Araştırma Çıktıları
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Item Fertility-sparing in cancer patients(IMR PRESS, 2021-01-01) Karakas, Sema; Kaya, Cihan; Schafer, Sebastian Daniel; Mikus, Mislav; Terzic, Milan; Abdullaev, Bekhzod; Andrisani, AlessandraObjective: This review aimed to investigate and summarize the current evidence on fertility-sparing options in cancer patients. Mechanism: Fertility preservation methods are becoming popular through the improved prognosis of cancer patients at a younger age and early diagnostic tools. However, currently, more and more women are suffering from iatrogenic ovarian failure and fertility loss because of cancer treatment. Most treatments have been used for hematological malignancies, but different gynecological cancers can be eligible. Findings in brief: Fertility preserving strategies such as oocyte and embryo cryopreservation, ovarian tissue preservation, ovarian transposition, and aspiration of ovarian follicles are the methods that could be suggestedto the patients. The current knowledge supports oocyte and embryo cryopreservation as feasible, safe, and effective treatment approaches for cancer patients seeking fertility preservation. Conclusions: Robust evidence is still needed to prove the effectiveness of cryopreservation of the ovarian tissue and ovarian follicle aspiration approaches since these techniques are still in early their steps.Item The role of dynamic thiol/disulfide homeostasis for the evaluation of oxidative stress in endometriosis patients(MARMARA UNIV, FAC MEDICINE, 2022-01-01) Topbas Selcuki, Nura Fitnat; Yalcin Bahat, Pinar; Kaya, Cihan; Neselioglu, Salim; Bagci, Kubra; Goksu, Mustafa; Kabakci, Merle; Erel, OzcanObjective: To evaluate the role of oxidative stress in endometriosis patients by determining dynamic thiol/disulfide homeostasis and ischemia modified albumin (IMA) levels. Patients and Methods: This prospective case-controlled study was conducted at a tertiary gynecology clinic in Istanbul, Turkey. 86 patients previously diagnosed with endometriosis and persistent endometriomas were included in the study group. 60 patients who visited the clinic during the study period for routine gynecological control were included in the control group. Thiol/disulfide parameters and IMA levels were determined from the serum samples. Results: When the thiol/disulfide parameters were compared between the study and the control group no significant difference was observed (p=0.49). Mean disulfide level in the control group was 18.58 +/- 5.73 mu mol/L, and in the study group was 18.61 +/- 7.37 mu mol/L. Levels were statistically similar in both groups (p=0.98). In addition, there were no differences between the groups in terms of IMA and albumin levels. Conclusion: The results of this study revealed no significant difference in the dynamic thiol/disulfide homeostasis among the endometriosis patients. Although, it has been accepted as a potential oxidative stress marker in other chronic inflammatory diseases, its use in determining the systemic oxidative stress level in endometriosis patients is limited.Item Telemedicine and Artificial Intelligence in the Management of Endometriosis: Future Forecast Considering Current Progress(GEORG THIEME VERLAG KG, 2021-01-01) Kaya, Cihan; Usta, Taner; Oral, EnginItem Hysteroscopy-Guided Natural Orifice Repair of Isthmocele(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2022-01-01) Kaya, Cihan; Aslan, Ozgur; Tetik, MuelayimIsthmocele can be defined as a hypoechoic field within the lower uterine segment, indicating a discontinuation of the myometrium at the uterine scar of a previous cesarean section. Postmenstrual spotting, pelvic pain, dysmenorrhea, dyspareunia, uterine rupture, cesarean scar pregnancy, and secondary infertility could be seen as the complications of existing isthmocele. Such defects are prevalent with the increasing number of cesarean deliveries. A 39-year-old woman who had three prior cesarean sections complaining irregular uterine bleeding for 2 years was examined. A uterine scar defect was observed. A hysteroscopy-guided natural orifice approach was planned to repair the defect. The patient was discharged without any complication in her postoperative 6th h. She had no pain or irregular bleeding in her 2-week postoperative visit.Item Endotrophin as a novel marker in