Reproductive biomedicine online最新文献

{"title":"AGE-STRATIFIED ANALYSIS OF ANTI-MüLLERIAN HORMONE (AMH) LEVELS AND THE PREVALENCE OF DIMINISHED OVARIAN RESERVE IN A POPULATION OF 22,920 WOMEN AGED 18-45: A RETROSPECTIVE STUDY","authors":"Kiper Aslan ,&nbsp;Aylin Tunali ,&nbsp;İlayda Tellioğlu ,&nbsp;Isil Kasapoglu ,&nbsp;Gurkan Uncu","doi":"10.1016/j.rbmo.2024.104550","DOIUrl":"10.1016/j.rbmo.2024.104550","url":null,"abstract":"<div><h3>Objective</h3><div>Anti-Müllerian hormone (AMH) is recognized as the most reliable indicator of ovarian reserve and is widely utilized in various clinical settings. AMH concentrations consistently decline as women age. Despite its widespread use, the lack of standardized, age-specific reference ranges for AMH in reproductive-aged women restricts its full clinical utility. This retrospective analysis aims to explore age-stratified AMH levels and establish the prevalence of diminished ovarian reserve (DOR) at different ages.</div></div><div><h3>Methods</h3><div>The study was conducted at a tertiary university hospital. An electronic database was screened for AMH results between the years 2015-2024. All analyzed AMH results were recorded regardless of the purpose of the analysis. Women aged between 18-45 were enrolled, ensuring each patient was only included once to avoid duplications. Correlation analysis was performed to show the relationship between AMH and age. Median AMH values for each age group were calculated, and the prevalence of diminished ovarian reserve according to AMH levels was analyzed. The Poseidon Criteria were used to define diminished ovarian reserve (&lt;1.2 ng/ml).</div></div><div><h3>Results</h3><div>A total of 24,587 AMH results were found in the electronic database for the years 2015-2024. After excluding duplications and results for women older than 45 and younger than 18, 22,920 AMH results were analyzed. Correlation analysis showed a significant relationship between AMH levels and age. As age increased, AMH levels significantly decreased. By age 36, median AMH levels had decreased below 1.2 ng/ml. The prevalence of DOR was 15.9% at age 18, while this ratio was nearly 96% at age 45.</div></div><div><h3>Conclusion</h3><div>This study presented age-stratified AMH levels for a large population of over 20,000 women. Although the study population consisted of patients from a tertiary hospital, the results may be beneficial in establishing age-specific AMH levels in clinical practice.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104550"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VAGINAL MICROBIOME TRANSPLANTATIONS - A POTENTIAL NEW TREATMENT IN REPRODUCTIVE DISEASE","authors":"Henriette Svarre Nielsen","doi":"10.1016/j.rbmo.2024.104508","DOIUrl":"10.1016/j.rbmo.2024.104508","url":null,"abstract":"<div><div>This talk is about the vaginal microbiome and will present studies about vaginal and endometrial dysbiosis and reproductive outcomes. Treatment studies will be presented including the Dyscover studies on vaginal microbiome transplantation.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104508"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EVALUATION OF THE RELATIONSHIP BETWEEN OBESITY AND OXIDATIVE STRESS IN PATIENTS WITH ADOLESCENT POLYCYSTIC OVARY SYNDROME","authors":"Cahidenur Selveroğlu ,&nbsp;Banuhan Şahin ,&nbsp;Hanife Kara","doi":"10.1016/j.rbmo.2024.104554","DOIUrl":"10.1016/j.rbmo.2024.104554","url":null,"abstract":"<div><h3>Objective</h3><div>Polycystic ovary syndrome (PCOS) is one of the most common diseases that starts in adolescence and is common in women of reproductive age. PCOS patients have menstrual dysfunction, signs of hyperandrogenism (such as hirsutism, acne), metabolic problems, increased cardiovascular risk, insulin resistance, risk of developing type 2 diabetes mellitus. Oxidative stress; It has high levels in patients with central obesity, insulin resistance and hyperandrogenicity. Human and animal studies on oxidative stress in insulin resistance in Turkey and in the world are insufficient. Based on this information, we aimed to obtain new data on the relationship between oxidative stress parameters, total antioxidant level (TAS), total oxidant level (TOS), and oxidative stress index (OSI) levels, with obesity in adolescence with PCOS.