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Objective: There are controversial results about the effects of GH/IGF-1 on retinal vasculature. Gremlin-1 has roles in both pituitary tumorigenesis and angiogenesis. Therefore, we aimed to detect retinal micro-vascular changes in acromegaly with OCTA and examine its association with serum Gremlin-1 levels. Design: A cross-sectional, case-control study Methods: We included 53 acromegaly patients and age/gender-matched 31 healthy controls. To evaluate retinal structure, optical coherence tomography angiography (OCTA) imaging was performed. Gremlin -1 levels were measured by the ELISA method. Results: Acromegaly patients had significantly lower superficial total density (p < 0.001), superficial parafoveal density (p = 0.002), superficial perifoveal density (p < 0.001); deep total density (p < 0.001), deep parafoveal density (p < 0.001), deep perifoveal density (p < 0.001). Total thickness and perifoveal thickness were significantly lower in the acromegaly group.Gremlin-1 levels were significantly lower in acromegaly patients (1.22(0.13) vs 1.38(0.29); p = 0.015, for acromegaly and control groups, respectively). We assessed study groups based on glucose tolerance status. Normal glucose tolerance (NGT) acromegaly patients had significantly lower superficial total density (p = 0.036), superficial perifoveal density (p = 0.003), deep total density (p = 0.023), and deep perifoveal density (p = 0.023) compared to NGT controls. According to backward linear regression analysis, the presence of acromegaly itself consistently showed a significant negative impact on all types of vascular density. Conclusion: Patients with acromegaly have decreased vascular density and lower levels of Gremlin-1 independent of glucose tolerance status. Acromegaly may cause a reduction in gremlin-1 as a compensatory mechanism due to high IGF-1 levels known as an angiogenic factor, which in turn leads to the decrease in vascular density, or gremlin-1 may already have shown a decline in response to chronic inflammation and endothelial dysfunction in acromegaly resulting in a reduction in vascular density.

Purpose: This study aims to evaluate the oxidant and antioxidant parameters in follicular fluid and embryo culture medium in IVF cycles and investigate their effects on embryo quality, fertilization success, and pregnancy. Materials and Methods: Fifty-one patients who underwent IVF/ICSI were included in this prospective study. Two hundred sixty of a total of 454 follicular fluids and the cell culture media of transferred fifty-one embryos (one from each patient) were examined. Antioxidant activity (AOA), Trolox equivalent antioxidant capacity (TEAC), thiobarbiturate reactive substances (TBARS), ferric antioxidant power (FRAP), paraoxonase, nitrotyrosine were analyzed. Results: TBARS were significantly lower in the follicular fluid of fertilized oocytes than in non-fertilized oocytes (21 vs. 29.75 nmol/ml). There was no difference in terms of other parameters. TEAC levels were higher in oocytes in the agonist protocol group than in the antagonist protocol group. In terms of embryo quality, there were no differences between the groups in any analysis. TEAC levels were higher in the embryo cell culture medium in the group that became pregnant after embryo transfer on the second day. Conclusion: When oxidative stress and antioxidant parameters were evaluated in both follicle fluid and embryo cell culture medium, it was determined that lipid peroxidation negatively affected fertilization. However, there is no significant difference in terms of embryo quality and pregnancy rates.