PCOS and its relation with other adipokines and metabolic parameters: a pilot study(SAGE PUBLICATIONS LTD, 2021-01-01) Guney, Gurhan; Taskin, Mine Islimye; Baykan, Ozgur; Adali, Ertan; Gul Tezcan, Selin; Sarikaya, Serkan; Kaya, Cihan; Tolu, EzgiBackground: Polycystic ovary syndrome is known to be the most common hormonal disorder in women of reproductive age. Current evidence shows that regulatory proteins secreted from the adipose tissue called adipokines may have a role in polycystic ovary syndrome. We planned to investigate the role of endotrophin that has never been researched in polycystic ovary syndrome before and its correlation with other metabolic parameters and adipokines such as adiponectin and ghrelin in patients with polycystic ovary syndrome. Methods: Forty-three women (n: 43) with polycystic ovary syndrome and 43 (n: 43) women as a control group were enrolled in this cross-sectional study. Serum levels of endotrophin, adiponectin, and ghrelin levels were measured with the enzyme-linked immunosorbent assay method. High-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol levels, luteinizing hormone/follicle-stimulating hormone ratio, total testosterone, and triglyceride levels were measured. Homeostasis model assessment for insulin resistance index, body mass index, Ferriman Gallwey Score, and waist-to-hip ratio were also evaluated. Results: Total testosterone, homeostasis model assessment for insulin resistance, C-reactive protein, luteinizing hormone/follicle-stimulating hormone ratio, and triglyceride levels were higher in patients with polycystic ovary syndrome (p < 0.01). No difference was detected between the groups in terms of body mass index, Ferriman Gallwey Score, waist-to-hip ratio, total cholesterol, low-density lipoprotein, and high-density lipoprotein levels (p > 0.05). We did not observe any significant difference in adiponectin and ghrelin levels between the groups (p > 0.05). Patients with polycystic ovary syndrome had significantly higher endotrophin levels (p < 0.01). According to our regression analyses {[}area under the curve: 0.973 (0.935-1.000), 95\% confidence interval, 95.2\% sensitivity, and 100\% specificity], it was shown that endotrophin greater than 92 ng/ml and homeostasis model assessment for insulin resistance greater than 2.5 might be good predictors for polycystic ovary syndrome diagnosis. Conclusion: We demonstrated that endotrophin level is higher in patients with polycystic ovary syndrome and may have predicted polycystic ovary syndrome with increased homeostasis model assessment for insulin resistance index. There was no significant difference in adiponectin and ghrelin levels in the polycystic ovary syndrome group. Endotrophin may have a role in polycystic ovary syndrome etiology rather than other adipokines.Item Predictive value of preoperative MRI using the \#ENZIAN classification score in patients with deep infiltrating endometriosis(SPRINGER HEIDELBERG, 2023-01-01) Tunca, Aysun Fendal; Iliman, Derya Ece; Gemici, Aysegul Akdogan; Kaya, CihanPurpose The aim of this study is to investigate the correlation between the magnetic resonance imaging (MRI) and intraoperative findings of deep infiltrating endometriosis using the \#ENZIAN score. Methods This retrospective study included 64 patients who underwent surgery for deep infiltrating endometriosis between January 2017 and August 2020. Preoperative abdominopelvic MRI assessment was evaluated and scored using the \#ENZIAN classification. Operative scores were considered the gold standard, and the sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of MRI for each category were calculated. Results MRI has higher sensitivity and specificity in showing the lesions of the compartments O (ovarian lesions), A (rectovaginal septum and posterior vaginal fornix), and B (uterosacral ligaments and parametrium) (100-100\%, 100-100\%, and 97-100\%, respectively, p < 0.001) compared to the other compartments. The lowest sensitivity, specificity, accuracy, and PPV of the MRI was found in compartment P (14\%, 76\%, 70\%, and 7\%, respectively). Conclusion We demonstrated that the \#ENZIAN classification in MRI reports has significant sensitivity and specificity in compartments A, B (uterosacral ligaments and parametrium), and O. Furthermore, the determination of peritoneal lesions via MRI is inadequate.