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  • Küçük Resim
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    Follicular fluid cerebellin and betatrophin regulate the metabolic functions of growing follicles in polycystic ovary syndrome
    (Korean Soc Reproductive Medicine, 2017) Erşahin, Aynur Adeviye; Acet, Mustafa; Erşahin, Suat Süphan; Acet, Tuba; Yardım, Meltem; Kenanoğlu, Ömer; Aydın, Süleyman
    Objective: The aim of this study was to assess the changes of follicular fluid (FF) and serum levels of cerebellin precursor protein 1 (cbln1) and betatrophin in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) with a gonadotropin-releasing hormone (GnRH) antagonist protocol. Methods: Twenty infertile women with PCOS and 20 control women diagnosed as poor responders undergoing ovarian stimulation with a GnRH antagonist were included. Blood samples were obtained during ovum pick-up. Follicular fluid from a dominant follicle was collected from the subjects. Using enzyme-linked immunosorbent assays, FF and serum levels of cblnl and betatrophin were measured in both groups of participants. Metabolic and hormonal parameters were also determined and correlated with each other. Results: Both groups of women had similar serum and FF betatrophin levels (55.0 +/- 8.9 ng/mL vs. 53.1 +/- 10.3 ng/mL, p = 0.11). The serum and FF betatrophin levels of poor responders were found to be similar (49.9 +/- 5.9 ng/mL vs. 48.9 +/- 10.7 ng/mL, p = 0.22). Conversely, the FF cbln1 levels of PCOS women were found to be significantly higherthan the serum cbln1 levels (589.1 +/- 147.6 ng/L vs. 531.7 +/- 743 ng/L, p < 0.02).The FF cbln1 levels of control participants without PCOS were significantly higher than their serum cbln1 levels (5993 +/- 211.5 ng/L vs. 5253 +/- 87.0 ng/L, p = 0.01). Positive correlations were detected among body mass index, insulin resistance, serum insulin, total testosterone, and betatrophin levels in the PCOS group. Conclusion: Follicular fluid betatrophin and cbln1 concentrations may playa pivotal role on follicular growth in PCOS subjects undergoing IVF/ICSI with an antagonist protocol.
  • Küçük Resim
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    Frozen embryo transfer prevents the detrimental effect of high estrogen on endometrium receptivity
    (2017) Erşahin, Aynur Adeviye; Acet, Mustafa; Erşahin, Suat Süphan; Güngör, Nur Dokuzeylül
    Objective: To investigate whether serum levels of estradiol affect reproductive outcomes of normoresponder women undergoing fresh embryo transfer (ET) versus frozen-thawed ET (FET).Material and Methods: Two hundred fifty-five normoresponder women underwent fresh ET in their first or second in vitro fertilization cycle. Ninety-two women with negative pregnacy test results underwent FET. Clinical and ongoing pregnancy rates, implantation, and live birth rates of women undergoing fresh ET versus FET were compared. Results: One hundred forty-seven (57.65%) out of the 255 normoresponder women receiving FET had positive beta-human chorionic gonadotrophin (hCG) results. The remaining 108 women had negative beta-hCG results. The clinical pregnancy rates of the fresh ET group were found as 55.69% (n=142). Ninety-two of the 108 women with failed pregnancies underwent FET; 72.83% had positive beta-hCG results (n=67), and 70.65% had clinical pregnancy (n=65). Both biochemical and clinical pregnancy rates of women undergoing FET increased significantly (p<0.012 and p<0.013, respectively). Ongoing pregnancy (60.87% vs. 52.94%) and live birth rates (59.87% vs. 48.63%) were similar in both fresh and FET groups. Serum E2 levels of women who failed to conceive were significantly higher than those women did conceive. Serum progesterone levels of women who conceived versus those that did not were similar. Conclusion: The detrimental effect of high serum estradiol levels on endometrial receptivity could be prevented by FET. (J Turk Ger Gynecol Assoc 2017; 18: 38-42)
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    Öğe
    Impact of endometrioma resection on eutopic endometrium metabolite contents: Noninvasive evaluation of endometrium receptivity
    (Sage Publications Inc, 2017) Erşahin, Aynur; Çelik, Önder; Acet, Mustafa; Erşahin, Süphan; Acet, Tuba; Bozkurt, Duygu Kara; İlhan, Selçuk
    The aim of this study was to determine whether endometrioma resection alters most commonly defined endometrial metabolites, lactate (Lac), N-acetylaspartate (NAA), creatine 1 (Cr1), creatine 2 (Cr2), and choline (Cho) during the window of implantation. Twenty patients with uni- or bilateral endometrioma and 7 patients having nonendometriotic benign ovarian cyst were included. Midluteal phase magnetic resonance spectroscopy analysis of eutopic endometrium was performed before surgery. Second spectrum of endometrium was obtained 3 to 5 months after laparoscopic endometrioma resection. Pre- and postoperative endometrial peaks of Lac, NAA, Cr, and Cho were measured in units and denominated in parts per million (ppm). Compared to preoperative peak values, significantly decreased NAA, Lac, and Cr1 signals were noted in patients undergoing endometrioma surgery. Nearly 5-fold decline in the NAA signal occurred after endometrioma surgery (1.94 +/- 3.24 vs 0.37 +/- 0.55). Likewise, 2.5-fold decline in Lac signals was noted after endometrioma resection (2.81 +/- 2.64 vs 1.06 +/- 1.88). Both uni- and bilateral endometrioma affected endometrium signals the same. The peak intensity of Cho, Cr1, Cr2, NAA, and Lac did not alter significantly after nonendometriotic cyst surgery. Endometrioma surgery straightens endometrial NAA, Lac, and Cr1 peaks, suggesting improvement in endometrial receptivity.