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Öğe Concomitant endometriosis in malignant and borderline ovarian tumours(Oxford University Press, 2015) Oral, Engin; İlvan, Şennur; Aydın, Övgü; Yılmaz, Hüma; Kumbak, Banu; Beşe, Tugan; Demirkıran, Fuat; Arvas, Macit[Abstract Not Available]Öğe Impact of luteal phase hysteroscopy and concurrent endometrial biopsy on subsequent IVF cycle outcome(Springer, 2014) Kumbak, Banu; Şahin, Levent; Özkan, Sema; Atılgan, RemziPurpose: Endometrial biopsy preceding implantation in in vitro fertilization (IVF) treatment causes a type of injury which facilitates implantation. Pre-treatment hysteroscopic evaluation of uterine cavity also raises the success in IVF. This study investigates whether office hysteroscopy and concurrent endometrial biopsy performed in the luteal phase, on the day of GnRH agonist initiation for long protocol, improves subsequent IVF outcome. Methods: A prospective, nonrandomized, controlled study of 128 normoresponder women was performed: In 70 women (study group), office hysteroscopy and concurrent endometrial biopsy were performed on the day of GnRH agonist initiation preceding ET cycle and in 58 women (control group), GnRH agonist was initiated without any intervention. However, uterine cavity was shown to be normal with hysteroscopy within the previous 6 months in those women. Implantation and pregnancy rates were compared between the groups. Results: Intrauterine pathologies were observed in 28 % of women in the study group. Implantation rate (38 vs. 25 %; p = 0.04) and pregnancy rate per ET (67 vs. 45 %; p = 0.01) were found to be significantly higher in the study group compared to the control group. Conclusion: Office hysteroscopy and concurrent endometrial biopsy performed in the luteal phase, on the day of GnRH agonist initiation for long protocol, provide direct evaluation of the uterine cavity immediately before ET cycle and also significantly improve the implantation and IVF outcome.Öğe Lower extremity venous doppler evaluation in patients undergoing laparoscopic gynecological operations(Mary Ann Liebert, Inc, 2013) Kumbak, Banu; Poyraz, Ahmet Kürşad; Başpınar, Melike; Şahin, Levent; Özkan, Zehra SemaBackground: Laparoscopy is established as a standard of care in a variety of gynecological pathologies. Pneumoperitoneum and reverse Trendelenburg positioning during laparoscopy have been claimed to increase thrombosis risk, albeit these proposals are still controversial. The aim of this study was to assess lower extremity venous blood flow by Doppler sonography in patients undergoing laparoscopic gynecological surgeries. Patients and Methods: A prospective, nonrandomized, controlled study was designed to compare lower extremity venous Doppler measurements in patients undergoing diagnostic and operative gynecological laparoscopies. In the period from May 2010 to April 2011, in total, 96 patients operated on for various gynecological complaints excluding malignancy were enrolled in the study. Thirty-two of these patients underwent diagnostic laparoscopy, 34 underwent operative laparoscopy, and 30 underwent open surgery. Lower extremity venous blood flow was investigated by Doppler sonography in patients the day before surgery and 24 hours afterward. Preoperative and postoperative Doppler measurements were obtained from bilateral common and superficial femoral, bilateral great saphenous, and bilateral popliteal veins. Results: Lower extremity venous Doppler measurements were similar in diagnostic and operative laparoscopy groups. Femoral venous blood flow measurements were observed to be similar, but great saphenous and popliteal blood flows were found to be significantly decreased in the open surgery group compared with laparoscopic operations. Conclusions: The laparoscopic approach in gynecological surgery is not associated with an adverse effect on lower extremity blood flow and seems not to bring an additional risk of thrombosis.Öğe Ozone (03)-Oxygen mixture therapy inhibits endometrial implant growth(CIC Edizioni Internazionali s.r.l., 2016) Aktün, Lebriz Hale; Atılgan, Remzi; Karaca, Nilay; Acet, Mustafa; Yorgunlar, Betül; Can, Behzat; Dağlı, Adile Ferda; Gül, Hüseyin Fatih; Kumbak, Banu; İrban, Arzu[Abstract Not Available]Öğe Ozone (03)-oxygen mixture therapy inhibits endometrial implant growth(E-Century Publishing Corp, 2016) Aktün, Lebriz Hale; Acet, Mustafa; Atılgan, Remzi; Karaca, Nilay; Yorgunlar, Betül; Can, Behzat; Dağlı, Adile Ferda; Gül, Hüseyin Fatih; Kumbak, Banu; İrban, ArzuThe aim of this study was to investigate potential therapeutic efficiency of ozone therapy in the treatment of experimental endometriosis in rats. Fifteen rats were divided into three groups, which were labeled as the (1) sham control, (2) the ozone (treated with intraperitoneal ozone-oxygen mixture) and (3) the GnRH-agonist (given single dose (1 mg) leuprolide acetate depot formulation) group. Endometrial implant activity of superoxide dismutase (SOD), malondialdehyde (MDA), interleukin-1 beta (IL-1 beta), IL-6, tumor necrosis factor-alpha (TNF-alpha), and vasculary endothelial growth factor (VEGF) were measured after