results: Variations in cycle variables with BMI and age showed that IVF cycles were negatively affected by increases in obesity and age. Clinical pregnancy rates were found to be lower in the obese group than in the other groups, particularly in the age group above 35 years; however, this difference could not be proven statistically. Conclusion: The present study evaluated obesity and clinical pregnancy rates in IVF cycles in PCOS patients according to age groups, and particularly in the obese group, the clinical pregnancy rates were observed to be lower in the age group >= 35 years than in the other BMI groups; however, this difference was found to be statistically insignificant.Öğe Factors affecting clinical pregnancy rates after IUI for the treatment of unexplained infertility and mild male subfertility(Galenos Yayincilik, 2016) Atasever, Melahat; Kalem, Muberra Namli; Hatirnaz, Safak; Hatirnaz, Ebru; Kalem, Ziya; Kalaylioglu, ZeynepObjective: The aim of the present retrospective study was to evaluate intrauterine insemination (IUI) clinical experiences and to define the variables for predicting success. Material and Methods: The present study was an observational trial performed in a private IVF center on subfertile couples who had applied for treatment between 2002 and 2012, in which the data of 503 IUI cases were retrospectively reviewed. Couples who had been diagnosed with unexplained and mild male subfertility were included. The primary outcome measure was the clinical pregnancy rate in an attempt to form a predictive model for the odds of a clinical pregnancy. Recorded parameters were used to determine the prediction model. Results: Utilizing univariate logistic regression analysis, clinical pregnancy was positively associated with the duration of infertility (OR=1.09, p=0.089), secondary infertility (OR=1.77, p=0.050), and +4 sperm motility after preparation (OR=1.03, p=0.091). Following an adjustment analysis involving a multivariate logistic regression, clinical pregnancy was still found to positively associate with secondary infertility (OR=2.51, p=0.008). Conclusion: IUI success in secondary infertile couples who were in the unexplained infertility and mild male subfertility groups was higher than that in primary infertile couples, and the chances of pregnancy increased as sperm numbers with +4 motility increased. It is difficult to concomitantly evaluate all these parameters and to determine a predictive parameter in IUI independent from other factors.Öğe Factors affecting the rates of caesarean sections in cases with premature rupture of membranes (PROM) at term(Taylor & Francis Inc, 2017) Kalem, Muberra Namli; Kosus, Aydin; Kamalak, Zeynep; Kosus, Nermin; Kalem, ZiyaThe aim of this retrospective study was to investigate the factors affecting the rates of caesarean section in cases with premature rupture of membranes (PROM) in term pregnancies. Eighty-two term PROM patients who presented to Turgut Ozal University and Erzurum Nene Hatun Hospitals between 2012 and 2014 were included. The effects of demographics, nulliparity, active-latent phase durations, presence of meconium and chorioamnionitis, requirement of oxytocin and cervical dilation at the initial examination on C/S rates were assessed. The C/S rates were changed with the duration of active period and the duration of latent period. It was found that the presence of cervical dilation at the initial examination significantly reduced the risk for progress to C/S at a rate of 87.5%. C/S rates did not change with other variables. We conclude that the factors increasing the risk for C/S in PROM at term group are not different from the non-term PROM.Impact statementThe aim of this retrospective study was to investigate the factors affecting the rates of caesarean section (C/S) in cases with premature rupture of membranes (PROM) in term pregnancies. The C/S rates were changed with the duration of active period and the duration of latent period. It was found that the presence of cervical dilation at the initial examination significantly reduced the risk for progress to C/S at a rate of 87.5%.We conclude that the factors increasing the risk for C/S in PROM at term group, are not different from the non-term PROM groups.Currently, the PROM is considered the start of a pathological process in both term and preterm pregnancies and also considered to increase the rates of caesarean sections. Studies on the management of PROM at term have concentrated rather on whether to intervene for accelerating the labour or spontaneous monitorisation. As found by the studies like this one in the literature, the factors having an impact on C/S rates in the cases of PROM at term are similar to those of non-PROM patients at term, may prevent clinicians from taking an invasive or aggressive approach towards the cases of PROM at term.