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1. multicentre prospective study

Author

Aydin, H, Celik, O, Yazici, D, Altunok, C, Tarcin, O, Deyneli, O, Sancak, S, Kiyici, S, Aydin, K, Yildiz, BO, Cakiroglu, AY, Ozer, A, Tuzcu, AK, Kan, A, Celik, A, Uysal, A, Atmaca, A, Evren, B, Taskiran, B, Bilir, BE, Duran, C, Arpaci, D, Tuzun, D, Kavak, EC, Aydeniz, E, Akbas, EM, Ustunyurt, E, Bil, E, Guney, E, Akbaba, E, Gurkan, E, Cagliyan, E, Karakilic, E, Karakas, E, Kilinc, F, Soylemez, F, Kucukler, FK, Yorulmaz, G, Akbaba, G, Uysal, G, Kurt, G, Yaylali, GF, Selimoglu, H, Sari, H, Piskinpasa, H, Celik, H, Peynirci, H, Bilal, I, Sahin, I, Gozukara, I, Anaforoglu, I, Senyuva, I, Ugur, K, Dogan, K, Keskin, L, Mert, M, Adas, M, Tonguc, M, Eroglu, M, Kulaksizoglu, M, Ozcan, M, Cinar, N, Kutbay, NO, Dikbas, O, Bakiner, O, Turhan, OT, Tutuncuoglu, P, Sari, R, Melekoglu, R, Ayaz, R, Emral, R, Mumusoglu, S, Gorar, S, Keskek, SO, Tosun, SA, Cetinkaya, SE, Temizkan, S, Unsal, S, Demir, T, Yuce, T, Aksoy, U, Cinkir, U, Simsek, Y, Uyar, Y, Turk, Y, Pekkolay, Z, Hekimsoy, Z, Canturk, Z, and Uc, ZA

