Copeptin: A potential marker for the prediction of poor ovarian reserve in the infertile women.

Objective: There is actually no evidence regarding the physiological effects of copeptin in infertile women with different ovarian reserve types. This study aimed to investigate the relationship of serum copeptin level with poor ovarian reserve (POR) and to reveal the predictive value of copeptin for POR development in the infertile women. Materials and Methods: All participant women were classified as the control group (n=77) included the women with diagnosis of unexplained infertility and the POR group (n=61) was composed of the women who met the European Society of Human Reproduction and Embryology consensus on POR [serum anti-Müllerian hormone (AMH) concentrations below 1.1 ng/mL]. The biochemical tests, including estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone, AMH and copeptin were analysed. The analyses of serum copeptin concentrations were measured by the means of competitive enzyme immunoassay. Results: A significant increase in the serum copeptin level existed only in the POR group. There was a significant positive correlation between serum copeptin with E2 and FSH levels in the POR group. Significant negative correlations between copeptin and AMH concentrations (r=-0.310, p=0.015) and between copeptin concentration and antral follicle counts (r=-0.284, p=0.027) were detected only in the POR group. The estimated areas under receiver operating characteristic curves for serum concentration were found to be statistically significant with a cut-off value of 3.52 (95% confidence interval 0.519-0.709), sensitivity 0.90 and specificity 0.72. Conclusion: This study confirmed that there was an elevated serum copeptin concentration in the infertile women with POR and that serum copeptin concentration may have a predictive value for POR diagnosis.

Association between dopamine transporter gene (DAT1/SLC6A3) variants and infertility in the Turkish females.

OBJECTIVE: Worldwide, approximately 10-15% of couples is affected by infertility and infertility is associated with disturbances in female and/or male reproductive systems. The aim of the current study is to investigate the relationship between DAT1 (SLC6A3) VNTR polymorphism with female infertility. METHODS: Genomic DNA extractions were performed in 98 fertile and 90 infertile females, 3' untranslated region (3' UTR) variable number tandem repeat (VNTR) polymorphism of DAT1/SLC6A3 was determined by the use of Polymerase Chain Reaction (PCR) method. RESULTS: It has been demonstrated that there was no statistically significant difference between female infertile and fertile groups in the terms of DAT1 genotypes (p > .05). Moreover, there was no significant difference regarding the frequencies of 9R and 10R alleles in infertile and fertile groups (p > .05). CONCLUSION: This is the first study for investigating the relationship between DAT1/SLC6A3 gene polymorphism and infertility in females. Our study contributes to the growing awareness of the relationship between dopaminergic system and female infertility despite no significant differences were reported between infertile females and corresponding fertile subjects in DAT1/SLC6A3 gene.

Alarin: A new predictive marker in infertile women with polycystic ovary syndrome: A case-control study.

AIM: There is scant evidence concerning the relationship of alarin concentrations for polycystic ovary syndrome (PCOS) status in the existing literature. Therefore, we aimed to reveal the relationship about predictive value of serum alarin concentrations for PCOS risk in infertile women. METHODS: This prospective case-control study included a total of 151 infertile women who met eligibility criteria of the study. Infertile women diagnosed with PCOS formed the study group (n = 80). Women with diagnoses of unexplained infertility constituted the control group (n = 71). The biochemical analyses of serum concentrations of lipid profiles, estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-Mullerian hormone (AMH) and alarin were performed. RESULTS: There were no differences for the study parameters, including age, body mass index, fasting glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total triglyceride, E2, and FSH levels in either group. Serum LH, AMH, alarin concentrations, and antral follicle counts had higher values in the PCOS group compared with the controls. Correlation analysis revealed that serum alarin levels were significantly positively correlated with LH and AMH levels, only in the PCOS group. Multivariate binary logistic regression analysis demonstrated that infertile women with high alarin concentrations were significantly more likely to develop PCOS (OR = 1.77, 95% CI = 0.095-0.332, p < 0.001). CONCLUSION: Higher serum concentrations of alarin and a positive correlation with serum LH levels were found in infertile women with PCOS. This evidence supported that high alarin concentrations might play a role in the development of PCOS.

