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Öğe Endometrial injury and fertility outcome on the day of oocyte retrieval(Bayrakol Medical Publisher, 2022) Turktekin, Nurettin; Karakus, Cemil; Ozyurt, RamazanAim: In this study, we aimed to investigate the effect of mechanical endometrial injury, performed on the day of egg retrieval, on pregnancy rates in patients who underwent IVF/ICSI due to PCOS and planned total embryo freezing. Material and Methods: Sixty women with PCOS scheduled for total embryo freezing due to the risk of ovarian hyperstimulation syndrome were included in the study. The participants were randomly divided into two groups as treatment and control, with 30 patients in each group. For patients in both groups, standard antagonist protocol for controlled ovarian stimulation was applied. The patients in the treatment group underwent endometrial scratching with a Pipelle cannula after egg collection. The patients in the control group (sham) were reached up to the fundus with a Pipelle catheter, but scratching was not performed. The primary outcome measures of the study were beta-hCG, clinical pregnancy rates (CPR), live birth rates (LBR), and miscarriage rates. Results: There was no significant difference between the two groups in terms of the percentage of beta-hCG positive patients, clinical pregnancy and live births (p>0.05). Clinical pregnancy and live birth rates of both groups were recorded as similar. No significant difference was found between the injury group and the control group in terms of miscarriages rates. All of the pregnancies in the scratching group and control group were intrauterine localized and no ectopic pregnancy was encountered. Discussion: Injury to the endometrium on the day of egg collection does not cause a significant increase in clinical pregnancy and live birth rates.Öğe Failed endometrial metabolite synthesis contributes to subfertility in women with unexplained infertility(Bayrakol Medical Publisher, 2022) Karakus, Cemil; Turktekin, NurettinAim: This study compares endometrial metabolite signal intensities of patients diagnosed with unexplained infertility (UEI) with those of fertile women. Material and Methods: A total of 20 patients diagnosed with UEI and 20 fertile women with at least two children were included in the study. UEI patients were matched with the fertile group in terms of age and BMI. UEI was defined as the absence of conception despite 12 months of unprotected intercourse, not explained by anovulation. Endometrial spectroscopy was applied to the women in both groups in the mid-luteal phase of the cycle. The endometrial signals of choline (Cho), creatine (Cr), lactate, and lipids were measured in units and denominated in parts per million. Results: All patients in both groups underwent successful spectroscopy and the main metabolites of Cho, Cr, lactate, and lipids were recorded. Cho (2.93 +/- 1.03 vs. 3.22 +/- 2.04, p<0.05) and Cr (2.33 +/- 1.30 vs. 2.76 +/- 1.43, p<0.01) metabolite signal intensities were found to be significantly lower in UEI patients compared to fertile controls. Lactate (0.56 +/- 0.11 vs. 0.62 +/- 0.30, p>0.66) and lipid (0.70 +/- 0.02 vs. 0.78 +/- 0.61, p>0.54) signal intensities were found to be similar between the groups. Discussion: Decreased Cho and Cr signals, which are physiological indicators of endometrial function, may be the possible cause of subfertility in UEI patients.Öğe Metformin decreases testicular damages following ischaemia/reperfusion injury in rats(Wiley, 2020) Saribal, Devrim; Erdem, Erkan; Gungor-Ordueri, Nazli Ece; Usta, Akin; Karakus, Cemil; Karacan, MericThe effects of metformin on a testicular torsion injury in adolescent rat testis after I/R were evaluated in the present study. Forty adolescent rats were divided into five groups with eight rats per group: a control group; a sham-operated group; an ischaemia group, where torsion was applied for 4 hr and testis was examined immediately after detorsion; an I/R group, where torsion was applied for 4 hr and the testis was examined 4 hr after detorsion; and an I/R + M group, where the metformin (300 mg/kg) administration was added to the identical procedures used for the I/R group. Spermatogenesis, basal membrane integrity and cleaved caspase-3 expression were