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    Cytogenetic Analysis Of Early Pregnancy Loss After Assisted Reproduction Treatment Using İntracytoplasmic Sperm İnjection
    (Medica sp, 2021) Hocaoğlu Emre, Fatma Sinem; Kamar, Aret; Turktekin, Nurettin; Özyurt, Ramazan; Karakuş, Cemil; Sarıbal, Devrim
    Objectives: To evaluate the incidence of numerical chromosomal abnormalities in the patients with early pregnancy loss (EPL) following in vitro fertilization, and evaluate the role of different confounders of the risk of chromosomal abnormality- related pregnancy loss. Material and methods: A retrospective chart review of all patients from our in vitro fertilization (IVF) center who conceived using assisted reproduction techniques between April 2017 and 2019, who experienced a subsequent early pregnancy loss, and whose abortus materials were successfully karyotyped were included. Results: Of the 243 patients experienced an early loss, the overall rate of chromosomal abnormality was 46.75%. The overall rate of aneuploidy in our patient group was 88.8% (64/72), whereas 6.94% (5/72) of the abnormal karyotypes were polyploid. The most common type of trisomy was Trisomy 16 (20.0%; 11/55) followed by Trisomy 15 (14.5%; 8/55). Univariate and multivariate analyses showed that maternal age (< 35 years) and the total number of retrieved oocytes per cycle (? 5) were risk factors for a chromosomal abnormality (< 0.001; < 0.05, respectively). The adjusted OR of karyotypic abnormalities was 0.45 for the antagonist cycle type (p < 0.05), and 0.58 for frozen embryo transfer (p < 0.05). Conclusions: Karyotypic abnormality is one of the main reasons for pregnancy loss following an IVF procedure. Although the pregnancy rates increased as a result of novel technologies, the ratio of EPL is still high. The implementation of preimplantation genetic screening techniques might lower the incidence of EPL due to chromosomal abnormalities, thus decreasing the burden on the physicians and the patients.
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    Endometrial injury and fertility outcome on the day of oocyte retrieval
    (Bayrakol Medical Publisher, 2022) Turktekin, Nurettin; Karakus, Cemil; Ozyurt, Ramazan
    Aim: 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.
  • Küçük Resim Yok
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    Failed endometrial metabolite synthesis contributes to subfertility in women with unexplained infertility
    (Bayrakol Medical Publisher, 2022) Karakus, Cemil; Turktekin, Nurettin
    Aim: 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.