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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item DHEA supplementation improves endometrial HOXA-10 mRNA expression in poor responders(GALENOS YAYINCILIK, 2017-01-01) Celik, Onder; Acet, Mustafa; Imren, Aytac; Celik, Nilufer; Ersahin, Aynur; Aktun, Lebriz Hale; Otlu, Baris; Celik, Sudenaz; Caliskan, Eray; Unlu, CihatObjective: The study was planned to investigate whether DHEA supplementation had an impact on endometrial receptivity in women who were poor responders (POR). Material and Methods: Twenty-eight POR women who were undergoing hysteroscopy and five fertile control subjects were included. The POR women were equally subdivided into two separate groups as patients who were currently using DHEA and those who were not. Endometrial samples of the subjects were obtained during hysteroscopy at the late follicular phase. Expression levels of endometrial HOXA-10, HOXA-11, and LIF mRNA were measured with the using real-time polymerase chain reaction. Spontaneous clinical pregnancy rates were also noted. Results: Compared with POR women who were not given DHEA, upregulated endometrial HOXA-10 (7.33-fold) and HOXA-11 (2.39-fold) mRNA expression were detected in POR women on DHEA. The increase in HOXA-10 mRNA was significant (p<0.03). The fold increase in HOXA-11 mRNA was found as 2.39, which indicated a positive upregulation. However, this fold increment was insignificant (p<0.45). An insignificant increase in spontaneous clinical pregnancy rates in POR women on DHEA (53.3\%) was observed compared with POR women who were not given DHEA (43.8\%). Conclusion: Oral DHEA supplementation in POR upregulates endometrial HOXA-10 mRNA expression, which is known to positively modulate endometrial receptivity.Item Uterine rupture in pregnancy subsequent to hysteroscopic surgery: A case series(GALENOS YAYINCILIK, 2017-01-01) Zeteroglu, Sahin; Aslan, Melisa; Akar, Bertan; Bender, Rukiye Ada; Basbug, Alper; Caliskan, ErayUterine rupture during pregnancy is associated with high mortality and morbidity rates in both the fetus and the mother. Hysteroscopic surgeries such as myomectomy and septum resection are known risk factors for uterine rupture in pregnancy following the operation. We present four infertile patients who were admitted to Kocaeli Medical Park Hospital between February 2014 and November 2016. Three of the patients underwent hysteroscopic septum resection without complication and one had hysteroscopic myomectomy and a 7-8 mm sized rupture was detected. All of the patients became pregnant in less than a year after the operations. The first three patients had uterine rupture at 22nd, 38th, and 10th week, which is the earliest rupture in the literature. The last patient had an uneventful pregnancy and the rupture was observed during cesarean section. A short interval between hysteroscopy and pregnancy may increase the risk of rupture. It may be possible to become pregnant despite rupture and not have any problems during the entire pregnancy.Item Laparoscopic endometrioma resection increases peri-implantation endometrial HOXA-10 and HOXA-11 mRNA expression(ELSEVIER SCIENCE INC, 2015-01-01) Celik, Onder; Unlu, Cihat; Otlu, Baris; Celik, Nilufer; Caliskan, ErayObjective: To determine whether laparoscopic endometrioma resection alters peri-implantation endometrial HOXA-10, HOXA-11, LIF, ITGB3 and ITGAV mRNA expression. Design: Case-control study. Setting: Medical school. Patient(s): Twenty infertile patients with uni-or bilateral endometrioma, five infertile patients having nonendometriotic benign ovarian cyst, and five fertile control subjects. Intervention(s): Mid-luteal-phase endometrial sampling was performed at the time of surgery. Second endometrial biopsies were obtained 3 months after laparoscopic endometrioma resection during the mid-luteal phase of the cycle. Main Outcome Measure(s): Endometrial HOXA-10, HOXA-11, LIF, ITGAV, and ITGB3 mRNA expressions were evaluated with the use of reverse-transcription polymerase chain reaction. Result(s): Significantly decreased endometrial ITGAV mRNA expression was noted in biopsies obtained from endometrioma and nonendometriotic cyst groups before surgery. Trends toward decreased endometrial HOXA-10, HOXA-11, LIF, and ITGB3 mRNA expressions were noted in the endometrioma and nonendometriotic cyst groups before surgery compared with the fertile subjects. However, the differences failed to show statistical significance. Compared with preoperative values, significantly increased HOXA-10 (12.1-fold change) and HOXA-11 (17.2-fold change) mRNA expressions were noted in endometrial biopsies obtained from subjects who were undergoing endometrioma surgery. Fold change in endometrial ITGAV mRNA after endometrioma surgery was found to be 30.1 and indicated a positive regulation. However, this fold increase was statistically insignificant. Expressions of these endometrial receptivity markers did not change significantly after surgical removal of nonendometriotic benign ovarian cysts. Conclusion(s): Laparoscopic endometrioma resection increases peri-implantation endometrial HOXA-10 and HOXA-11 mRNA expression, suggesting an improvement in endometrial receptivity. (C) 2015 by American Society for Reproductive Medicine.