The effect of estradiol on pregnancy rates for luteal phase support in IVF-ICSI-ET agonist cycles

Purpose: The aim of this study was to investigate the effect of transdermal estrogen on pregnancy rates in addition to progesterone for luteal phase support in agonist in-vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) / embriyo transfer (ET) cycles. Materials and Methods: This randomized controlled study (RCT) enrolled a total of 142 patients with an indication for IVF/ICSI. We randomized patients prospectively to administer either progesterone (control group n=71) and additionally transdermal estrogen patch (study group n=71) as luteal support after oocyte retrieval. The levels of estrogen was determined on the day of transfer of embryo and 12th day. The main outcome measure was the ongoing pregnancy rate. Both groups were also compared for the induction characteristics, estrogen levels, beta-hCG positivity, and abortion rates. Results: There were no significant differences between the groups according to age, infertility time, and indications. Both groups were similar for induction characteristics and E2 levels. beta-hCG positivity rate was similar and the ongoing pregnancy rate was similar in both groups. Biochemical and clinical abortion rates were also similar in both groups. On the 12th day, estrogen levels increased significantly in those who became pregnant group. Conclusion: Our study showed that adding supplementary estrogen to the progesterone has no positive effect on beta-hCG positivity, ongoing pregnancy, and abortion rates

Challenges on the morbidly obese endometrial cancer surgery: Laparotomy or laparoscopy, lymphadenectomy or no lymphadenectomy?

Objectives: A considerable proportion of endometrial cancer patients are morbidly obese. Management of these cases is a serious dilemma. The aim of this study was to investigate the relevance of laparoscopic route and omission of lymphadenectomy as morbidity-reducing strategies in this special population. Material and methods: Endometrial cancer patients’ archival records were retrospectively reviewed and cases with body mass index ≥ 40 kg/m2 were selected. A comparative evaluation of their characteristics and survival rates were performed. Firstly, according to the surgical approach; laparoscopy or laparotomy, and then regarding to performing lymphadenectomy or not. Results: There were 146 patients enrolled in this study. Whereas, significantly higher postoperative complications and longer hospital stays were determined in the laparotomy compared to laparoscopy groups. Five years disease-free and overall survival were not significantly different (83.6% vs 70.7%, p = 0.184 and 83.9% vs 86.6%, p = 0.571, respectively). On the other hand, operation length, postoperative hospitalization time, both intraoperative and postoperative complications were significantly lower in the non-lymphadenectomy compared to the lymphadenectomy groups. However, five-years disease-free and overall survival were not significantly different (77.3% vs 81.3%, p = 0.586 and 87.5% vs 78%, p = 0.479, respectively). Conclusions: Laparoscopic approach and omission of lymphadenectomy are worthy policies in the morbidly obese endometrial cancer patients

The role of dinoprostone for labor induction in postterm and high-risk term pregnancies

Purpose: To determine the effect of controlled release vaginal dinoprostone (CRVD) in post-term and high-risk term pregnancies on successful ripening, the length of active labour, the total time for delivery, route of delivery, and maternal-neonatal outcomes. Methods: We performed a retrospective study on women undergoing cervical ripening with CRVD. A total of 94 post-term pregnancies (group 1) were compared with 138 high-risk pregnancies requiring labour induction due to maternal and/or fetal indications at term (group 2). The primary outcome of the study was vaginal delivery within 24 hours. Length of active labour, the total time for delivery, route of delivery and maternal and neonatal outcomes were evaluated as secondary outcomes. Results: Vaginal delivery rates were 73.4% (69/94) and 81.9% (113/138) in groups 1 and 2, respectively (p = 0.123). The mean delivery lengths were 16.6 +/- 9.5 and 16 +/- 8.9 hours in groups 1 and 2, respectively (p = 0.259). Both groups were also similar regarding the length of active labour (9.3 +/- 6.7 and 9.6 +/- 6.8 hours; p = 0.717). Cesarean section rates were 23.4% and 13% in groups 1 and 2, respectively (p = 0.04). There were no differences in maternal and neonatal outcomes between the groups. Conclusion: Our study showed that dinoprostone is effective for labour induction, particularly in high-risk term pregnancies