Abstract

Aim Prevalence rates of gestational diabetes mellitus (GDM) show considerable variation among different countries and regions of the world. The primary aim of this study was to determine the nationwide prevalence and predictors of GDM in Turkey. Methods We conducted prospective nationwide screening among pregnant women. Between August 2016 and November 2017, a total of 2643 pregnant women from 51 centres in 12 different regions were enrolled. A two-step screening method and Carpenter and Coustan criteria were used in the diagnosis of GDM. Clinical and biochemical data were obtained using electronic database software. Results The national prevalence of GDM was found to be 16.2% [95% confidence intervals (CI) 15.0% to 17.4%] without a significant difference between urban and rural regions. Women with GDM were older (mean age: 32 +/- 5 vs. 28 +/- 5 years, P < 0.001) and heavier (mean BMI: 27.2 +/- 5.1 vs. 24.7 +/- 4.7 kg/m(2), P < 0.001) than their counterparts without GDM. The prevalence of GDM tended to increase with age (< 25 years, 6.9%; 26-35 years, 15.6%; and 36-45 years, 32.7%; P < 0.001). Maternal age, maternal BMI, history of previous GDM and family history of diabetes mellitus were independent predictors of developing GDM (P < 0.05 for all). Low-risk women (age < 25 years, BMI < 25 kg/m(2), no family history of diabetes) comprised 10.7% of the total population and the prevalence of GDM in these women was 4.5% (95% CI 2.4% to 7.8%). Conclusion The results of this nationwide study indicate that GDM is very common, affecting one in seven pregnancies in Turkey. Implementation of international guidelines on screening and management of this public health problem is required. C1 [Aydin, H.] Acibadem Univ, Med Fac, Dept Endocrinol & Metab, Istanbul, Turkey. [Celik, O.] Acibadem Univ, Med Fac, Dept Endocrinol & Metab, Istanbul, Turkey. [Yazici, D.] Koc Univ, Med Fac, Dept Endocrinol & Metab, Istanbul, Turkey. [Altunok, C.; Deyneli, O.] Yeditepe Univ, Med Fac, Dept Biostat, Istanbul, Turkey. [Tarcin, O.] Marmara Univ, Med Fac, Dept Endocrinol & Metab, Istanbul, Turkey. [Sancak, S.] Fatih Sultan Mehmet Educ & Res Hosp, Dept Endocrinol & Metab, Istanbul, Turkey. [Kiyici, S.] Univ Hlth Sci, Bursa Yuksek Ihtisas Educ & Training Hosp, Dept Endocrinol & Metab, Bursa, Turkey. [Aydin, K.] Lutfi Kirdar Educ & Training Hosp, Dept Endocrinol & Metab, Istanbul, Turkey. [Yildiz, B. O.] Hacettepe Univ, Sch Med, Div Endocrinol & Metab, Dept Internal Med, Ankara, Turkey. [Cakiroglu, Ahmet Yigit] Kocaeli Univ, Med Fac, Dept Gynecol & Obstet, Kocaeli, Turkey. [Ozer, Alev] Sutcu Imam Univ, Med Fac, Dept Gynecol & Obstet, Kahramanmaras, Turkey. [Tuzcu, Alparslan Kemal; Pekkolay, Zafer] Dicle Univ, Dept Endocrinol & Metab, Med Fac, Diyarbakir, Turkey. [Kan, Atilla] Tekirdag Govt Hosp, Dept Gynecol & Obstet, Tekirdag, Turkey. [Celik, Ayhan] Fatih Sultan Mehmet Educ & Res Hosp, Dept Gynecol & Obstet, Istanbul, Turkey. [Uysal, Aysel] Antalya Educ & Res Hosp, Dept Gynecol & Obstet, Antalya, Turkey. [Atmaca, Aysegul] OndokuzMayi Univ, Med Fac, Dept Endocrinol & Metab, Samsun, Turkey. [Evren, Bahri] Inonu Univ, Med Fac, Dept Endocrinol & Metab, Malatya, Turkey. [Taskiran, Bengur] Yunus Emre Educ & Res Hosp, Dept Endocrinol & Metab, Eskisehir, Turkey. [Bilir, Betul Ekiz] Tekirdag Govt Hosp, Dept Endocrinol & Metab, Tekirdag, Turkey. [Duran, Cevdet] Usak Univ, Med Fac, Dept Endocrinol & Metab, Usak, Turkey. [Arpaci, Dilek] Bulent Ecevit Univ, Dept Endocrinol & Metab, Med Fac, Zonguldak, Turkey. [Tuzun, Dilek] Sutcu Imam Univ, Dept Endocrinol & Metab, Med Fac, Kahramanmaras, Turkey. [Kavak, Ebru Celik] Firat Univ, Med Fac, Dept Gynecol & Obstet, Elazig, Turkey. [Aydeniz, Elif] Acibadem Univ, Dept Gynecol & Obstet, Med Fac, Istanbul, Turkey. [Akbas, Emin Murat] Erzincan Univ, Med Fac, Dept Endocrinol & Metab, Erzincan, Turkey. [Ustunyurt, Emin] Bursa YuksesIhtisas Educ & Res Hosp, SBU, Dept Gynecol & Obstet, Bursa, Turkey. [Bil, Enes] Mehmet Akif Inan Educ & Res Hosp, Dept Gynecol & Obstet, Sanliurfa, Turkey. [Guney, Engin] Adnan Menderes Univ, Med Fac, Dept Endocrinol & Metab, Aydin, Turkmenistan. [Akbaba, Eren; Akbaba, Gulhan; Cinar, Nese] Sitki Kocman Univ, Med Fac, Dept Endocrinol & Metab, Mugla, Turkey. [Gurkan, Eren; Karakas, Esra] Mustafa Kemal Univ, Med Fac, Dept