The Effect of Coasting on Intracytoplasmic Sperm Injection Outcome in Antagonist and Agonist Cycle.

BACKGROUND: Coasting can reduce the ovarian hyperstimulation syndrome (OHSS) risk in ovulation induction cycles before intracytoplasmic sperm injection (ICSI). This study aimed to investigate the effect of gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist protocols to controlled ovarian hyperstimulation (COH) cycles with coasting on the parameters of ICSI cycles and the outcome. MATERIALS AND METHODS: In a retrospective cohort study, 117 ICSI cycles were per- formed and coasting was applied due to hyperresponse, between 2006 and 2011. The ICSI outcomes after coasting were then compared between the GnRH agonist group (n=91) and the GnRH antagonist group (n=26). RESULTS: The duration of induction and the total consumption of gonadotropins were found to be similar. Estradiol (E2) levels on human chorionic gonadotropin (hCG) day were found higher in the agonist group. Coasting days were similar when the two groups were compared. The number of mature oocytes and the fertilization rates were similar in both groups; however, the number of grade 1 (G1) embryos and the number of transferred embryos were higher in the agonist group. Implantation rates were significantly higher in the antagonist group compared to the agonist group. Pregnancy rates/embryo transfer rates were higher in the antagonist group; however, this difference was not statistically significant (32.8% for agonist group vs. 39.1% for antagonist group, P>0.05). CONCLUSION: The present study showed that applying GnRH-agonist and GnRH-antago- nist protocols to coasted cycles did not result in any differences in cycle parameters and clinical pregnancy rates.

Effects of the etonogestrel contraceptive implant (Implanon®) on bone metabolism during lactation: a prospective study.

AIM: To evaluate the effects of the etonogestrel contraceptive implant (Implanon®) on bone metabolism in lactating women using markers for bone formation and resorption. STUDY DESIGN: This single-centre, prospective cohort study was conducted in Turgut Ozal University Medical Faculty Obstetrics and Gynecology Department with healthy lactating women aged between 24 and 38 years to compare the effect on bone metabolism of 6 months' use of either the implant or a non-hormonal contraceptive method. The study group (n=25) used an implant and the control group (n=25) used a non-hormonal contraceptive intrauterine device inserted 40 days' postpartum. Bone metabolism differences at the time of insertion and after 6 months were assessed quantitatively by biochemical analysis of serum and urine samples. RESULTS: At baseline, serum levels of bone metabolism parameters were similar for the two groups. In the implant group, serum alkaline phosphatase (ALP) levels decreased (p=0.004) and total protein levels increased (p=0.045) at 6 months. In the control group, serum levels of bone metabolism parameters did not change at 6 months compared to baseline. However, serum levels of phosphorus (p=0.013) and ALP (p=0.003) decreased at 6 months compared to baseline. CONCLUSION: Six months' postpartum use of Implanon was found to have no deleterious impact on bone turnover in healthy lactating women.

Pittsburgh Sleep Quality Index scores and their relationship with body measurements in late menopause patients.

BACKGROUND/AIM: With an increase in life expectancy, women live about one-third of their lives in the postmenopausal period. Our aim was to investigate the findings regarding quality of sleep and sleep apnea in postmenopausal women and research the relationship between sleep complaints and body measurements. MATERIALS AND METHODS: The Pittsburgh Sleep Quality Index (PSQI) was administered to all participants and their height, weight, and neck circumferences were measured. RESULTS: A total of 206 patients (mean age: 61.4 ± 8.8 years) were included. Their mean weight gain after menopause was 8.1 ± 12.8 kg, and their mean neck circumference and body mass index was 39.7 ± 2.6 cm and 33.4 ± 2.1, respectively. The rate of patients who snored each night increased from 3.4% to 13.2% (P = 0.000) after menopause. The rate of self-reported poor sleep quality was found in 57.8% of patients according to the PSQI global score (≥5). The prevalence of sleep medication usage increased from 5.8% to 11.2% with menopause. Although body measurements were a little lower in patients with a total PSQI score of less than 5, this difference was insignificant. CONCLUSION: The prevalence of self-reported poor sleep quality was high in the postmenopausal period and the prevalence of snoring increased significantly with weight gain after menopause.

Prohepcidin in maternal circulation: is it related to spontaneous preterm labor?

BACKGROUND/AIM: To investigate whether spontaneous preterm labor (PTL) with intact membranes is associated with changes in maternal serum prohepcidin concentrations. MATERIALS AND METHODS: The study consisted of patients with spontaneous PTL with intact membranes (n = 25), a control group of healthy pregnant women between the 24th and 37th gestational weeks (n = 22), and uncomplicated term pregnancies in spontaneous labor (n = 19). Blood samples were collected from patients at the time of clinical diagnosis. Levels of prohepcidin, hemoglobin, serum ferritin, serum iron, unsaturated iron binding capacity, total iron binding capacity, transferrin and transferrin saturation, C reactive protein, and interleukin-6 were measured. RESULTS: Patients with spontaneous PTL had significantly lower maternal serum prohepcidin concentrations than term delivery and control subjects. CONCLUSION: Maternal serum prohepcidin concentration is lower in patients with spontaneous PTL compared to term delivery and control subjects. This suggests that measuring maternal serum prohepcidin concentrations in PTL may be a feasible method for understanding etiologic causes of spontaneous preterm delivery, but, before suggesting this as a course of action, low levels of prohepcidin in patients with PTL need to be more fully investigated.