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Öğe Awareness of Pregnant Women About Routine Applied Screening Tests and Supportive Treatments in a University Hospital(Istanbul Training & Research Hospital, 2020) Kutlu, Ruhusen; Uzun, Latife; Karaoglu, Nazan; Gorkemli, HuseyinIntroduction: in this study, we aimed to evaluate the awareness of pregnant women about routine applied screening tests and supportive treatments in a university hospital and the factors affecting this. Methods: This observational, descriptive study was carried out between 15th April and 30th November 2018. Four hundred and ninety-three volunteer pregnant women who applied to the Necmettin Erbakan University Meram Faculty of Medicine outpatient clinic for the first time or were being followed up formed the study cohort. In order to determine socio-demographic characteristics, awareness of screening tests, and supportive therapies, and the factors affecting this, a questionnaire consisting of 36 multiple-choice, open-ended questions was applied through face-to-face interviews. Results: The median age of the participants was 27. More than half (57.4%) were graduated from primary school or did not receive education, and 89.0% were unemployed. The majority of the participants stated that they knew screening tests (92.1%) and supportive treatments (93.9%). Forty-eight point one percent and 44.0% of screening tests and supportive treatments were learned from obstetricians, respectively. The reason stated by 57.6% of the participants who did not want to have screening tests was, I find it unnecessary because I do not want to end my pregnancy. Participants who were 27 years old or older (p=0.021), who were at least high school graduates (p=0.016), who were employed (p=0.041), and who had given birth before (p<0.001) knew the screening tests more significantly. Conclusion: The study results showed that the awareness of pregnant women about screening tests and supportive treatments increased with increasing maternal age, education level, employment status, and the number of births. Although the percentage of getting information from healthcare workers about screening tests and supportive treatments was higher, it was still not at the desired level. Therefore, we believe that healthcare workers should be more sensitive to informing and counseling during prenatal care, especially for young and low-educated mothers living in rural areas.Öğe Comparison of embryo morphokinetics following intracytoplasmic sperm injection in smoker and non-smoker couples: Are the results different?(Pakistan Medical Assoc, 2017) Salvarci, Ahmet; Gurbuz, Ali Sami; Uzman, Sukru; Kaya, Melek; Gorkemli, HuseyinObjective: To assess early embryo development via time-lapse in smokers and non-smokers. Methods: The retrospective study was conducted at Novafertil IVF centers in Konya, Turkey and comprised oocytes of both smoker and non-smoker couples subjected to in vitro fertilisation /introcytoplasmic sperm injection from 2012 to 2015. Age, basal follicle-stimulating hormone, number of stimulation days, amount of gonadotropin used, number of metaphase II oocytes, number of embryos transferred and pregnancy, abortus and clinical pregnancy rates were noted. The embryos were observed for 72 hours in the time-lapse monitoring system. SPSS 22 was used for data analysis. Results: Of the 257 couples, 132(51.4%) were non-smokers and 125(48.6%) were smokers. A total of 1,414 oocytes were collected from non-smokers and 1,280 oocytes from smokers. There was no significant difference in the age of patients and number of stimulation days between the smoker and non-smoker groups (p>0.05). The number of oocytes, fertilised oocytes, transferred embryos and metaphase II oocytes was significantly less in the smoker group (p<0.05). The rate of pregnancy and ongoing pregnancy was also lower in the smoker group (p<0.05)smoker and non-smoker groups (p<0.05). A prolongation was observed in time to pronuclear fading. A difference was observed in time of pronuclei appearance, t8, t9+ cleavage times in time-lapse in the and t2 cleavage times in time-lapse in the non-smoker group (p<0.05). Some chromosomal number and structural defects were identified in preimplantation genetic in some embryos with prolongation in time-lapse cleavage time in the smoker and nonsmoker groups. Conclusion: The negative impacts of smoking were not observed at each cleavage phase of embryo development in time-lapse.