</div></div><div><h3>Materials and Methods</h3><div>Between 01.02.2021 and 01.02.2022, Amasya University Sabuncuoğlu Şerefeddin Education and Research Hospital Preferred to Gynecology and Obstetrics outpatient clinics, four groups were created, 31 normal weight and 32 overweight/obese non-PCOS; 30 normal weight and 32 overweight/obese PCOS. Rotterdam criteria was used for PCOS diagnosis. Research permission and informed consent were obtained from all patients. Blood samples were analyzed for glucose, total testosterone (TT), dehydroepiandrosterone sulfate (DHEA-S), Luteinizing hormone (LH), Follicle stimulant hormone (FSH), estrogen, progesterone, 17OH-progesterone (17OH-P), creatinine and hemogram levels. TAS, TOS and OSI were calculated with TAS and TOS kits and differences between groups were examined.</div></div><div><h3>Result</h3><div>Among the study groups, TT, 17OH-P, DHEA-S, WBC, CRP, ALT values, TAS, TOS and OSI were significantly higher in the obese and PCOS groups. While there is a strong correlation between TOS and OSI; there is a moderate degree between TAS and OSI. As part of the research, especially in the Obese/PCOS group patients, as the WBC value increased compared to other groups, TOS increased; TAS increased as CRP value increased; TOS increased as TT increased; As the ALT value increased, it was found that both TAS and TOS increased. A statistically significant difference in TOS and TAS values was found in the Obese/PCOS groups with Normal Weight/Normal Patient. A statistically significant difference in TAS values was found in the Obese/PCOS binary group comparison with Normal Weight/PCOS.</div></div><div><h3>Conclusion</h3><div>In our study, we observed changes in TOS and OSI levels in overweight/obese and non-overweight/obese adolescences with PCOS and non-PCOS. An inflammatory process in obesity was found to be effective in pathology of adolescence PCOS.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104554"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COMPARISON OF CYCLE CHARACTERISTICS OF PATIENTS WITH UNEXPLAINED INFERTILITY TREATED WITH PROGESTIN PRIMED OVARIAN STIMULATION AND ANTAGONIST PROTOCOL","authors":"Ramazan Erda Pay ,&nbsp;Oya Aldemir ,&nbsp;Runa Özelçi ,&nbsp;Candan İltemir Duvan ,&nbsp;Serdar Dilbaz ,&nbsp;Yaprak Üstün","doi":"10.1016/j.rbmo.2024.104566","DOIUrl":"10.1016/j.rbmo.2024.104566","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The aim of controlled ovarian hyperstimulation (COH) in assisted reproductive techniques is to obtain the maximum number of mature oocytes required to achieve pregnancy. At this stage, where follicular development is simultaneously achieved, it is very important to prevent premature ovulation that may develop before the oocyte retrieval procedure and premature luteinizing hormone (LH) peak.(1) Gonadotropin-releasing hormone (GnRH) agonists and antagonists have been used for many years to prevent premature LH peak by suppressing the pituitary gland. Although GnRH agonists or antagonists provide satisfactory results in this regard, they create disadvantages for patients due to the discomfort caused by their daily injection and their high prices. Progestins, in addition to effectively suppressing the LH peak and ovulation, are also cheap and easy to use, which has led to numerous studies in recent years evaluating the effects of different progesterone preparations on different patient groups, and different progestin-primed ovarian stimulation (PPOS) protocols have been investigated.(2) In our study, we aimed to retrospectively compare the COH results obtained in patients who applied to our clinic with the indication of unexplained infertility and who were applied PPOS or antagonist protocols.