The relationship between oxidative stress markers and endometrial hyperplasia: A case-control study

Objective: Endometrial hyperplasia (EH) is considered an endometrial cancer precursor. This study aimed to determine the role of oxidative stress and thiol groups with antioxidant properties in EH pathogenesis. Materials and Methods: In our prospective case-control study, participants were washed with 5 mL of saline before the endometrial biopsy. Endometrial washing fluid was taken into microtubules, and thiol and disulfide levels were analyzed using the Ellman reagent. Results: A total of 108 patients were in the EH group and 84 patients in the control group. The total and native thiol levels were higher values in the control group (p<0.001, for both). Disulfide levels were higher in the EH group (p<0.001). Native/total thiol ratio and disulfide/total thiol ratio were higher in the EH group (p<0.001, for both). The analysis performed in the control group revealed a significant positive correlation between estradiol and disulfide levels (r=0.322, p=0.033). No significant correlation was found between estradiol and disulfide in the EH group. Conclusion: Oxidative stress level was higher in the washing fluids of patients with EH and this stress plays a role in the EH etiology.

Comparison of the effectiveness of screening methods for the diagnosis of gestational diabetes mellitus in pregnant women: A cross-sectional study.

OBJECTIVE: The methods and criteria used for gestational diabetes mellitus (GDM) screening in pregnant women are updated by the relevant organisations in certain periods. We aimed to compare the efficiency of GDM screening tests in pregnant women and to investigate the reasons of different prevalence values reported in the literature. MATERIALS AND METHODS: In this retrospective cross-sectional study, a total of 2406 pregnant women who were admitted to the obstetric outpatient clinic for screening GDM, were included. All pregnant women were randomly screened between 24 and 28 gestational weeks, using one-step (75 gr glucose loading) or two-step (50 gr and 100 gr glucose loading) methods. The demographic, clinical and biochemical parameters of the study population were analysed. RESULTS: In our study, 680 pregnant women were screened by one-step method and 1726 by two-step method. The average age of the one-step and two-step groups was 28.3 ± 5.7 and 28.1 ± 5.1, respectively, and no statistically significant difference was found between the ages of the two groups (P = .647). Other baseline characteristics, including maternal age, maternal weight, height, body mass index, gestational week, multiparity, systolic blood pressure, diastolic blood pressure, pulse, fasting plasma glucose were not significantly different between the two groups (P > .05, for all). The prevalence of GDM was significantly higher in the one-step group than that in the two-step group: 158/680 (23.2%) versus 143/1683 (8.5%), respectively. A statistically significant difference was found between the prevalence of the two groups (P < .001). CONCLUSION: The reason for the different prevalence values obtained in GDM screening studies may be because of the preferred method. Considering the advantages and disadvantages of both methods, studies are needed in which international organisations will revise their diagnostic criteria. We think it would be more appropriate to use the two-step screening method until international professional organisations develop a new methodology and new cut-off values.

Kisspeptin and Hematologic Parameters as Predictive Biomarkers for First-Trimester Abortions.

