Apoptosis through regulation of Bcl-2, Bax and Mcl-1 expressions in endometriotic cyst lesions and the endometrium of women with moderate to severe endometriosis.

The aim of the study was to evaluate apoptosis through regulation of Bcl-2, Bax and Mcl-1 proteins by comparing their expressions in endometriotic cyst lesions and the endometrium of the patients with moderate to severe endometriosis. This is a cross-sectional study of 30 women in reproductive age with a clinical or sonographic suspicion of endometrioma, who underwent laparoscopy. Bcl-2 expression was positive both in cystic endometriotic lesions and endometrium, and its expression was significantly reduced in the cystic endometriotic lesions (p < 0.0001). There was a significant difference in Bcl-2 expression between cystic endometriotic stromal cells and endometrial stromal cells (p < 0.0001). Bax expression was positive both in cystic endometriotic lesions and endometrium, and its expression was significantly lower in the endometrium (p < 0.0001). There was a significant difference in Bax expression between cystic endometriotic stromal cells and endometrial stromal cells (p = 0.03). Mcl-1 expression was positive both in cystic endometriotic lesions and endometrium, and its expression was significantly lower in the cystic endometriotic lesions (p = 0.003). Apoptosis may play a role in the pathophysiology of endometriosis by potentially contributing to the survival of regurgitating endometrial cells in the peritoneal cavity.

Relevance of thrombophilia and impact of office hysteroscopy on recurrent in vitro fertilization failures: a case series.

The study evaluated the validity of office hysteroscopy (OH) in 51 infertile women and whether congenital or acquired thrombophilia is more prevalent in women with recurrent IVF failures.

Relevance of anti-Müllerian hormone on in vitro fertilization outcome.

PURPOSE: The aim of this study was to investigate the relevance of serum and follicular anti-Müllerian hormone (AMH) concentrations on ovarian reserve and clinical pregnancy. MATERIALS AND METHODS: Thirty patients were prospectively included in this study. Serum AMH levels were quantitatively measured on the follicle aspiration day. Retrieving less than five oocytes was defined as poor response. Eleven days after embryo transfer, beta-human chorionic gonadotropin (beta-hCG) level in the blood was measured. Two weeks after the beta-hCG test, a clinical pregnancy was confirmed by transvaginal ultrasound (TVUS). RESULTS: There was a statistically significant correlation between serum AMH and number of retrieved oocytes (p = 0.024). There was a correlation between the number of retrieved oocytes and baseline antral follicle count (AFC), between ovarian reserve and baseline follicle-stimulating hormone (FSH), and between ovarian reserve and serum AMH (p < 0.05). Serum AMH cut-off value for the normal ovarian reserve was calculated as 0.37ng/ml (sensitivity 71.43%, specificity 66.67%, positive prediction 83.33%, negative prediction 50%). CONCLUSION: Increasing use of serum AMH will be of considerable benefit. Consequently, the observed positive correlation between serum AMH and ovarian reserve will require larger sampling to refine the role of AMH.

Evaluation of low-dose letrozole addition to ovulation induction in IVF.

PURPOSE: The aim was to investigate the impact of low-dose letrozole usage along with gonadotropin treatment in vitro fertilization (IVF) cycles in comparison to gonadotropin treatment alone. MATERIALS AND METHODS: Fifty patients were prospectively included in this randomized study and were divided into two groups. Age, demographic features, causes, and period of infertility were adjusted and matched for both groups. Group 1 included 25 patients who received gonadotropin treatment and letrozole along with gonadotropin-releasing hormone (GnRH) antagonist protocol; group 2 included 25 patients who received gonadotropin treatment along with GnRH antagonist protocol. RESULTS: Total follicle-stimulating hormone (FSH) and daily FSH doses were lower in group 1, although not statistically significant (p > 0.05). The period of ovulation induction was significantly shorter in group 2. While numbers of retrieved oocytes and transferred embryos were lower in group 1, they were not statistically significant (p > 0.05). Number of clinical pregnancies per embryo transfer, number of clinical pregnancies per cycle, and number of ongoing pregnancies (> 16 gestational weeks) were similar in both groups (p > 0.05). CONCLUSIONS: Addition of low-dose letrozole to gonadotropin treatment in GnRH antagonist protocols may result in a lower dose of gonadotropin administration. However, routine clinical practice remains questionable due to no evident positive effect on pregnancy rates.

Does tension-free vaginal tape and tension-free vaginal tape-obturator affect urodynamics? Comparison of the two techniques.

AIM: To evaluate the effects of tension-free vaginal tape (TVT) and tension-free vaginal tape-obturator (TVT-O) operations on urodynamics and subjective and objective outcomes. MATERIALS AND METHODS: Thirty-six patients with stress or mixed urinary incontinence underwent TVT or TVT-O. Bristol Female Lower Urinary Tract Symptoms (BFLUTS) Questionnaire-Scored Form, one-hour pad test, Q-tip test, perineometer, and urodynamics were performed before and after the operations. Blaivas-nomogram was used for assessment of postoperative voiding difficulty. RESULTS: Nineteen patients underwent TVT-O and 17 patients underwent TVT. Mean follow-up was 18.4 +/- 6.8 months. There was no difference between two groups regarding demographic variables, degree of prolapse, type of incontinence, perineometer, Q-tip test, pad test, and urodynamics. There was a significant increase in the maximum urethral closure pressure (MUCP) and residual volume in TVT-O group. According to Blaivas-nomogram, five patients had mild, one had medium obstruction in the TVT-O group, whereas one had mild and three had medium obstruction in TVT group. Two bladder perforations occurred during TVT. One patient developed groin pain after TVT-O. CONCLUSIONS: TVT-O may lead to an increase in MUCP and residual urine volume. TVT-O is as efficient as TVT and leads to milder obstruction when compared to TVT.