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;For our cross-sectional retrospective observational study, 138 patient data from the Health Sciences University Etlik Zübeyde Hanım Gynecology and Pediatrics Training and Research Hospital UYT/IVF unit, whose diagnosis, follow-up and treatments were planned, and whose COH results were obtained, between January 2022 and March 2023, were retrospectively scanned from the patient registration system. For COH purposes, 59 patients (42.1%) who were applied PPOS protocol and 81 patients (57.9%) who were applied antagonist protocol were divided into group1 and group2. Demographic, laboratory, stimulation data and oocyte characteristics of the groups were compared.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Data of 59 patients (42.1%) who were applied PPOS protocol were compared in group1 and 81 patients (57.9%) who were applied antagonist protocol were compared in group2. No difference was observed between demographic data of the patients such as age, male age, infertility duration and BMI (p&gt;0.05). (Table1) No difference was observed between basal FSH, LH, E2, AFC and AMH values of the patients in terms of ultrasonography and laboratory values ​​(p&gt;0.05). (Table1) No difference was observed between clinical and COH results of the patients in terms of total gonadotropin dose, stimulation duration, number of oocytes collected and number of mature oocytes (p&gt;0.05). (Table1)&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In our study, similar results were observed between the PPOS protocol and the antagonist protocol. PPOS can be seen as a good alternative to antagonist protocols due to the advant","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104566"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EVALUATION OF ENDOPLASMIC RETICULUM STRESS IN GRANULOSA CELLS OF INFERTILE PATIENTS DIAGNOSED WITH ENDOMETRIOMA AND INVESTIGATION OF ITS EFFECT ON OOCYTE QUALITY","authors":"KÜBRA ÖZLEM BİLGİÇ ,&nbsp;IŞIL KASAPOĞLU ,&nbsp;MÜNİR KİPER ASLAN ,&nbsp;CİHAN ÇAKIR ,&nbsp;BERRİN AVCI ,&nbsp;GURKAN UNCU","doi":"10.1016/j.rbmo.2024.104547","DOIUrl":"10.1016/j.rbmo.2024.104547","url":null,"abstract":"<div><h3>Objective</h3><div>Endometriosis is a disease characterized by the implantation and growth of endometrial tissue outside the uterus in women of reproductive age, and its etiopathogenesis remains unclear. It is most commonly seen in the ovaries (endometrioma). It is estimated that it negatively affects folliculogenesis, ovulation, embryogenesis and causes infertility by causing endoplasmic reticulum (ER) stress in the ovary through different mechanisms. ER stress occurs when cell homeostasis is disrupted as a result of the accumulation of unfolded or misfolded proteins. In this case, the cell first activates ER stress response pathways, aiming to restore homeostasis and keep the cell alive. If ER stress cannot be coped with, the cell is directed to apoptosis. The aim in our study is to determine the local and/or systemic negative effects of endometriosis on the ovary, the endoplasmic reticulum stress it creates in the ovaries as a result of these effects, and which pathway or pathways are activated in case of stress.</div></div><div><h3>Materials and methods</h3><div>ER stress parameters (GADD34, Caspase12, Caspase3, BIP, CHOP, XBP1, ATF4) were investigated using ELISA method in granulosa cells, which are waste cells collected during oocyte retrieval after in vitro fertilization (IVF) treatment from infertile patients diagnosed with unilateral endometrioma and healthy female patients diagnosed with male factor and will not be used in IVF treatment. The study design was planned in 3 groups; Group 1: ovary with endometrioma diagnosed with unilateral endometrioma (n=23), Group 2: ovary without endometrioma diagnosed with unilateral endometrioma (n=23), Group 3: control group male factor (n=20).</div></div><div><h3>Conclusions</h3><div>Although no significant difference was observed in ovarian and embryological parameters between the two groups with and without endometrioma, a significantly lower total antral follicle count, AMH levels, oocyte retrieval numbers, oocyte maturation, and embryo quality were detected when compared to the control group. As the size of the endometrioma increased, particularly when exceeding a threshold of 4 cm, it was found that the PERK pathway, an ER stress pathway, as well as the caspase apoptotic process, were activated. We can say that the PERK pathway is primarily preferred among the ER stress pathways examined in the endometrioma group and by dimensioning. The results can be supported by more comprehensive studies.