OBJECTIVE: Spontaneous abortion is the most common complication of early pregnancy, affecting up to 20% of recognized pregnancies. Kisspeptin is predominantly released by placental syncytiotrophoblasts, and regulates their placental invasion into the uterine matrices. We aimed to establish an association of serum kisspeptin levels with pregnancy outcomes during the early gestational stage of the first trimester. METHOD: In this prospective study, 90 pregnant women in their 7 to 8 6/7 gestational weeks were classified into three groups: (i) The control group, consisting of healthy pregnant women (n=30), (ii) the threatened abortion group (n=30), and (iii) the spontaneous abortion group (n=30). The maternal serum samples were analyzed for complete blood count parameters and kisspeptin levels. RESULTS: There was no statistical difference regarding body mass index (BMI) and gestational age (p=0.370). Regarding detailed obstetric notations, including gravida, parity, abortion, and living children, socioeconomic levels, and employment rates, all study groups were comparable (p>0.05, for all). No significant association was found regarding the biochemical parameters of complete blood count, including neutrophil, lymphocyte, and platelet concentrations, as well as neutrophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratios (PLR) (p>0.05, for all). The median serum kisspeptin levels of the study groups did not differ between the groups (p=0.153). Correlation analysis revealed no significant relationship between serum kisspeptin levels and other study parameters in any study groups (p>0.05, for all). CONCLUSION: We found no statistically significant relationship between serum kisspeptin concentrations and pregnancy outcomes in the early gestational stage of the first trimester, and serum kisspeptin concentrations did not seem to be a reliable marker to distinguish abortion status from viable pregnancy.

The circulating alarin level was elevated in infertile women with poor ovarian reserve.

OBJECTIVE: We aimed to reveal the association of serum alarin level with POR status of the infertile women in the present study. METHODS: The eligibility criteria for this prospective cross-sectional study included a total of 92 infertile women attending the Hitit University Hospital, and all participant women were categorized into two main groups of ovarian reserve: (i) Poor ovarian reserve (POR) group (n = 40) based on ESHRE consensus and (ii) Control group (NOR) (n = 52). RESULTS: The mean adjusted-ages and BMI values of the NOR and POR groups were statistically comparable (p = .057 and p = .600, respectively). The mean E2, FSH, and LH levels were elevated in the POR group (p < .001, for all). The mean AFC and AMH concentration were significantly reduced in the POR group (p < .001, for both). In addition, there was a significant increase in the serum alarin level in the POR group (p < .001). Pearson's analysis revealed that the mean BMI value of the POR group had a weak and negative correlation (r = 0.318, p = .046). Also, there was no correlation between serum alarin with E2 and FSH levels in both study groups. A weak and positive correlation was found between serum alarin and LH concentration only in the POR group (r = 0.318, p = .045). The mean AMH and AFC values were not significantly correlated with serum alarin levels. CONCLUSION: The circulating alarin level was significantly elevated in infertile women with POR patterns. In addition, the alarin level was significantly correlated with the serum LH concentration in the POR pattern.

Impact of anxiety levels on difficulty of intrauterine insemination and treatment outcomes.

AIM: The objective of this study was to determine the effect of anxiety on intrauterine insemination (IUI) results in couples with unexplained infertility. Second, the relationship between difficulty level of IUI procedure and anxiety were investigated. METHODS: A total of 100 women undergoing first IUI treatment were enrolled into this prospective cross-sectional study. Participants were asked to complete the Beck Anxiety Inventory (BAI) before the IUI procedure and classified into two groups according to the anxiety score (minimal anxiety; BAI score <8, n = 73 and mild-to-moderate anxiety; BAI score ≥8, n = 27). Cervical condition was evaluated with speculum and presence of congenital anomalies, extensive leucorrhea or polypoid lesions were classified as unfavorable cervix. All of the patients were evaluated for difficulty of IUI and asked to state the severity of their pain with a visual analog scale after the procedure. Clinical pregnancy rates were also analyzed. RESULTS: There was no statistically significant difference between the groups in terms of pregnancy rates (12.3% vs 14.8%, P = 0.743). visual analog scale score was significantly higher in mild-to-moderate anxiety group (P = 0.002). Anxiety levels were higher in patients with difficult IUI (10.5 vs 4.3, P < 0.001). In multivariate analysis, higher BAI scores (odds ratio: 1.1, 95% confidence interval: 1.0-1.2, P = 0.01) and unfavorable cervical condition (odds ratio: 3.6, 95% confidence interval: 1.2-10.7, P = 0.01) emerged as independent predictors for difficulty of IUI. CONCLUSION: Evaluation of anxiety before IUI might help to predict difficulty of IUI and related pain. Although anxiety increases the difficulty of IUI, it does not affect pregnancy outcomes of the treatment.

