• ÖZ

OBJECTIVE: We aimed to investigate the effect of acupuncture performed as an adjuvant therapy to in vitro fertilization, on pregnancy rates by performing acupuncture on the day of embryo transfer, one hour before the procedure and one hour after the procedure. STUDY DESIGN: In this open-label randomized prospective controlled study, 60 unexplained infertility patients enrolled for in vitro fertilization treatment were randomized by a computer-based number generator for acupuncture performance and no-treatment. All patients received rFSH (Gonal-F®) for ovulation induction and the antagonist Cetrorelix (Cetrotide®) to prevent premature ovulation. Ovulation was triggered by using hCG (Ovitrelle®) and egg collection was done after 36-48 hours. In the study group, acupuncture was performed by intradermal needling, bilaterally with a sterile needle, both one hour before and one hour after the embryo transfer. Acupuncture was not performed on the control group. The results of the treatment were evaluated 12 days after embryo transfer. RESULTS: Thirty patients were randomized into the study group and 30 patients were randomly placed in the control group. Although there was no statistically significant difference between groups in terms of β-hCG positivity, it was 43.3% in the study group and 36.7% in the control group (p>0.05). CONCLUSION: The success rate of in vitro fertilization was higher in terms of pregnancy rate in the patient group who received acupuncture procedure as well, but the difference was not statistically significant. This may be due to the type of acupuncture procedure selected or insufficient sample size. As a result, further studies involving larger numbers of participants and using different acupuncture techniques are needed.

• ÖZ

Removal of uterus during laparoscopic hysterectomy (LH) is occasionally challenging and therefore sometimes requires morcellation. Morcellation techniques for hysterectomy can spread the cancer cells which were presumed benign preoperatively in to the abdomen or pelvis. Probability of an undetected malignity should not be disregarded and accordingly must be shared with the patient prior to LH. The present study aimed to identify the demographic and the clinical factors associated with the need for morcellation in patients undergoing LH. A total of 153 patients who underwent LH for presumed benign causes were enrolled in this retrospective study. Subjects were divided into two groups according to the need for the morcellation during the LH: Morcellation group and intact vaginal removal (IVR) group (it was possible to deliver the uterine specimen vaginally). The two groups were compared with respect to demographic and clinical characteristics, indications for LH, preoperative ultrasonographic findings and postoperative complications. The frequency of the postmenopausal women was significantly higher in the morcellation group than the IVR group (p = 0.005). Preoperative uterus width (p < 0.001) and postoperative Uterus weight (p < 0.001) were significantly higher in the morcellation group compared to that of the IVR group. There were no significant differences between the groups regarding the complication rate. Uterine weight (OR: 1.020, 95 % CI: 1.008-1.031, p = 0.001) and menopause (OR: 2.571, 95 % CI: 1.328-4.980, p < 0.001) were predictive for the need of morcellation. A cut-off value of 287.5 gram was able to predict the need for morcellation with 87% sensitivity and 71 % specificity. The present study demonstrates that uterine weight and presence of the menopause are predictive for the need of morcellation at the time of the total LH. These factors should be considered in preoperative planning and used to further guide surgeons in providing LH.