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104547"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A SINGLE-CENTER EXPERIENCE OF OVARIAN TISSUE TRANSPLANTATION IN 15 PATIENTS","authors":"Batuhan Aslan ,&nbsp;Nilüfer Akgün ,&nbsp;Meltem Sönmezer ,&nbsp;Yavuz Emre Şükür ,&nbsp;Sinan Özkavukçu ,&nbsp;Özgür Çınar ,&nbsp;Batuhan Özmen ,&nbsp;Cem Atabekoglu ,&nbsp;Murat Sönmezler","doi":"10.1016/j.rbmo.2024.104523","DOIUrl":"10.1016/j.rbmo.2024.104523","url":null,"abstract":"<div><h3>Objective</h3><div>Ovarian tissue cryopreservation (OTC) and transplantation has become a promising option for fertility preservation in women facing the risk of premature ovarian failure. We aim to report our experience with 15 patients who underwent frozen thawed ovarian tissue transplantation (OTT).</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 15 women who underwent OTT in our tertiary referral center between December 2011 and June 2024. All the patients had previously undergone OTC using a slow freezing protocol with a home-made pre-prepared freezing medium including DMSO and sucrose. All patients diagnosed with acute leukemia had received consolidation chemotherapy prior to OTC before undergoing bone marrow transplantation (BMT). A medical clearance was obtained from each patient's hematologist-oncologist, and a vial of tissue was thawed to screen for the presence of residual leukemic cells. All OTT procedures were performed laparoscopically, with the ovarian cortical fragments being transplanted either into a retroperitoneal pocket (n=11), created 2 days earlier to enhance vascularization, or directly onto the menopausal ovary (n=1), or both(3).</div></div><div><h3>Results</h3><div>All 15 patients who underwent OTT regained ovarian function, as demonstrated by decreased FSH levels, increased estradiol and resumption of menstruation. Patient characteristics are shown in Table 1. No major surgical complications or adverse events were observed. The median age at OTC and OTT were 23.31± 7.9 years and 32.6 ± 1.48 years respectively. The indications were as follows; leukemia (n= 6), lymphoma (n=5), breast cancer (n=1), pineal gland tumor (n=1), thalassemia (n=1), and aplastic anemia (n=1). Mean serum AMH before OTC and following OTT was 1.37± and 0.16±0.11, respectively. Following IVF, 8 healthy live births occurred in 6 patients (Two of them was twin), summing up a pregnancy rate of 45.46% per patient (5/11) in those undergoing IVF (Patient 15 does not included). In one patient diagnosed with acute leukemia, IVF resulted in a healthy ongoing pregnancy following second OTT, and in another patient diagnosed with acute leukemia 2 euploid blastocysts were frozen in the first ovarian stimulation cycle (patient 14). In patient 15, who had 2 previous IVF cancellation due to POR, a healthy live birth occurred from the menopausal ovary following retroperitoneal OTT. Except one patient who underwent OTT very recently, no relapse was recorded in 5 patients with acute leukemia over a mean follow-up &gt;50 months. Graft survival was &gt; 24 months in all patients.</div></div><div><h3>Conclusion</h3><div>Transplantation of frozen thawed ovarian tissue remains a promising and established technique for fertility preservation, with prolonged graft longevity and increased pregnancy rates. We suggest that OTT may be feasible in carefully screened leukemia survivors following BMT.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104523"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SEVERE ELEVATED ANTIMULLERIAN HORMONE LEVEL RELATED TO THE CUMULATIVE LIVE BIRTH RATE AND OBSTETRICS AND PERINATAL OUTCOMES AFTER INTRACYTOPSLASMIC SPERM INJECTION CYCLES?","authors":"Esra Nur Tola ,&nbsp;Sevinç Ozmen","doi":"10.1016/j.rbmo.2024.104586","DOIUrl":"10.1016/j.rbmo.2024.104586","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To evaluate the association between intra cytoplasmic sperm injection (ICSI) success and obstetrics and perinatal outcome after ICSI cycle and elevated antimullerian hormone (AMH) levels.