Aim: To evaluate the hysteroscopy results performed before IVF treatment and its pathological findings that may affect pregnancy outcomes in patients undergoing the first IVF cycle.
Materials and Methods: This descriptive study was carried out retrospectively at Gazi University Hospital and a private IVF Clinic between January 2016 and December 2021. A total of 458
patients who had hysteroscopy procedures prior to the planned IVF cycle were analyzed. Appropriate surgery was performed simultaneously during hysteroscopy in patients with uterine cavity
abnormalities. Outcome measures were the frequency of uterine abnormalities detected during the
hysteroscopy and confirmation of these abnormalities with their pathological findings.
Results: Unexplained infertility was the most frequent infertility etiology among patients (50.9%).
The most finding abnormality was endometrial polyp detected in 45.2% of patients during hysteroscopy. The second frequent abnormal finding was intrauterine adhesion, with a ratio of 15.9%
of patients. The uterine cavity was seen as normal in 9.6% of patients during the hysteroscopy procedure. Endometrial sampling was performed in 75.5% of patients. The most common pathological
result was endometrial polyp that was consistent with hysteroscopy findings (44.3%). Only 20.8%
of patients had normal findings after pathological examination on the endometrial tissue samples.
Conclusion: Evaluating the uterine cavity before the IVF cycle is necessary to reach successful outcomes. Undetected intrauterine lesions are frequently observed during hysteroscopy in asymptomatic
patients previously examined by conventional methods. Hysteroscopy may be a reasonable approach
to assess and restore the uterine cavity in patients undergoing the first IVF cycle.
|
Objective: This study aimed to compare the pregnancy outcomes of natural cycles (NC) and artificial cycles (AC) in patients undergoing endometrial
preparation for frozen-thawed embryo transfer (FET).
Materials and Methods: This retrospective cohort study was conducted in a private infertility clinic between September 2016 and January 2021 and
reviewed 1696 FET cycles. Among these FET cycles, endometrial preparation protocols that are performed as the NC (group 1) and AC (group 2) were
analyzed. Outcome measures were live birth rates (LBR), clinical pregnancy rates (CPR), implantation rates (IR), and miscarriage rates (MR).
Results: The mean serum estradiol level before progesterone supplementation was significantly higher in group 2, whereas endometrial thickness before
progesterone supplementation was higher in group 1 (p<0.05). The mean number of transferred embryos and embryo quality score rates regarding cleavage
and blastocyst stages were similar in both groups. The IR and MR were similar between groups (p>0.05). Additionally, CPR and LBR were similar in groups
1 (39.2% and 32.8%) and 2 (37.3% and 28.5%) (p=0.517, p=0.134, respectively). Multivariate logistic regression analyses revealed that female age at
embryo freezing time and the number of transferred embryos were predictable variables of live birth [odds ratio (OR): 0.970, confidence interval (CI):
0.948-0.991, p<0.05, and OR: 1.359, CI: 1.038-1.780, p<0.05, respectively].
Conclusion: Suitable endometrial preparation is essential to obtain successful pregnancy rates; however, no superiority was determined in NC or AC
protocols in frozen-thawed cycles. One of these protocols may be performed depending on menstrual regularity and clinical experience.
|
OBJECTIVE: In this study, we aimed to determine the frequency of etiologic factors that causes postmenopausal bleeding.STUDY DESIGN: For the purpose, a total number of 200 women with postmenopausal bleeding wereincluded in the study. Medical records regarding history, physical examination, and endometrium biopsyof these cases were retrospectively analyzed. The frequency of etiologic factors and relevancy of pathological results with demographic factors were determined.RESULTS: Most frequent histopathologic diagnosis of the women with postmenopausal bleeding wereestablished as endometrial atrophy, endometrial polyp, inadequate material, cancer, proliferative endometrium, endometrial hyperplasia, and other disorders respectively. Contrarily the previous studies,our study showed that estrogen replacement therapy was not a reason for postmenopausal bleeding.CONCLUSION: Although endometrial atrophy is the most frequent cause, postmenopausal bleedingshould promptly be evaluated since endometrial hyperplasia and cancer are frequently the underlyingcause. We found that premalignant and malignant lesions were related to the patients’ BMI (body massindex), duration of postmenopause, the presence of diabetes, determination of thick endometrium by ultrasonography.
|
OBJECTIVE: The aim of this study is to evaluate the postoperative wound infection rate, newborn effect and, the effect of skin to peritoneum incision time between diathermy and scalpel for the operation time during primer cesarean section cases. STUDY DESIGN: A retrospective study was carried out at Gazi University Hospital. A total of 74 patients met inclusion criteria in this study but 6 patients were excluded in electrocautery group for not to come controls, group I patients, n=37, underwent operation via scalpel incision and group II patients, n=31, underwent operation by diathermy incision. The main outcome measures were the operation time, post-operative wound infection rate, scar character, neonatal Apgar scores, and need of neonatal intensive care unit. RESULTS: There were no significant differences between newborn Apgar scores (1st and 5th minutes), wound infections, and operation times (p=0.35, p=0.69, p=0.32, respectively). CONCLUSION: Related to findings, it could be suggested that diathermy might be an alternative to the scalpel in Pfannenstiel incisions contrary to the old belief about its high infection rates.
|