ozone-therapy. Furthermore, peritoneal fluid activity of SOD, MDA, and TNF-alpha were also measured before and after ozone-therapy. Serum AMH levels of the rats those were given ozone-therapy and control groups were measured. The rats given ozone-therapy showed significantly reduced endometriotic implant volumes. After ozone-therapy, a significant increase in activity of SOD in peritoneal fluid was detected. Conversely, implant levels of SOD in rats given ozone therapy was found to be significantly decreased. Both peritoneal fluid and implant levels of MDA were significantly decreased after ozone-therapy. Implant levels of TNF-alpha, IL-1 beta, and IL-6 were significantly increased following ozone-therapy. VEGF levels of implant was found to be unchanged after ozone-therapy. Serum AMH levels of animals were given ozone-therapy and control groups were similar. The number of both primordial and preantral follicles were significantly decreased after ozone-therapy. However, the number of atretic follicles were similar in ozone-therapy and control groups. Repeated administration of ozone-oxygen therapy in non-toxic doses inhibits growth of endometrial implants.Öğe Ozone (O3)-oxygen mixture therapy inhibits endometrial implant growth(Taylor & Francis Ltd, 2016) Aktün, Lebriz Hale; Atılgan, Remzi; Karaca, Nilay; Acet, Mustafa; Yorgunlar, Betül; Can, Behzat; Dağlı, Ferda; Gül, Fatih; Kumbak, Banu; İrban, Arzu[Abstract Not Available]Öğe Response to: Impact of luteal phase hysteroscopy and concurrent endometrial biopsy on subsequent IVF cycle outcome(Springer Verlag, 2015) Kumbak, Banu; Şahin, Levent; Özkan, Sema; Atılgan, RemziWe would like to thank Dr. Shokeir for his interest in our manuscript presenting improved outcome in women who had luteal phase hysteroscopy and concurrent endometrial biopsy in the cycle prior to starting ovarian stimulation for IVF [1]. In fact, the initial data about this issue came from the women with recurrent implantation failure [2]. The results in 2062 women with recurrent implantation failure suggested that inducing injury in the cycle preceding IVF was 70 % more likely to result in a clinical pregnancy compared to no intervention [2]. Furthermore, regards to the type of endometrial injury, this meta-analysis revealed that clinical pregnancy rates were twice as high with biopsy/scratch as compared to hysteroscopy [2]. It is hypothesized that local injury to endometrium prior to IVF initiated changes in the immune system and gene expression leading to a more favorable endometrium for implantation in the next cycle. Nevertheless, the exact mechanism(s) and the optimal timing and the type of intervention (hysteroscopy or endometrial biopsy/scratch) still need to be clarified [3]. Unlike the meta-analysis mentioned, a recent randomized study proposed that endometrial aspiration in the mid-luteal phase in the cycle preceding ovarian stimulation for IVF did not improve the ongoing pregnancy rate in unselected subfertile women undergoing their first IVF treatment [4]. Further randomized studies investigating all the aspects of local endometrial injury and treatment outcome in patients undergoing first IVF cycle are needed.Öğe What is the impact of Th1/Th2 ratio, SOCS3, IL17, and IL35 levels in unexplained infertility?(Elsevier, 2014) Özkan, Zehra Sema; Deveci, Derya; Kumbak, Banu; Şimşek, Mehmet; İlhan, Fulya; Şekercioğlu, Samet; Sapmaz, EkremImplantation necessitates complex interactions among the developing embryo, decidualizing endometrium, and developing maternal immune tolerance and/or alterations in cellular and humoral immune responses. Overstimulation of T helper 1 (Th1) or Th2 cytokines in systemic and local environments, alterations of the prevalence of IL17 and regulatory T cell (Treg) cytokines have also been suggested to contribute to the pathogenesis of implantation failure. We aimed to investigate the plasma levels of IL4, IL6, IL10, TNF alpha, IFN gamma, TGF beta, IL17, IL35, and SOCS3 in infertile and fertile women. This case-control study was conducted with 80 women suffering from unexplained infertility and 40 fertile women. Peripheral venous blood samples were drawn on day 21 of the menstrual cycle. The extracted plasma samples were assayed by an enzyme linked immunosorbent assay. Statistical analysis was performed using SPSS version 16.0. Our main findings were as follows: despite the significantly high IL17 and IL35 plasma levels of infertile women, IL35/IL17 ratio was significantly lower in the infertile group compared with that in the fertile group; SOCS3 plasma levels showed an inverse relation with plasma levels of all cytokines except IL35; increased plasma IL17 levels (>3.42 pg/mL) have a negative impact on fertility; TNF alpha/IL10, IFN gamma/IL10, IFN-gamma/16, and IFN gamma/IL4 ratios were significantly higher in infertile group compared with those in the fertile group. It is not possible to show the major immunological factor(s) of unexplained infertility, but our findings point out that the decreased suppressor activity of the immune system may play a role in implantation failure. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