Sexual function and depressive symptoms in primary infertile women with vitamin D deficiency undergoing IVF treatment.

OBJECTIVE: To investigate the prevalence of female sexual dysfunction (FSD) and depression in primary infertile women with 25-Hydroxyvitamin D3 (25-OH VD) deficiency undergoing in-vitro fertilization (IVF)-intracytoplasmic sperm injection (ICSI) treatment. MATERIALS AND METHODS: A total of 80 women with 25-OH VD3 deficiency (<20 ng/mL = group 1), 80 women with 25-OH VD3 insufficiency (20-29.9 ng/mL = group 2), and 80 women with a normal 25-OH VD3 level (30-60 ng/mL = group 3) were included the study. Female sexual function and depression were measured using the Female Sexual Function Index (FSFI) and Beck Depression Inventory (BDI). RESULTS: No statistically significant differences were found among the groups in terms of demographic characteristics, baseline and laboratory parameters. Statistically significant differences were observed among the groups with regard to FSD and depression. The FSFI (group 1 = 22.46 ± 2.13, group 2 = 25.82 ± 2.13 and group 3 = 28.66 ± 2.13, respectively) and sexual domain scores were low in women with 25-OH VD deficiency, and the number of women with depression (BDI score ≥ 17) was high (p < 0.05). Correlation analysis showed that the sexual domain scores were positively correlated with the 25-OH VD level, and the BDI score showed a significant negative correlation with the total FSFI score and 25-OH VD levels. CONCLUSION: The 25-OH VD status was associated with FSD and depression and that the degree of sexual dysfunction could depend on the severity of 25-OH VD levels. Further studies are needed to elucidate this issue.

Relationship between elevated serum level of placental growth factor and status of gestational diabetes mellitus.

Objective: As only limited and confusing evidence about serum placental growth factor (PlGF) level in gestational diabetes mellitus (GDM) exist in the known literature, the aim of this study was to evaluate the association of maternal serum PlGF level with GDM status.Methods: The pregnant women attending the Obstetrics Outpatient Unit of Hitit University Hospital were screened at 24 and 28 weeks of gestation for GDM according to the suggestions of the American College of Obstetricians and Gynecologists (ACOG). Concisely, all of the low-risk pregnant women were evaluated with a 50 g glucose challenge test (GCT). Women with serum glucose ≥140 mg/dL at 1 h after GCT were subjected to a 100 g oral glucose tolerance test (OGTT). According to the criteria of Carpenter and Coustan, the GDM diagnosis was confirmed. Consequently, a total of 158 pregnant women eligible for inclusion criteria were categorized into two main groups; 76 of the GDM group, 82 of the control group. The demographic characteristic and biochemical parameters of the study population including age, body mass index (BMI), gestational age were recorded at the second trimester. The assays for glucose, insulin, and PlGF were carried out.Results: The mean maternal age of control and GDM groups were 27.9 and 30.5 years, respectively. The parameters such as age, BMI, and gestational age were statistically similar in both groups (p>.05, for all). As expected, serum insulin level and homeostasis model assessment-insulin resistance (HOMA-IR) value were significantly elevated in women with GDM (p<.001, for both). Moreover, maternal PlGF concentration was found to be higher in the GDM group compared to the control group (p=.029). Pearson's correlation analysis of PlGF with other study parameters revealed that there was a negative moderate and significant correlation in only control group (r= -0.416, p<.05). However, this correlation was not detected in the GDM group (r = 0.099, p>.05). None of the variables including maternal age, BMI, insulin, and HOMA-IR showed significant correlations in GDM and control groups.Conclusion: Our findings revealed that maternal serum PlGF level is increased in pregnant women complicated with GDM. Early identification of pregnant women who subsequently will pose GDM risk could improve the pregnancy outcomes.