Öğe Effects of Sperm Parameters to Fertility for Intrauterine Insemination Patients According to WHO 2010 Criteria(Modestum Ltd, 2015) Tursun, Tugba Sekmenli; Gorkemli, Huseyin; Yilmaz, Fatma Yazici; Aktan, Tahsin MuratTo evaluate sperm parameters as morphology of sperms in conjunction with number of motile sperms, according to 2010 World Health Organization (WHO) criteria's and to obtain optimal sperm parameters. We have examined prospectively 50 Intrauterine Insemination (IUI) cases for sperm parameters (morphology, TPMSC) and effects of some variables (woman age, infertility duration, FSH level, primary and secondary infertility) to pregnancy rate. First we divided cases in to 2 groups according to TPMSC (Total Progressive Motile Sperm Count) less than 1 million-greater than 1million- and compared number of progressively motile sperms and fertility rate. There was no statistically significant difference between pregnancy rate and sperm morphology (p>0.05) The pregnancy rate for the patient population with TPMSC >1 million was more than another and this was statistically significant (p<0.05). There was no significant fertility difference among subgroups for Morphology and TPMSC as these 2 parameters are evaluated together (p>0.05). There was no significant difference according to age related pregnancy rate (p>0.05). There was no significant statistical differences among groups and subgroups in infertility duration, FSH level and woman age (p>0.05). Our study shows that pregnancy rate has no correlation with sperm morphology -as sperm parameter-for patients that IUI was applied. For the group with TPMSC >1 million, fertility rate was higher and this was statistically significant. Sperm parameters especially TPMSS that are important in determining the treatment plans of infertile patients but the effectiveness of morphology should be discussed.Öğe Effects of Sperm Parameters to Fertility for Intrauterine Insemination Patients According to WHO 2010 Criteria(Modestum Ltd, 2015) Tursun, Tugba Sekmenli; Gorkemli, Huseyin; Yilmaz, Fatma Yazici; Aktan, Tahsin MuratTo evaluate sperm parameters as morphology of sperms in conjunction with number of motile sperms, according to 2010 World Health Organization (WHO) criteria's and to obtain optimal sperm parameters. We have examined prospectively 50 Intrauterine Insemination (IUI) cases for sperm parameters (morphology, TPMSC) and effects of some variables (woman age, infertility duration, FSH level, primary and secondary infertility) to pregnancy rate. First we divided cases in to 2 groups according to TPMSC (Total Progressive Motile Sperm Count) less than 1 million-greater than 1million- and compared number of progressively motile sperms and fertility rate. There was no statistically significant difference between pregnancy rate and sperm morphology (p>0.05) The pregnancy rate for the patient population with TPMSC >1 million was more than another and this was statistically significant (p<0.05). There was no significant fertility difference among subgroups for Morphology and TPMSC as these 2 parameters are evaluated together (p>0.05). There was no significant difference according to age related pregnancy rate (p>0.05). There was no significant statistical differences among groups and subgroups in infertility duration, FSH level and woman age (p>0.05). Our study shows that pregnancy rate has no correlation with sperm morphology -as sperm parameter-for patients that IUI was applied. For the group with TPMSC >1 million, fertility rate was higher and this was statistically significant. Sperm parameters especially TPMSS that are important in determining the treatment plans of infertile patients but the effectiveness of morphology should be discussed.Öğe The evaluation of recombinant LH supplementation in patients with suboptimal response to recombinant FSH undergoing IVF treatment with GnRH agonist down-regulation(Taylor & Francis Ltd, 2015) Yilmaz, Fatma Yazici; Gorkemli, Huseyin; Colakoglu, Mehmet Cengiz; Aktan, Murat; Gezginc, KazimWe aimed to evaluate the clinical efficacy of r-LH supplementation to r-FSH in patients with suboptimal response to ovarian stimulation undergoing assisted reproduction with GnRH-a downregulation and stimulation with r-FSH. One-hundred thirty-seven patients were included in the study; among them 52 showed normal ovarian response to stimulation and composed the control group (Group 1), and 85 showed suboptimal response to stimulation and were divided into two groups. For Group 2 (n = 50), 75 IU/L r-LH was added to the treatment, for Group 3 (n = 35) r-FSH dose was increased by 75 IU/L. IVF results were compared between the groups. Implantation rates were 34.8% in control group, and 36.1% and 15% in LH supplementation group and increased-dose r-FSH group, respectively. Implantation rates were statistically significantly higher in Groups 1 and 2 compared to Group 3 (p < 0.02). Pregnancy rate was noticed in 64.7% of Group 1, 57.8% of Group 2 and at 32.4% of Group 3. Pregnancy rate was significantly higher in Group 2 than Group 3 (p < 0.05). r-LH supplementation is an option for improving IVF outcome in patients with suboptimal ovarian response to ovulation induction with r-FSH during GnRH agonist down-regulation. Particularly, r-LH is recommended as it may have a beneficial action on implantation in selected group.