Quality of life in Turkish infertile couples and related factors.

Infertility is a major life crisis affecting couples' psychosocial and physical health. We aimed to assess the quality of life in Turkish infertile couples. This cross-sectional survey was carried out in 127 infertile couples admitted to a University Hospital. The quality of life was measured using the fertility quality of life tool (FertiQoL) scale. Women had lower overall quality of life than men. Women and men who were married for fewer than 10 years had a significantly lower emotional score. Women who had a history of infertility treatment, men who have lived in the town or village men with primary infertility and men who have had primary education or lower, had lower scores for mind/body subscale. Social scores were found lower in women under the age of 30, women with middle or low income, men who were married for fewer than 10 years, men who did not have children for 5 years or more and men with primary infertility. The tolerability and environment scores were significantly higher in women who had been married more than once. We conclude that health care providers should be aware of the factors affecting the quality of life (QoL) and give counselling to improve couples' quality of life at infertility clinics.

Immunohistochemical and ultrastructural analysis of the effect of omega-3 on embryonic implantation in an experimental mouse model.

OBJECTIVE: Implantation is the first step to a healthy pregnancy. Omega-3 supplementation is common to use during pregnancy, for its antioxidant and membrane stabilising effect. In this study we have aimed to study the effect of Omega-3 supplementation on implantation in a mouse model by immunohistochemical methods and electron microscopic evaluation. MATERIALS AND METHODS: Mice were randomized into three groups to receive standard food, Omega-3 400 mg/kg and Omega-3 1000 mg/kg one menstrual cycle before mating. Mice were sacrificed on third day of estimated implantation and uterine horns were evaluated immunohistochemically for staining of Laminin and Leukemia Inhibitory Factor (LIF) and ultrastructural morphology. RESULTS: Laminin and LIF immunoreactivity were increased signifcantly in the high dose group when compared to the control and low-dose groups in lumen epithelium basal membrane, gland epithelium basal membrane and endometrial stroma. Electron-microscopic evaluation showed a decrease in epithelial height and microvilli loss in the high dose groups. CONCLUSION: Omega-3 supplementation increased implantation markers Laminin and LIF and decreased epithelial height and microvilli thus seems to prepare the endometrium for a favorable environment of implantation.

Assessment of serum chemerin, vaspin and omentin-1 levels in patients with polycystic ovary syndrome.

OBJECTIVE: To determine serum chemerin, vaspin and omentin-1 in overweight and normal weight patients with polycystic ovary syndrome (PCOS) and investigate the possible relationship between these adipokines and metabolic syndrome. METHODS: This cross sectional study enrolled women with PCOS and healthy women. Serum chemerin, vaspin and omentin-1 were assessed by enzyme-linked immunosorbent assay methods. RESULTS: Forty patients with PCOS and 30 healthy controls were included in the study. In the PCOS group, 18 women were overweight (body mass index [BMI] = 25.0-29.9 kg/m(2)) and 22 had normal weight (BMI = 18.5-24.9 kg/m(2)). Chemerin, total cholesterol, dehydroepiandrosterone sulphate and free androgen index (FAI) were significantly higher; and high-density lipoprotein cholesterol and sex hormone binding globulin were significantly lower in overweight PCOS patients compared with normal weight PCOS patients. A positive correlation was found between chemerin and BMI, triglyceride, insulin, homeostatic model assessment of insulin resistance and FAI in the PCOS group. There was no difference in serum chemerin, vaspin and omentin-1 between PCOS patients and healthy controls. CONCLUSION: Circulating chemerin was increased in overweight compared with normal weight PCOS patients. The most predictive variables for circulating chemerin in PCOS patients were BMI, FAI and age.

Rectus abdominis muscle endometriosis.

Endometriosis is characterized by an abnormal existence of functional endometrial tissue outside the uterine cavity, typically occuring within the pelvis of women in reproductive age. We report two cases with endometriosis of the abdominal wall; the first one in the rectus abdominis muscle and the second one in the surgical scar of previous caesarean incision along with the rectus abdominis muscle. Pre-operative evaluation included magnetic resonance imaging. The masses were dissected free from the surrounding tissue and excised with clear margins. Diagnosis of the excised lesions were verified by histopathology.

Leptin expression in proliferative, secretory and hyperplastic endometrial tissues.

OBJECTIVE: The goal of this study was to detect endometrial leptin expression in proliferative and secretory phases and then to compare the results with that of hyperplastic endometrium. MATERIAL AND METHODS: Seventeen proliferative, 23 secretory phase and 18 hyperplastic endometrial tissues diagnosed in our hospital between 2002 and 2007 were included in the study. These samples were stained with leptin antibody using an immunohistochemical method. Endometrial glandular and surface epithelium and stroma were evaluated for staining distribution and intensity. CONCLUSION: Staining intensity seen in early proliferative phase samples (2.33±0.51) increased significantly throughout the middle (2.40±0.54) and late phases (2.83±0.40) (p<0.05). Early secretory phase samples had the least staining intensity (1.42±0.53), while it increased significantly in later periods (2.38±0.51) (p<0.05). There was no difference in staining intensity among proliferative, secretory and hyperplastic tissues (p>0.05). CONCLUSION: Although endometrial leptin expression was observed in a differential manner throughout the whole menstrual period, no difference was seen in endometrial hyperplasia. We consider that leptin does not play a role in hyperplastic transformation of the endometrium.