Effects of preoperative anxiety on postcesarean delivery pain and analgesic consumption: general versus spinal anesthesia.

Objective: The aim of this study was to determine the effects of preoperative anxiety on the postoperative pain and analgesic consumption in patients undergoing cesarean deliveries (CDs).Materials and methods: This observational cohort study included 160 women, with ages ranging from 18 to 40 years old and a 37-week minimum gestation, received general (Group 1, n = 80) or spinal (Group 2, n = 80) anesthesia during an elective CD. The State Anxiety Inventory (SAI), Trait Anxiety Inventory (TAI), and Somatosensory Amplification Scale (SSAS) were used to measure the prenatal anxiety. The postoperative pain intensity was evaluated using the Visual Analogue Scale (VAS), and the pain and analgesic requirements were recorded at the 1st, 6th, 12th, 18th, and 24th postoperative hours.Results: No statistically significant differences were found between the groups in the demographics, clinical characteristics, or laboratory parameters. In addition, there were no differences with regard to the mean SAI, TAI, and SSAS scores and the diclofenac and pethidine consumptions (p > .05). The 1st hour [4.15 ± 1.84 versus 3.28 ± 2.41, odds ratio (OR) = 0.832, 95% confidence interval (CI) = 0.725-0.956, p = .009], 6th hour (3.85 ± 2.02 versus 3.13 ± 1.51, OR = 0.793, 95% CI = 0.668-0.942, p = .008), and 12th hour (3.64 ± 2.11 versus 2.94 ± 2.03, OR = 0.851, 95% CI = 0.737-0.983, p = .028) VAS scores were lower in Group 2 than in Group 1. No correlations were noted between the SAI, TAI, and SSAS scores and the VAS.Conclusions: While the patients with preoperative SAI scores >45 and who underwent cesarean deliveries (CDs) with general anesthesia had higher pain intensity scores in the first 12 hours than those underwent CDs with the spinal anesthesia, no difference was observed between the groups in terms of the postoperative analgesic requirements. Evaluating the patient's anxiety state and psychiatric evaluation may be useful for decreasing the postoperative pain intensity. Further studies are needed to corroborate our findings.

Efficacy of striae gravidarum extension and localization on predicting intraperitoneal adhesion risk.

AIM: To evaluate the diagnostic value of striae gravidarum (SG) presence and localization in predicting the intraperitoneal adhesion (IPA) risk in pregnant women with a history of at least one previous cesarean delivery (CD). METHODS: A total of 100 pregnant women with repeated CD were included in this prospective observational study. Patients were divided into three groups according to severity of SG with Davey scoring system. Intraoperative adhesion severity and extension were evaluated by using Nair classification system. Moreover, operation duration and neonatal outcomes were analyzed. RESULTS: Demographic features were comparable between the groups. Adhesion scores were significantly higher in mild and severe SG groups (for mild SG: 1.93 ± 0.99, for severe SG: 2.81 ± 0.88 and for no SG: 1.4 ± 0.57; P < 0.001). Analysis revealed a positive correlation between IPA and severity of SG (P < 0.001). There was a correlation between increased striae density and adhesion severity especially in the right and left upper quadrants of the abdomen (for right quadrant: r = 0.515, P < 0.001; for left quadrant: r = 0.359, P = 0.005). CONCLUSION: Our results suggest that preoperative evaluation of SG severity and extend particularly in upper quadrants is a feasible option to predict IPA risk in patients with repeated CD.

Is There a Relationship Between Vitamin D Deficiency Status and PCOS in Infertile Women?