Endocrinol & Metab, Antakya, Turkey. [Cagliyan, Erkan] Dokuz Eylul Univ, Med Fac, Dept Gynecol & Obstet, Izmir, Turkey. [Karakilic, Ersen] Canakkale 18 Mart Univ, Med Fac, Dept Endocrinol & Metab, Canakkale, Turkey. [Kilinc, Faruk] Elazig Educ & Res Hosp, Dept Endocrinol & Metab, Elazig, Turkey. [Soylemez, Feride; Cetinkaya, Serife Esra; Yuce, Tuncay] Ankara Univ, Med Fac, Dept Gynecol & Obstet, Ankara, Turkey. [Kucukler, Ferit Kerim] Hitit Univ, Med Fac, Dept Endocrinol & Metab, Corum, Turkey. [Yorulmaz, Goknur] Osmangazi Univ, Med Fac, Dept Endocrinol & Metab, Eskisehir, Turkey. [Uysal, Gulsum] Adana Numune Educ & Res Hosp, Dept Gynecol & Obstet, Adana, Turkey. [Kurt, Gursel] Bandirma Private Hosp, Dept Gynecol & Obstet, Balikesir, Turkey. [Yaylali, Guzin Fidan] Pamukkale Univ, Med Fac, Dept Endocrinol & Metab, Denizli, Turkey. [Selimoglu, Hadi] Bandirma Private Hosp, Dept Endocrinol & Metab, Balikesir, Turkey. [Sari, Hakan] Bagcilar Educ & Res Hosp, Dept Internal Med, Istanbul, Turkey. [Piskinpasa, Hamide; Mert, Meral] Bakirkoy Dr Sadi Konuk Educ & Res Hosp, SBU, Dept Endocrinol & Metab, Istanbul, Turkey. [Celik, Handan] Ondokuz Mayis Univ, Med Fac, Dept Gynecol & Obstet, Samsun, Turkey. [Peynirci, Hande] Kastamonu Govt Hosp, Dept Endocrinol & Metab, Kastamonu, Turkey. [Bilal, Isil] Adana Gynecol & Childrens Hosp, Dept Internal Med, Adana, Turkey. [Sahin, Ibrahim] Inonu Univ, Med Fac, Dept Endocrinol & Metab, Malatya, Turkey. [Gozukara, Ilay] Mustafa Kemal Univ, Med Fac, Dept Gynecol & Obstet, Antakya, Turkey. [Anaforoglu, Inan] Med Pk Hosp, Dept Endocrinol & Metab, Trabzon, Turkey. [Senyuva, Irem] Usak Univ, Med Fac, Dept Gynecol & Obstet, Usak, Turkey. [Ugur, Kader] Firat Univ, Med Fac, Dept Endocrinol & Metab, Elazig, Turkey. [Dogan, Keziban] Bakirkoy Dr Sadi Konuk Educ & Res Hosp, SBU, Dept Gynecol & Obstet, Istanbul, Turkey. [Keskin, Lezzan] Malatya Educ & Res Hosp, Dept Endocrinol & Metab, Malatya, Turkey. [Adas, Mine] Okmeydani Educ & Res Hosp, SBU, Dept Endocrinol & Metab, Istanbul, Turkey. [Tonguc, Mensure] Kastamonu Govt Hosp, Dept Gynecol & Obstet, Kastamonu, Turkey. [Eroglu, Mustafa] Hakkari Govt Hosp, Dept Endocrinol & Metab, Hakkari, Turkey. [Kulaksizoglu, Mustafa] Necmettin Erbakan Univ, Med Fac, Dept Endocrinol & Metab, Konya, Turkey. [Ozcan, Muge] Mehmet Akif Inan Educ & Res Hosp, Dept Endocrinol & Metab, Sanliurfa, Turkey. [Kutbay, Nilufer Ozdemir] Gazi Yasargil Educ & Res Hosp, Dept Endocrinol & Metab, Diyarbakir, Turkey. [Dikbas, Oguz] Giresun Univ, Med Fac, Dept Endocrinol & Metab, Giresun, Turkey. [Bakiner, Okan] Baskent Univ, Med Fac, Dept Endocrinol & Metab, Adana, Turkey. [Turhan, Omer Talip] Kartal Lutfi Kirdar Educ & Res Hosp, SBU, Dept Gynecol & Obstet, Istanbul, Turkey. [Tutuncuoglu, Pelin] Katip Celebi Univ, Med Fac, Dept Endocrinol & Metab, Izmir, Turkey. [Sari, Ramazan] Akdeniz Univ, Med Fac, Dept Endocrinol & Metab, Antalya, Turkey. [Melekoglu, Rauf] Inonu Univ, Dept Gynecol & Obstet, Malatya, Turkey. [Ayaz, Reyhan] Van Educ & Res Hosp, Dept Gynecol & Obstet, Van, Turkey. [Emral, Rifat] Ankara Univ, Med Fac, Dept Endocrinol & Metab, Ankara, Turkey. [Mumusoglu, Sezcan] Hacettepe Univ, Sch Med, Dept Gynecol & Obstet, Ankara, Turkey. [Gorar, Suheyla] Antalya Educ & Res Hosp, Dept Endocrinol & Metab, Antalya, Turkey. [Keskek, Sakir Ozgur] Adana Numune Educ & Res Hosp, Dept Internal Med, Adana, Turkey. [Tosun, Sebnem Alanya] Giresun Univ, Med Fac, Dept Gynecol & Obstet, Adana, Turkey. [Temizkan, Sule] Yeditepe Univ, Med Fac, Dept Endocrinol & Metab, Istanbul, Turkey. [Unsal, Sule] Canakkale Govt Hosp, Dept Gynecol & Obstet, Canakkale, Turkey. [Demir, Tevfik] Dokuz Eylul Univ, Med Fac, Dept Endocrinol & Metab, Izmir, Turkey. [Aksoy, Ulku] Mem Hosp, Dept Gynecol & Obstet, Kayseri, Turkey. [Cinkir, Umit] Van Educ & Res Hosp, Dept Endocrinol & Metab, Van, Turkey. [Simsek, Yasin] Mem Hosp, Dept Endocrinol & Metab, Kayseri, Turkey. [Uyar, Yildiz] Celal Bayar Univ, Med Fac, Dept Gynecol & Obstet, Manisa, Turkey. [Turk, Yusuf] Eskisehir Govt Hosp, Dept Gynecol & Obstet, Eskisehir, Turkey. [Hekimsoy, Zeliha] Celal Bayar Univ, Med Fac, Dept Endocrinol & Metab, Manisa, Turkey. [Canturk, Zeynep] Kocaeli Univ, Med Fac, Dept Endocrinol & Metab, Kocaeli, Turkey. [Uc, Ziynet Alphan] Usak Univ, Med Fac, Dept Endocrinol & Metab, Usak, Turkey.