Öğe Lower serotonin level and higher rate of fibromyalgia syndrome with advancing pregnancy(Taylor & Francis Ltd, 2017) Atasever, Melahat; Kalem, Muberra Namli; Sonmez, Cigdem; Seval, Mehmet Murat; Yuce, Tuncay; Aker, Seda Sahin; Koc, AcarObjective: The aim of the study is to investigate the relationship between changes in serotonin levels during pregnancy and fibromyalgia syndrome (FS) and the relationships between FS and the physical/psychological state, biochemical and hormonal parameters, which may be related to the musculoskeletal system.Study design: This study is a prospective case-control study conducted with 277 pregnant women at the obstetric unit of Ankara University Faculty of Medicine, in the period between January and June 2015. FS was determined based on the presence or absence of the 2010 ACR diagnostic criteria and all the volunteers were asked to answer the questionnaires as Fibromyalgia Impact Criteria (FIQ), Widespread Pain Index (WPI), Symptom Severity Scale (SS), Beck Depression Inventory and Visual Analog Scale (VAS). Biochemical and hormonal markers (glucose, TSH, T4, Ca (calcium), P (phosphate), PTH (parathyroid hormone) and serotonin levels) relating to muscle and bone metabolism were measured.Results: In the presence of fibromyalgia, the physical and psychological parameters are negatively affected (p<0.001). There was no significant difference between the fibromyalgia and control groups in terms of glucose, Ca (calcium), P (phosphorus), PTH (parathyroid hormone), TSH (thyroid stimulant hormone), fT4 (free T4) levels (p=0.060, 0.799, 0.074, 0.104, 0.797, 0.929, respectively). A reduction in serotonin levels may contribute to the development of fibromyalgia but this was not statistically significant. The Beck Depression Inventory scale statistically showed that increasing scores also increase the risk of fibromyalgia (p<0.001).Conclusion: Our study has shown that serotonin levels in women with FS are lower than the control group and that serotonin levels reduce as pregnancy progresses. Anxiety and depression in pregnant women with FS are higher than the control group. The presence of depression increases the likelihood of developing FS at a statistically significant level. Serotonin impairment also increases the chance of developing FS, but this correlation has not been shown to be statistically significant.Öğe Methods for endometrial preparation in frozen-thawed embryo transfer cycles(Galenos Yayincilik, 2016) Kalem, Ziya; Kalem, Muberra Namli; Gurgan, TimurFrozen-thawed (FT) embryo transfer is a procedure used for the storage and transfer of excess embryos obtained during in vitro fertilization-intracytoplasmic sperm injection cycles. In recent years, improvements in laboratory conditions and limitations on the number of embryos to be transferred have led to a progressive increase in FT embryo transfer cycles. However, the best solution for endometrial preparation in these cycles is still a matter of debate. In this study, we aimed to review the current methods of endometrial preparation in FT embryo transfer cycles. In light of the current literature, it is hard to determine which method is the best for endometrial preparation. It is therefore necessary to conduct randomized controlled studies in a prospective design, which will also evaluate the above-mentioned factors.Öğe Problems of modern approaches to management of early pregnancy failure(Galenos Yayincilik, 2015) Kalem, Muberra Namli; Kalem, Ziya; Yuce, Ebru; Eser, Ayla; Duvan, Zehra Candan IltemirIn the last 20 to 30 years, early diagnosis of pregnancy has markedly decreased ectopic pregnancy-related maternal mortality, and the necessity for surgical treatment. With modern approaches in the treatment of ectopic pregnancy, surgical therapy has been replaced by medical therapy and medical treatment by spontaneous follow-up in appropriate cases. However, this current trend has led to some problems, including the maximization of ultrasonographic interpretations, misunderstandings in serial human koryonik gonadotropin hormon measurements, and complications due to inappropriate methotrexate use. The aim of the present study was to review the literature relating to the diagnosis and follow-up of early pregnancies, to underline some of the important considerations, and to help avoid possible iatrogenic errors.