Introduction It is still unclear in the literature whether low vitamin D levels play a role in the pathogenesis of polycystic ovary syndrome (PCOS), especially with respect to the regulation of anti-Müllerian hormone (AMH). Therefore, we aimed to investigate whether there could be a relationship between vitamin D deficiency status and PCOS. Materials and Methods A total of 146 infertile women were divided into two groups according to their ovarian reserve patterns: (i) normal (NOR), and (ii) high (PCOS). The participants were also categorized into two groups according to vitamin D concentrations: (i) Group A < 10 ng/mL, and (ii) Group B 10 - 20 ng/mL. Samples were obtained and analyzed for estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone sulfate (DHEA-S) and AMH. Results In the NOR group, there were significant differences between Group A and Group B in terms of anthropometric characteristics (p < 0.05, for all). The women in both Group A and Group B had similar AMH concentrations (p > 0.005). Only the NOR group showed a significant though moderate negative correlation between 25(OH)D levels and anthropometric parameters. AMH levels were not correlated with 25(OH)D levels in the NOR or the PCOS group (r = - 0.112, p = 0.008; r = 0.027, p = 0.836). Multivariate regression analysis showed no impact of 25(OH)D on other study parameters. Only AMH measurements were significant enough (p < 0.001) to differentiate between PCOS and NOR patterns. Conclusion We found no difference in serum 25(OH)D and AMH levels between women with and women without PCOS. No correlation could be demonstrated between 25(OH)D and AMH in the PCOS group or controls.

Is There a Need to Alter the Timing of Anti-Müllerian Hormone Measurement During the Menstrual Cycle?

Introduction There are numerous conflicting studies which have addressed the question whether the measurement of anti-Müllerian hormone (AMH) concentrations should be done at a certain time during the menstrual cycle. We aimed to investigate AMH fluctuations during the follicular and luteal phases of the menstrual cycle and to determine whether AMH variations, if present, might influence the clinical utility of ovarian reserve markers. Materials and Methods A total of 257 infertile women eligible for inclusion were categorized into three groups based on their total antral follicle count: 1. hypo-response group (< 7 follicles, n = 66), 2. normo-response group (7 - 19 follicles, n = 98), and 3. hyper-response group (> 19 follicles, n = 93). Results Mean follicular AMH levels were elevated compared to levels in the luteal phase in all response groups (p < 0.001). There were significant and strong positive correlations between follicular and luteal AMH levels in all response groups (Spearman's r = 0.822, r = 0.836, and r = 0.899, respectively; p < 0.001 for all groups). Fisher's Z-test comparisons of these correlations in all response groups demonstrated that there was no statistically significant difference (Z = 0.277, Z = - 1.001, and Z = - 1.425, respectively; p < 0.001). Conclusion We found that serum AMH levels in the follicular phase were higher than those in the luteal phase in all three response groups. In current practice, fluctuations in serum AMH concentrations are not large enough to alter the timing of AMH measurements during the menstrual cycle. The issue is important for the assessment of ovarian reserve in infertile women with AMH levels near to the cut-off value.

The effects of serum granulin levels on anthropometric measures and glucose metabolism in infertile women with different ovarian reserve status.

INTRODUCTION: Granulin (GRN) is an adipokine with proinflammatory features, which plays important role in glucose metabolism and insulin resistance pathogenesis. It has been reported that granulin precursors were localised in developing follicles in animal studies. The purpose of this study was to evaluate the association of granulin levels with anthropometric features, glucose metabolism, and ovarian reserve. MATERIAL AND METHODS: A total of 109 infertile women were included in this cross-sectional, prospective study, who attended a tertiary clinic. All participants were categorised into diminished ovarian reserve (DOR) and normal ovarian reserve groups (NOR), in accordance with Bologna criteria. The demographic characteristics, including age, BMI, waist-hip circumferences, and biochemical parameters, were recorded. Serum granulin level was determined by enzyme-linked immunosorbent assay. RESULTS: No significant difference was observed in the GRN levels (p = 0.229) between the groups. There was a positive correlation between GRN levels and BMI, WC, HC, and 75 g oral glucose tolerance values in NOR group (p < 0.01, p < 0.05, p < 0.01, and p < 0.05, respectively). CONCLUSIONS: Our results suggest that granulin is associated with anthropometric features in infertile patients and might be an important indicator of obesity and impaired glucose metabolism. Elevated levels of granulin may have a diabetogenic effect and predispose women to high glucose levels.