Surrogate Endpoints and Real Outcomes in Perinatology

21st European Congress of Perinatal Medicine -- SEP 10-13, 2008 -- Istanbul, TURKEYWOS: 000272171800068

A unilateral tubal twin pregnancy

[No abstract available

Annular hymenotomy for imperforate hymen

PubMedID: 27094100Aim: Imperforate hymen is the most common obstructive anomaly of the female genital tract. Conventional surgical treatment for this condition is the cruciate incision made on the hymen. The aim of this study was to evaluate a novel technique that preserves virginity after hymenotomy using electrocautery. Methods: Patients diagnosed with imperforate hymen and treated with annular hymenotomy between 2009 and 2013 were included in this retrospective cohort study. Annular incision was done using electrocautery on the hymen whilst sparing the intact hymenal tissue circumferentially at least 5 mm from the base. Results: Fifteen patients were included in the study. Mean age of patients was 14.2 ± 2.2 years. The median operation time was 5 min (3–9 min). No complications occurred. During the follow-up examinations, none of the patients had hymenal closure and all had regular menstrual bleeding. Conclusion: This novel technique showed complete success without any observed complication. This technique might be a good alternative for patients seeking to preserve virginity after surgery. © 2016 Japan Society of Obstetrics and Gynecolog

An Evaluation of Risk Factors in Pregnant Women with Candida Vaginitis and the Diagnostic Value of Simultaneous Vaginal and Rectal Sampling

PubMedID: 21293929In this study, we investigated the epidemiological characteristics of VVC among pregnant women. We conducted a prospective survey among 372 pregnant women to investigate the prevalence, clinical forms, etiological agents, and predisposing factors of VVC. In addition, we determined the relationship between vaginal and rectal flora by simultaneously obtaining one high vaginal swab and one rectal swab from each patient using sterile cotton-tipped swabs. Furthermore, we compared the recovery and identification performances of chromID Candida agar to Sabouraud dextrose agar with gentamicin and chloramphenicol. Clinically and mycologically confirmed cases of VVC were detected in 139 (37. 4%) and vaginal colonization described in 42 (11. 3%) of 372 pregnant women. Rectal cultures were also positive in 98 of the 139 (70. 5%) VVC cases. Candida albicans and C. glabrata were identified in vaginal samples in 58. 0 versus 19. 0% and from rectal samples in 49. 0 versus 13. 5%, respectively. Increases in gestational week and gravidae were identified to be statistically significant in patients with acute VVC (AVVC) and symptomatic recurrent VVC (RVVC), and asymptomatic RVVC (P = 0. 04 and P = 0. 03, respectively). In the laboratory diagnosis of VVC, specifically tailored chromogenic media are reliable tools for both the recovery and rapid identification of common Candida spp., particularly C. albicans, as well as for the detection of polyfungal populations in vaginal samples (P > 0. 05). In addition, rectal colonization is a common finding in cases of AVVC and symptomatic-RVVC cases and corresponds well with the presence of the same yeast species in the vagina. © 2011 Springer Science+Business Media B.V.TF2010BAP1Acknowledgments This study was supported by the Research Fund of Cukurova University (Project No: TF2010BAP1). We gratefully acknowledge all of the patients who agreed to participate in this study. We also greatly appreciate to Selim Mısırlıoglu, MD; Erdem Akter, MD; Enver Naci Tuncer, MD; and Tuba Yuksel, MSc for their kind assistance in the laboratory workup

Unusual complication of 1st-trimester surgical abortion in patient with a septate uterus: Intrauterine fallopian tube herniation

PubMedID: 24456453[No abstract available