assessed. The I/R + M group had a significantly higher Johnsen score than the I/R group (7.9 +/- 0.1 vs. 7.5 +/- 0.2; p F-value = 14.2). Failure of basal membrane integrity was highest in the ischaemia group (45 +/- 5) compared to the other groups (control group, 20 +/- 5; sham-operated group, 16.6 +/- 2.8), but not different between the I/R + M (31.6 +/- 12.5) and the I/R groups (25 +/- 3.5). Cleaved caspase-3 expression was highest in the ischaemia group (73.5 +/- 0.7), and significantly lower in the I/R + M group (33.4 +/- 0.9) than the I/R group (58.5 +/- 0.2; p F-value = 7.6). Metformin decreases testicular damage by exerting protection against the harmful effects of I/R on spermatogenesis and alleviating apoptosis in adolescent rat testis.Öğe Regulation of Endometrial NF-Kappa B Expression in Patients with PCOS Undergoing Total Embryo Freezing(IMR PRESS, 2022) Karakus, CemilBackground: To investigate Nuclear Factor kappa B (NF-?B) expression pattern in the endometrial samples taken on the day of egg collection in women with polycystic ovarian syndrome (PCOS)scheduled for total embryo freezing due to the risk of ovarian hyper stimulation syndrome (OHSS). Methods: Forty women with PCOS scheduled for total embryo freezing due to the risk of ovarian hyperstimulation syndrome were included in the study. Twenty-five infertile women who decided to freeze all of their embryos for any reason other than PCOS were utilized as the control group. Endometrial sampling was performed from all patients in both groups im mediately following the egg collection. Five fertile women with at least two children constituted the second control group. Endometrial sampling was performed from fertile patients during the mid-luteal phase. After immunohistochemical staining of endometrial samples with NF-?B/p65, the intensity of endometrial NF-?B/p65 expression was measured utilizing the H-score method. Results: NF-?B/p65 immunoreactivity was detected in both luminal and glandular endometrial cells from all samples. The mean H-score of endometrial NF ?B/p65 expression in the PCOS group was significantly increased compared to age and Body mass index (BMI) matched control group and fertile controls. NF-?B/p65 immunoreactivity of the control and fertile groups were found to be similar. There was no statistically significant difference in the mean H-score of endometrial NF-?B/p65 expression between the control and fertile groups. A positive and significant correlation was found between H-score values of NF-?B and E2 (estradiol), endometrial thickness, total oocyte count and total follicle stimulating hormone (rFSH) dose on human chorionic gonadotropin (hCG) day. Similarly, a strong positive correlation was found between serum testosterone, insulin levels, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) values and NF-?B values. In addition to progesterone values on hCG day, no significant correlation was found between other parameters and NF-?B. Con clusions: Increased endometrial NF-?B/p65 expression may contribute to the diminished reproductive potential of women with PCOS undergoing total embryo freezing.Öğe Second hysterosalpingography in the evaluation of unilateral proximal tubal obstruction(Bayrakol Medical Publisher, 2022) Ozyurt, Ramazan; Karakus, CemilAim: In this study, we aimed to test how often PTO persists in the second HSG of infertile patients with unilateral proximal tubal obstruction (PTO) in the first hysterosalpingography (HSG). Material and Methods: One hundred patients who underwent HSG during the infertility work-up and were found to have unilateral PTO were included in the study. Forty patients who accepted our proposal of expectant treatment or intrauterine insemination (IUI) were excluded from the study. The remaining 60 patients underwent a second HSG in the next cycle, and the results were compared with the results of the first HSG. Results: Bilateral tubal patency was detected in 35 of 60 patients who underwent a second HSG for PTO confirmation (58.3%). In the remaining 25 patients, unilateral PTO persisted (41.6%). Discussion: In patients with unilateral PTO in the first HSG, performing a second HSG before planning further examination with laparoscopy or hysteroscopy provides bilateral tubal patency in more than half of the patients.