Obesity Does not Compromise Ovarian Reserve Markers in Infertile Women.

Introduction In the literature, conflicting results from studies examining the relationship between obesity and ovarian reserve have been reported. The purpose of the study is to investigate whether obesity adversely affects serum concentrations of ovarian reserve markers in infertile women with different ovarian reserve status. Materials and Methods A total of 402 women were assigned to three groups according to body mass index (BMI; < 25 kg/m 2 : normal, n = 198; 25.0 - 29.9 kg/m 2 : overweight, n = 126; and ≥ 30 kg/m 2 : obese, n = 78). The women were also divided into two groups according to waist circumference (WC; < 80 cm: normal, n = 103; and ≥ 80 cm: obese, n = 299). Participants were also categorized into three types of ovarian reserve patterns: normal (n = 146), high (n = 112), and poor ovarian reserve (n = 144). The serum anti-Mullerian hormone (AMH), estradiol (E2), and follicle-stimulating hormone (FSH) levels were assayed and compared in all groups. Results There were no significant differences in BMI and WC in the three ovarian reserve groups. There were significant differences between all ovarian reserve groups for AMH, E2, and FSH (p < 0.001 for all). The comparisons of ovarian reserve parameters (AMH, E2, and FSH) and obesity parameters (BMI and WC) revealed no significant differences in women with all ovarian reserve patterns. Conclusion The parameters of ovarian reserve do not seem to be affected by increased BMI and WC. Thus, AMH may be considered as a reliable marker of ovarian reserve.

Is the Concentration of Cadmium, Lead, Mercury, and Selenium Related to Preterm Birth?

Environmental pollution and exposure of people to heavy metals cause many bad obstetric outcomes. Our aim is to demonstrate the role of cadmium (Cd), lead (Pb), mercury (Hg), and selenium (Se) in preterm labor etiology with a case-control study. In this study, between November 2017 and April 2018, preterm delivery mothers and term delivery mothers were compared in Çorum, Turkey. All deliveries were performed with cesarean sections and there were 30 mothers in the control group and 20 in the study group. The maternal blood, maternal urine, umbilical cord blood, and heavy metal levels in the amnion fluid in both groups were studied. Graphite furnace atomic absorption spectrometry was used to determine the blood concentration of Cd, Pb, Hg, and Se. We found lower levels of selenium in blood and urine of preterm delivery mothers and umbilical cord and amnion fluids of preterm infants (p < 0.01). We found a statistically significant positive correlation at selenium levels between mother's blood and umbilical cord blood (r (50) = 0.896, p < 0.001) and between maternal urine and amniotic fluid (r (50) = 0.841, p < 0.001). We have not found a similar correlation between mother and fetus of other metals (p > 0.05). We found that selenium levels were lower in mothers who were preterm birth in the light of the data in our study. We could not determine the positive or negative correlation of Cd, Pb, and Hg levels in blood, urine, and amniotic fluid samples with preterm birth.

Serum progranulin levels are elevated in infertile women with obesity.