Öğe Incidence of Metabolic Syndrome and Long-Term Chronic Health Problems in Infertile Women(Istanbul Training & Research Hospital, 2017) Kutlu, Ruhusen; Ozberk, Derya Isiklar; Gorkemli, HuseyinIntroduction: Infertility is a condition wherein there is no pregnancy within 1 year despite regular sexual intercourse without birth control. The aim of this study was to evaluate the incidence of metabolic syndrome (MetS) and chronic long-term health problems in infertile female patients. Methods: This cross-sectional and analytical study was retrospectively conducted on 701 women who applied to family medicine outpatient clinic and received a medical report with the complaint of female infertility. The weight, height, waist circumference, blood pressure, and laboratory results of subjects were recorded from the information in the files. MetS was diagnosed according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) guideline. Results: The mean age of the 701 infertile women in the study was 29.9 +/- 4.4 (20-42) years; 81.6% (n=572) were housewives and 56.8% (n=398) completed primary school and were undergraduates. Of the patients, 78.9% (n=553) were admitted due to primary infertility. The incidence of MetS was 19.8% in the subjects of this study. The risk of MetS was 6,389 times higher in obese than in non-obese individuals [ odds ratio (OR)=6,389; % 95 confidence interval (CI): (4,260-9,581)], and this difference was statistically significant (p<0.001). The most common MetS components were triglyceride elevation (59.6%) and fasting blood glucose (55.0%). MetS was detected in 50.3% of hypertensive patients. Of the participants, 22.8% had hypothyroidism and 2.7% were found to have brucella seropositivity. Conclusion: Obesity, long-term health problems, smoking, and some infectious diseases, which are among the replaceable factors associated with infertility, should be excluded before infertility treatment. Healthy lifestyle changes such as well-balanced and correct nutrition, physical activity, giving up smoking and alcohol will reduce the risk of obesity and increase the chances of infertility treatment.Öğe Incidence of unexpected leiomyosarcoma in a Turkish province: a retrospective multi-centre study in a low income setting(Taylor & Francis Inc, 2022) Tasdemir, Umit; Ceran, Mehmet Ufuk; Dirican, Aylin Onder; Akar, Serra; Celik, Cetin; Energin, Hasan; Gorkemli, HuseyinThe aim of the current study was to estimate the incidence of unexpected leiomyosarcoma (LMS) in patients who underwent surgery due to leiomyomas in Konya province, and to contribute to the literature discussing comparisons with similar studies. The digital archives of eight high-volume hospitals were studied for surgeries performed due to leiomyomas between January 2012 and January 2019, and leiomyosarcoma incidence was calculated based on the data obtained. Twenty-one patients in 3703 cases were found to have unexpected leiomyosarcoma, which means we can expect one leiomyosarcoma in 176 (0.56%) surgeries. Six more malignant tumours were detected among the remaining cases. Thus, our study estimated the incidence of unexpected leiomyosarcoma as 1/176 (0.56%), which is higher than most of the studies in the literature justifying the debate started by the FDA in 2014. As the tumour biology is not yet clear, and the incidence of unexpected leiomyosarcoma tends to be so high, the key focus must be to try to detect uterine leiomyosarcomas preoperatively for robust patient care.IMPACT STATEMENT What is already known on this subject? The incidence of unexpected leiomyosarcoma varies widely from 1/498 to 1/8300 depending on the study method and the type of procedure, and there is still controversy, even after the FDA statement that led to a major restriction in laparoscopic surgeries due to concerns about inadvertent morcellation of leiomyosarcomas. What do the results of this study add? To the best of our knowledge, the current study found the highest incidence of unexpected leiomyosarcoma, and consequently a serious evaluation of all patients undergoing surgery due to leiomyomas preoperatively considering a leiomyosarcoma candidate is recommended. What are the implications of these findings for clinical practice and/or further research? Studies on tumour biology and novel markers must be supported for accurate preoperative diagnosis of leiomyosarcoma.Öğe Prenatal diagnosis of double trisomy 48, XXX,+18; case report(Taylor & Francis Inc, 2018) Ercan, Fedi; Tasdemir, Pelin; Pekin, Aybike Tazegul; Sayal, Berkan; Gorkemli, Huseyin; Acar, Ali[Abstract Not Availabe]Öğe Villoglandulary papillary adenocarcinoma co-existing with high-grade squamous intraepitelial lesion; arising from an endocervical polyp(Modestum Ltd, 2017) Findik, Siddika; Gorkemli, HuseyinAdenocarcinomas account for 10-20% of invasive cervical carcinomas. The villoglandular papillary adenocarcinoma has been recognized as a subtype of mucinous adenocarcinoma and identified as a distinctive histological entity from the usual invasive adenocarcinomas of the uterine cervix. We report a new case of villoglandulary papillary adenocarcinoma, which was peculiar because of its association with a co-existing high grade squamous intraepithelial lesion and arising from an endocervical polyp. Excellent prognosis of isolated villoglandulary papillary adenocarcinoma is important in terms of making differential diagnosis from other adenocarcinomas and eliminating unnecessary aggressive treatments. It is also important to keep in mind for pathologists since it allows them to examine endocervical polyps that we often encounter in daily life and shows that malignant tumoral lesions can develop from polyps.