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;A total of 389 ICSI cycles were included retrospectively. All of the participants had serum AMH levels&gt;3.8 ng/ml. Participants were divided into two groups on the basis of their serum AMH levels: Group 1 (AMH= 3.8-7.9 ng/ml) and Group 2 (AMH≥8 ng/ml). Antagonist protocol with gonadotropin were performed for ovarian stimulation. Oocyte pick-up (OPU) was performed 36 hours after ovulation trigger. Embryo(s) was transferred under ultrasound guidance. If patients exhibited evidence of ovarian hyperstimulation syndrome (OHSS) or were at risk of OHSS, embryo transfer (ET) was cancelled and embryos were cryopreserved and in frozen-thaw cycles, embryos were placed in the uterus.&lt;/div&gt;&lt;div&gt;Cumulative rates were calculated until two years after ovum pick up, or exhaustion of preserved embryos before two years, including both fresh ET cycles and subsequent frozen-thaw (FET) cycles. Implantation was defined as positive serum pregnancy test. Clinical pregnancy was defined as a gestational sac with a fetal heart beat detected. Live birth rate was defined as a delivery of a live infant. Abortion was defined as pregnancy loss before 20 weeks of gestation. Gestational complications, anthropometric measures of neonates, admission to neonatal intensive care unit (NICU) and the presence of congenital anomaly were noted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Demographic features were similar between two groups. Gonadotropin dose performed for ovarian stimulation, endometrial thickness on trigger day and asynchronous follicular development rate were similar between groups. Estradiol levels, the number of cumulus ooforus cells, metaphase II and fertilized oocyte were higher in Group 2 than Group 1 (p&lt;0.05). Ovulation trigger agent was different between the groups (p=0.03). Dual trigger was performed in the most of the Group 1 and analog trigger was performed in the most of the Group 2. No embryo transfer (fresh/frozen-thaw) was performed in 8 cases due to cleavage arrest. All of the cause of the cancelled fresh embryo transfer was OHSS or OHSS risk. Fresh ET was performed in 29.5% of Group 1 and 24.8% of Group 2. Frozen-thaw ET was performed in 70.5% of Group 1 and 75.2% of Group 2. ET day and transferred embryo number were similar between two groups. The two groups had similar cumulative implantation, clinical pregnancy, and abortion rates. However live birth rate was decreased in Group 2 than Group 1 (p=0.04). In Group 1, there was two ectopic pregnancy and one stillbirth. In Group 2, there was one ectopic pregnancy and one stillbirth. Preterm delivery, fetal anthropometric measurements, pregnancy complications, presence of congenital anomaly were comparable between groups (Table 1).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104586"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AN ACTINOMYCES ABSCESS FOLLOWING INTRAOVARIAN INJECTION OF PLATELET-RICH PLASMA (PRP): A CASE STUDY","authors":"Arife Akay ,&nbsp;Yasin Semih Ekici ,&nbsp;Bakiye Akbaş ,&nbsp;Gülsün Özbay ,&nbsp;Ayşe Zehra Özdemir ,&nbsp;Davut Güven","doi":"10.1016/j.rbmo.2024.104591","DOIUrl":"10.1016/j.rbmo.2024.104591","url":null,"abstract":"<div><h3>Introduction</h3><div><strong>The</strong> intraovarian injection of platelet-rich plasma (PRP) represents a novel approach with the potential to enhance folliculogenesis and elevate live birth rates in poor responders. Nevertheless, as with any interventional procedure, there is a possibility of adverse effects associated with the administration of PRP.