Öğe The Effect of Coasting on Intracytoplasmic Sperm Injection Outcome in Antagonist and Agonist Cycle(Royan Inst, 2017) Duvan, Z. Candan Iltemir; Kalem, Muberra Namli; Onaran, Yuksel; Keskin, Esra Aktepe; Ayrim, Aylin; Pekel, Aslihan; Kafali, HasanBackground: Coasting can reduce the ovarian hyperstimulation syndrome (OHSS) risk in ovulation induction cycles before intracytoplasmic sperm injection (ICSI). This study aimed to investigate the effect of gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist protocols to controlled ovarian hyperstimulation (COH) cycles with coasting on the parameters of ICSI cycles and the outcome. Materials and Methods: In a retrospective cohort study, 117 ICSI cycles were performed and coasting was applied due to hyperresponse, between 2006 and 2011. The ICSI outcomes after coasting were then compared between the GnRH agonist group (n=91) and the GnRH antagonist group (n=26). Results: The duration of induction and the total consumption of gonadotropins were found to be similar. Estradiol (E-2) levels on human chorionic gonadotropin (hCG) day were found higher in the agonist group. Coasting days were similar when the two groups were compared. The number of mature oocytes and the fertilization rates were similar in both groups; however, the number of grade 1 (G1) embryos and the number of transferred embryos were higher in the agonist group. Implantation rates were significantly higher in the antagonist group compared to the agonist group. Pregnancy rates/embryo transfer rates were higher in the antagonist group; however, this difference was not statistically significant (32.8% for agonist group vs. 39.1% for antagonist group, P > 0.05). Conclusion: The present study showed that applying GnRH-agonist and GnRH-antagonist protocols to coasted cycles did not result in any differences in cycle parameters and clinical pregnancy rates.Öğe The relationship between postmenopausal women's sclerostin levels and their bone density, age, body mass index, hormonal status, and smoking and consumption of coffee and dairy products(Springer Heidelberg, 2017) Kalem, Muberra Namli; Kalem, Ziya; Akgun, Nilufer; Bakirarar, BatuhanTo investigate the relationship between postmenopausal women's sclerostin levels and bone density and the factors that may affect this relationship. 135 postmenopausal patients' ages, BMIs, hormonal statuses, BMD values, and smoking, and consumption of coffee and dairy products were compared with their sclerostin levels. No statistical relationship was found between sclerostin level and age in the group with osteoporosis (p = 0.204, r = -0.305). There was a positive, high-level relationship between sclerostin levels and BMI in the osteoporosis group and it was found to be statistically significant (p < 0.001, r = 0.786). No statistical relationship was found between sclerostin level and age in the non-osteoporosis group with (p = 0.496, r = -0.88). There was a positive, moderate relationship between sclerostin levels and BMI in the non-osteoporosis group and it was found to be statistically significant (p < 0.001, r = 0.505). No statistically significant relationship could be found between sclerostin levels and vitamin D (p = 0.723), PTH (p = 0.112), FSH (p = 0.795), E-2 (p = 0.627), TSH (p = 0.517), T-3 (p = 0.788), and T-4 (p = 0.664) blood levels. No significant difference was found among the groups formed by smoking, consumption of coffee and milk, and dairy products, either (p = 0.405; p = 0.626; p = 0.234, respectively). It was monitored that sclerostin's negative effect observed on BMD scores was independent from age; however, it had a positive correlation with BMI. As blood sclerostin levels increase, bone mineral density decreases. This negative effect of sclerostin on bone density increases as BMI increases, too. Effects of sclerostin levels on bone density are independent from age, and they are not affect by levels of vitamin D: PTH, FSH, E-2 and thyroid hormones, and daily activities, such as smoking and consumption of coffee and milk and dairy products, either.