Oxidative stress but not endothelial dysfunction exists in non-obese, young group of patients with polycystic ovary syndrome.

OBJECTIVE: To determine if oxidative stress and endothelial dysfunction exist at the same time in a young, non-obese group of patients with polycystic ovary syndrome (PCOS). DESIGN: Cross-sectional study. SETTING: Celal Bayar University, School of Medicine, Manisa, Turkey. SAMPLE: Thirty-one young, non-obese patients with PCOS and 23 age- and body mass index-matched controls. METHODS: Following clinical and biochemical diagnosis, malonyldialdehyde (MDA), superoxide dismutase (SOD), von Willebrand Factor (vWF), and nitric oxide (NO) levels of patients and controls were measured and compared. MAIN OUTCOME MEASURES: To find out oxidative stress and endothelial dysfunction parameters. RESULTS: MDA (0.12+/-0.03 vs 0.10+/-0.03, p=0.01) and SOD (8.0+/-0.7 vs 7.28+/-0.8, p=0.001) levels were significantly higher in PCOS group while there was no difference in vWF (527.2+/-280.1 vs 568.1+/-276.8, p>0.05) and NO levels (169.9+/-47.4 vs 168.9+/-80, p>0.05). When the results of the PCOS patients were divided into two subgroups in terms of insulin resistance (IR- and IR + ), the IR- subgroup had significantly higher MDA levels compared to the control (0.125+/-0.03 vs 0.101+/-0.03, p=0.03). Though IR+ group also had higher MDA than the control group, it did not reach to a significant level (0.117+/-0.05 vs 0.101+/-0.03, p>0.05). Both IR- and IR+ groups had significantly higher SOD levels compared with control group (7.99+/-0.7 vs 7.28+/-0.8, p=0.009 and 8.22+/-0.8 vs 7.28+/-0.8, p=0.03, respectively). vWF and NO levels were not different among these three groups (p>0.05). CONCLUSIONS: Oxidative stress is prominent while endothelial dysfunction does not exist in young, non-obese patients with PCOS.

Effect of insulin on rat ovarian leptin expression by immunohistochemical staining.

AIM: Leptin and insulin may interact in regulating ovarian steroid synthesis. The objective of this study was to investigate immunohistochemical staining of leptin in normal rat ovarian tissues and in rats treated with insulin and insulin plus human chorinoic gonadotropin (hCG). METHODS: Paraffin blocks of rat ovarian tissues from a previous study, in which 18 adult, female Wistar rats with an average weight of 250 g were divided into three groups to receive either saline solution, human insulin (2 U/day) or human insulin (2 U/day) plus hCG (4 U/day) for 4 weeks, were used in this study to compare the effects on leptin staining. The results were analysed using a semiquantitative scoring system, such as mild, moderate and strong. RESULTS: No staining was observed in granulosa cells and theca interna cells of normal ovarian tissues. Theca externa cells had mild staining intensity (+), corpus luteum had moderate (+ +) and stroma had mild (+) staining intensity. Histological structure was impaired in the insulin group, luteinized cells had mild staining, there was no difference in other cell groups. Only theca externa cells of the developing follicles were stained in insulin plus hCG group, luteinized cells again had mild staining. CONCLUSIONS: Besides damaging the rat ovarian structure, insulin reduced staining intensity of leptin in luteinized cells. Insulin may stimulate ovarian steroid synthesis not only through its own receptors, but also by acting on the leptin expression of these cells.

Tear function changes of postmenopausal women in response to hormone replacement therapy.

OBJECTIVE: The goal of this study was to search the effect of hormone replacement therapy (HRT) on tear function changes in postmenopausal women. METHODS: Following initial ophtalmic evaluation and tear sample collection, the subjects were given daily 0.625 mg conjugated estrogen, and either continuous combined or cyclic 5 mg medroxyprogesterone acetate was added. Eye examination included visual acuity, slit-lamp examination, fundus examination, tonometry, Schirmer's test, and break up time (BUT) evaluation. Six months later, control examination was done and repeat tear samples were obtained. Tear immune globulin A (IgA) and lysozyme levels were measured by gel electrophoresis. The pictures of the bands were evaluated by digital image analysis with Scion Image program. RESULTS: Conjunctival vascular congestion, laxity and corneal desquamation did not change before and after HRT (P>0.05). A significant improvement was noted in meibomian gland inflammation (P=0.034). We have not observed any significant difference in burning, foreign body sensation, and tearing (P>0.05). In addition, no significant difference was noted in BUT (P=0.370) and Schirmer's test values (P=0.271). Though both lysozyme and IgA levels were elevated following the therapy, only IgA levels increased significantly (P=0.04). CONCLUSION: HRT decreased meibomian gland inflammation and increased tear lysozyme and IgA levels in postmenopausal women.

Giant mucinous cystadenocarcinoma: a case report.

We present a mucinous cystadenocarcinoma weighing 10 kg in a postmenopausal woman and the way how we managed the case.