</div></div><div><h3>Case Report</h3><div>A 22-year-old female patient, who had undergone intraovarian injection of PRP at another centre two weeks prior, was prescribed ciprofloxacin for the treatment of groin pain that developed one week following the procedure. The patient was admitted with a history of increasing groin pain, fever, and chills. Despite the stability of the vital signs, the patient exhibited tenderness in the lower quadrants of the abdomen. The laboratory findings indicated elevated levels of C-reactive protein (CRP), procalcitonin (PCT), and white blood cells (WBC). The computed tomography (CT) scan revealed the presence of a 7 cm tubo-ovarian abscess in the right sight. On the second day of hospitalization, the patient subsequently underwent abscess drainage in the interventional radiology department, and an abscess culture was obtained. The infectious diseases department recommended piperacillin-tazobactam 3*4.5 g IV. Subsequently, these treatments resulted in an improvement in the patient's condition and a reduction in acute-phase reactants (AFRs), with a decrease in CRP (308-&gt;92), PCT (1.8-&gt;0.69), and WBC (21.600-&gt;18.550). However, on the fifth day, the AFRs began to increase once more, piperacillin-tazobactam was discontinued following the identification of Actinomyces in the abscess culture, and ampicillin-sulbactam 4*1.5 g IV was initiated in conjunction with the gentamicin-clindamycin protocol. A clinical and laboratory evaluation conducted on the seventh day of hospitalization revealed no improvement. Following the detection of free fluid in the abdomen and persistent abscess sites via ultrasonography (Video 1), a decision was made to proceed with laparoscopic abscess drainage. An encapsulated abscess extending from the anterior surface of the uterus to the upper abdomen towards the spleen was cleaned with the contributions of the general surgery team, and a soft drain was placed laparoscopically (Figure 1). Following the procedure, a favorable response was observed in both the clinical condition and the AFR regression with the current antibiotic regimen. The patient was discharged on the 12th day with oral amoxicillin-clavulanate.</div></div><div><h3>Conclusion</h3><div>Despite the existence of ongoing randomized controlled trials evaluating the efficacy of PRP in women with poor responses, its clinical application remains considered experimental. The intraovarian injection of PRP, an invasive approach designed to enhance ovarian response, has been observed to manifest in rare instances as serious complications.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104591"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE DISCRIMINATIVE ROLE OF CALPONIN-2 FOR ECTOPIC PREGNANCY","authors":"Muhammed Ahsen Öğrenci ,&nbsp;Gülten Özgen ,&nbsp;Nergis Kender Ertürk ,&nbsp;Burcu Dinçges ,&nbsp;Levent Özgen","doi":"10.1016/j.rbmo.2024.104564","DOIUrl":"10.1016/j.rbmo.2024.104564","url":null,"abstract":"<div><h3>Objectives</h3><div>Since ectopic pregnancy is still the leading cause of mortality and morbidity, finding diagnostic markers have crucial role in this area (1,2). Calponin-2 (CNN2), found in tubal smooth muscle cells, increases with muscle tension (3). The aim of this study is to determine the role of CNN-2 in tubal ectopic pregnancies that leads to muscle tension in tuba.</div></div><div><h3>Materials and Methods</h3><div>A total of 195 patients between September 2022 and 2023 were included. Participants were divided into 3 groups as ectopic pregnancy (n=65), healthy first trimester pregnancy (n=80) and miscarriage (n=50). Demographic and laboratory findings were compared between groups.</div></div><div><h3>Results</h3><div>CNN2 levels were measured as 13.6(0.12-39.6) ng/ml in ectopic pregnancy, 0.18(0.12-5.34) ng/ml in miscarriage and 0.16 (0.12-1.4) ng/ml in healthy pregnancy which was statistically significant difference (p&lt;0.001). In all patients, it was found that CNN2 above 0.49 ng/ml predicted ectopic pregnancy with 63.08% sensitivity and 98.52% specificity (AUC=0.793, p&lt;0.001). Also, it was found that CNN2 above 0.41 ng/ml distinguished ectopic pregnancy from healthy pregnancy with 63.08% sensitivity and 98.82% specificity (AUC=0.807, p&lt;0.001). In the logistic regression analysis, the rate of ectopic pregnancy was 8 times higher in cases with progesterone levels of 9.2 ng/ml and below compared to those without, and approximately 90 times higher in cases with CNN2 levels of 0.49 ng/ml and above compared to those without.