Published
2019

2. DOES LH SUPPLEMENTATION IN POOR RESPONDERS AFFECT GRANULOSA CELL APOPTOSIS RATE IN ART?

Author

Basak Aru, Şebnem Alanya Tosun, Ebru Cogendez, Gulderen Yanikkaya Demirel, Mehmet Sipahi, Enis Ozkaya, Tosun, SA, Ozkaya, E, Aru, B, Demirel, GY, Cogendez, E, Sipahi, M, Yeditepe Üniversitesi, Fakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve Doğum Ana Bilim Dalı, and Tosun, Şebnem Alanya

Subjects
Andrology, Reproductive Medicine, business.industry, Poor responder, Obstetrics and Gynecology, Medicine, business, Affect (psychology), Granulosa cell apoptosis
Abstract

75th Scientific Congress of the American-Society-for-Reproductive-Medicine (ASRM) -- OCT 12-16, 2019 -- Philadelphia, PA WOS: 000487821304065 … Amer Soc Reprod Med Giresun University Scientific Research Projects DepartmentGiresun University [SAG-BAP-A-2302] This study was supported by grants from Giresun University Scientific Research Projects Department (SAG-BAP-A-2302)

Published
2019

3. Diagnostic accuracy and validity of the O-RADS MRI score based on a simplified MRI protocol: a single tertiary center retrospective study.