INTRODUCTION: The aim of the present study was to investigate the changes in serum progranulin and sex hormone levels in infertile women with obesity. MATERIAL AND METHODS: A total of 171 infertile women who had fertility desire were included in this cross-sectional study. The initial assessment included measurements of weight, height, waist circumference, and hip circumference to calculate body mass index (BMI) and waist/hip ratio. All participants were categorised into two groups in accordance with BMI as a control group ( < 30 kg/m², n = 135) and a study group (≥ 30 kg/m², n = 36). After anthropometric measurements, venous blood samples were taken for analyses of oestradiol and follicle stimulating hormone (FSH), luteinising hormone, total testosterone (TT), 17-hydroxyprogesterone, dehydroepiandrosterone sulphate, anti-Müllerian hormone, and progranulin. RESULTS: The present study demonstrated that the overweight women had higher FSH levels (p < 0.01). Elevated TT levels were detected in obese women (p < 0.05). Progranulin concentrations were higher in the study group than in the control group (p < 0.05). Regression analysis demonstrated that there was a relationship between the serum progranulin concentrations and BMI (p < 0.05). CONCLUSIONS: Our findings support that the elevated progranulin levels are associated with obesity in infertile women. Therefore, infertile and obese patients may benefit if their serum progranulin levels decrease. Further studies are needed to elucidate this issue.

Evaluation of ovarian reserve in women with overt or subclinical hypothyroidism.

INTRODUCTION: Thyroid dysfunction is among the most common autoimmune disorders in women of reproductive age. Previous studies have shown the association between autoimmune thyroid disease (AITD) and infertility. Anti-Müllerian hormone (AMH) is secreted by granulosa cells and is a useful marker for assessment of ovarian reserve. In the present study, we sought to evaluate the ovarian reserves of women with autoimmune thyroid disorder by measurement of AMH values. MATERIAL AND METHODS: This prospective study included women with newly diagnosed AITD aged between 20 and 40 years. Patients were divided into three groups: subclinical hypothyroidism (SCH, n = 21), overt hypothyroidism (OH, n = 21) and controls (CG, n = 32). Study parameters included serum free T4, free T3, thyroid-stimulating hormone, anti-thyroglobulin, anti-thyroid peroxidase antibodies, follicle-stimulating hormone, luteinizing hormone, estradiol and AMH concentrations measured in the early follicular phase. Antral follicle count (AFC) was assessed with ultrasound. Body mass index (BMI) and waist circumference of the patients were noted. RESULTS: No significant difference was found among SCH, OH and CG in regard to ovarian reserves measured by AMH values (p = 0.19) and AFC (p = 0.80). A significant negative correlation was found between AMH and BMI (r = -0.382, p = 0.001). Anti-Müllerian hormone and waist circumference (r = -0.330, p = 0.004) were also negatively correlated. CONCLUSIONS: Although AMH values were not significantly different among groups, AMH values were lower in OH and SCH patients, indicating a possible need for close monitoring of these patients.

Is there a role for kisspeptin in pathogenesis of polycystic ovary syndrome?

AIM: To investigate association of kisspeptin levels in infertile women with different ovarian reserve patterns. MATERIALS AND METHODS: In this prospective cross-sectional study, 157 participants were recruited. The women were divided into three groups: (i) adequate ovarian reserve (AOR) (n = 57), (ii) high ovarian reserve (PCOS) (n = 60), (iii) diminished ovarian reserve (DOR) (n = 40). Weight, height, waist circumference (WC), hip circumference (HC), body mass index (BMI), waist/hip ratio (WHR) were measured. The blood samples were analyzed for estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), 17-hydroxy progesterone (17OHP), dehydroepiandrosterone sulfate (DHEAS), antimullerian hormone (AMH), kisspeptin measurements. RESULTS: FSH concentration was higher and AMH concentration was lower in DOR group (p < .001, p < .001, respectively). The mean LH, TT and DHEAS levels were higher in PCOS group (p = .001, p < .00 and p = .003, respectively). The 17OHP level did not differ among the groups (p = .15). Women with PCOS possessed the highest kisspeptin level (p = .01). The kisspeptin level was negatively correlated with FSH level (r = -0.18, p = .02) and positively correlated with TT and DHEAS levels (r = 0.17, p = .02 and r = 0.23, p = .003, respectively). CONCLUSIONS: Women with PCOS had increased serum kisspeptin levels. Kisspeptin concentrations were negatively correlated with serum FSH and positively correlated with serum TT and DHEAS levels.