</div></div><div><h3>Conclusion</h3><div>Serum CNN2 could be a valuable biomarker in distinguishing ectopic pregnancy from other pregnancies. We suggest that single measurement of CNN2 can be an alternative approach instead of serial beta hcg measurement.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104564"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COMPARISON OF ONGOING PREGNANCY RATES BETWEEN NATURAL PROLIFERATIVE PHASE AND MODIFIED NATURAL CYCLE PROTOCOLS IN FROZEN BLASTOCYST TRANSFERS","authors":"Onur Ince ,&nbsp;Gonca Ozten Dere ,&nbsp;Neslihan Coskun Akcay ,&nbsp;Figen Besyaprak ,&nbsp;Zuhal Yapici Coskun ,&nbsp;Lale Karakoc Sokmensuer ,&nbsp;Sezcan Mumusoglu","doi":"10.1016/j.rbmo.2024.104526","DOIUrl":"10.1016/j.rbmo.2024.104526","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The Natural Proliferative Phase (NPP) frozen embryo transfer (FET) protocol is an emerging method with increasing reports in the literature. Unlike conventional natural cycle FET protocols, the NPP protocol offers flexibility in FET timing and potentially avoids increased rates of perinatal complications due to the absence of corpus luteum in artificial cycles. This study aims to share the initial results of our clinic's first trials with the NPP protocol and to investigate its impact on ongoing pregnancy rates (OPRs) compared to the modified natural cycle (mNC) protocol.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;This retrospective cohort study included cycles with single blastocyst embryo transfers without preimplantation genetic testing at Hacettepe University IVF Unit, between June 2022 and June 2024. Each patient was included with a single cycle. The choice of endometrial preparation protocol was based on scheduling embryo transfers on weekdays. In the mNC protocol, when the leading follicle diameter was 14-21 mm, endometrial thickness was ≥7 mm, and serum progesterone was &lt;1.5 ng/ml, rhCG 250 mg was administered, vaginal progesterone (P) 3 × 200 mg was initiated 4 days after hCG trigger, and blastocyst transfer was performed 7 days after hCG trigger. In the NPP protocol, with the same criteria, vaginal P 3 × 200 mg and subcutaneous P 1 × 1 were started. Blastocyst transfer was performed 5 days after starting P. The primary outcome was ongoing pregnancy, defined as the presence of an intrauterine fetal heartbeat. Secondary outcomes included positive pregnancy test (serum beta-HCG &gt;5 IU/L 9 days post-transfer) and clinical pregnancy (visualization of an intrauterine gestational sac).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The study included 52 cycles, with 17 NPP and 35 mNC single blastocyst transfer cycles. The mean age, BMI, and infertility duration were 32.85 ± 4.01 years, 23.73 [IQR: 21.63, 26.20] kg/m², and 41.00 [IQR: 29.00, 60.75] months, respectively, with no significant differences between the NPP and mNC groups. There were no significant differences in positive pregnancy test rates (9/17 [53%] vs. 21/35 [60%], p=0.629), clinical pregnancy rates (6/17 [35%] vs. 20/35 [57%], p=0.139), and OPRs (5/17 [29%] vs. 18/35 [51%], p=0.134). According to univariate logistic regression, the odds ratio (OR) of having an ongoing pregnancy in NPP cycles was 0.39 [95% CI: 0.11-1.30] compared to the mNC protocol. Multivariate logistic regression, adjusted for age, BMI, infertility duration, cycle number, number of blastocysts transferred, and embryo quality, showed an OR of 0.43 [95% CI: 0.09-1.74] for ongoing pregnancy in NPP cycles compared to the mNC protocol.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The initial results from our clinic indicate that pregnancy outcomes between NPP and mNC protocols are not significantly different. Further randomized controlled trials or cohort studies with larger sample sizes","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"49 ","pages":"Article 104526"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}