Author

Aslan S and Tosun SA

Subjects
Female, Humans, Retrospective Studies, Ultrasonography, Predictive Value of Tests, Sensitivity and Specificity, Magnetic Resonance Imaging methods, Adnexal Diseases pathology
Abstract

Background: Adnexal masses (AM) are a common gynecological problem. It is important to use a reliable imaging method in the differentiation of benign and malignant AMs., Purpose: To assess the accuracy and validity of the O-RADS magnetic resonance imaging (MRI) score for characterizing AM using a simplified MRI protocol., Material and Methods: The study population comprised 332 women who underwent MRI due to the detection of indeterminate AM on ultrasonography between January 2018 and June 2020. An experienced radiologist calculated the O-RADS MRI score into five categories, using an MRI protocol with a simplified dynamic study. Sensitivity, specificity, positive and negative predictive values, and area under the curve (AUC) were calculated (cutoff for malignancy, score ≥ 4). The reference standard was histopathologic diagnosis or imaging findings during >24 months of follow-up., Results: Of 237 AMs, 28 (11.9%) were malignant. The malignancy rates of AMs with scores of 1, 2, 3, 4, and 5 were 0% (0/12), 0% (0/111), 1.2% (1/77), 50% (10/20), and 100% (17/17), respectively. The O-RADS MRI score showed 96.3% sensitivity, 95.2% specificity, and 95.3% accuracy in malignancy prediction. The AUC for the differentiation of benign and malignant masses were 0.983. False positivity rate was high in cases with an O-RADS MRI score of 4 (50%)., Conclusion: The O-RADS MRI score, based on a simplified MRI protocol, has high accuracy and validity in distinguishing benign from malignant sonographically indeterminate AMs. Its use in clinical practice can classify the malignancy risks of masses and prevent unnecessary surgery in benign lesions.

Published
2023
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4. Does LH supplementation in poor responders affect granulosa cells apoptosis rate in ART? A prospective randomised controlled trial.

Author

Tosun SA, Ozkaya E, Aru B, Yanikkaya Demirel G, Cogendez E, and Sipahi M

Subjects
Adult, Female, Humans, Oocyte Retrieval methods, Ovulation Induction methods, Pregnancy, Pregnancy Rate, Prospective Studies, Apoptosis drug effects, Cell Survival drug effects, Follicular Fluid cytology, Granulosa Cells drug effects, Luteinizing Hormone administration & dosage
Abstract

The aim was to compare granulosa cell's (GCs) apoptosis rate with (group A) or without (group B) luteinising hormone (LH) supplementation in poor ovarian responders (PORs) during controlled ovarian stimulation (COS). After oocyte retrieval, the follicular fluid was analysed by cytoflowmetry. Primary outcomes were GCs apoptosis rate in terms of viability, early apoptosis, late apoptosis and necrosis. Secondary outcome was clinical pregnancy rate. The viability was 96.7{IQR: 8} and 83.5{IQR: 20} for groups A and B, respectively ( p < .001). Late apoptosis rates were significantly lower in group A (median 1.5, {IQR: 3.1}) than group B (median 9.5, {IQR: 20.6}) ( p < .001). Median early apoptosis rates were 1.4 {IQR: 2.9} and 5.2 {IQR: 6.5} for group A and B respectively ( p = .04). No significant difference was observed in the clinical pregnancy rate. Although LH seems necessary in PORs to decrease late granulosa apoptosis rates, this does not improve clinical pregnancy rates.IMPACT STATEMENT What is already known on this subject? LH supplementation during COS has long been an issue in PORs to overcome the rFSH responsiveness due to the LH polymorphism. LH receptors have also been on GCs and their expression increases in preovulatory follicles. GCs apoptosis rates may show the oocyte quality and reproductive potential of oocyte retrieved and the requirement for LH supplementation. What do the results of this study add? The present study shows that LH supplementation during COS for PORs promotes the GC viability and reduces early/late apoptosis rates. Similarly, the number of MII oocytes was significantly higher in the LH regimen group. However, there was no significant difference in terms of clinical pregnancy rates. What are the implications of these findings for clinical practice and/or further research? The oocyte quality parameters such as higher GC viability and lower GC early/late apoptosis rates verify the LH supplementation in PORs during COS. However, the limited size of this study requires further multi-centre research in a larger cohort of patients. Results obtained with a sensitive and validated method will help clinicians to make better decisions in patient care.

Published
2022
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