Medicine and Health Sciences Commons^™

Sperm Dna Quality Predicts Intrauterine Insemination Outcome: A Prospective Cohort Study, Eyup Duran, M. Morshedi, S. Taylor, S. Oehninger

Eyup Hakan Duran

BACKGROUND: We aimed to investigate whether sperm DNA quality may predict intrauterine insemination (IUI) outcome. METHODS: The study was designed in a prospective cohort fashion, at a tertiary centre for reproductive medicine. A total of 119 patients underwent 154 cycles of IUI. Parameters related to demography, cycle management and semen sample used for IUI were evaluated. Conventional semen parameters, morphology (strict criteria), sperm DNA fragmentation and stability [evaluated by terminal deoxynucleotidyl transferase-mediated dUDP nick-end labelling (TUNEL) and acridine orange staining under both acid and acid + heat denaturing conditions respectively] were measured. The main outcome measure was clinical pregnancy, defined …

Efficacy And Pregnancy Outcome Of Two Methods Of Semen Preparation For Intrauterine Insemination: A Prospective Randomized Study., Mahmood Morshedi, E. Duran, Steven Taylor, Sergio Oehninger

Eyup Hakan Duran

OBJECTIVE: To examine pregnancy outcome with two methods of semen preparation for intrauterine insemination (IUI).

DESIGN: Prospective and randomized study.

SETTINGS: Academic tertiary center.

PATIENT(S): Three hundred eleven couples undergoing 676 consecutive cycles of assisted conception using IUI.

INTERVENTION(S): Semen samples collected for IUI were randomized to wash only or density gradient centrifugation (DGC) processing.

MAIN OUTCOME MEASURE(S): Various prepreparation and postpreparation semen parameters were used for IUI. The influence of the method of semen processing, and impact of various semen parameters and female factors on pregnancy were examined by receiver operating characteristics (ROC) curves, logistic regression, and life table …

Cyclophosphamide Therapy In A Serious Case Of Lupus Nephritis During Pregnancy., H Kart Köseoglu, A. Yücel, G. Künefeci, F. Ozdemir, E. Duran

Eyup Hakan Duran

Systemic lupus erythematosus (SLE) flare is common, and renal involvement is one of the most serious problems during pregnancy. Aggressive immunosuppressive therapy should be considered for patients with diffuse proliferative lupus nephritis. These individuals are at high risk for progression to end-stage renal disease. Immunosuppressive drugs can cause significant toxic and teratogenetic effects. In this report, we describe the case of a pregnant patient with lupus nephritis who was treated with cyclophosphamide. The patient was in the second trimester of her first pregnancy and did not respond to corticosteroid therapy. She underwent intensive in-hospital care while she was on cyclophosphamide …

Achievement Of Pregnancy In Globozoospermia With Y Chromosome Microdeletion After Icsi., Hulusi Zeyneloglu, Volkan Baltaci, E. Duran, Esra Erdemli, Sertac Batioglu

Eyup Hakan Duran

Pregnancy achieved with sperm from a patient with globozoospermia is rare, even after ICSI, since the activation of the oocyte may not occur in this disorder. Therefore, activation of the oocytes by piezoelectricity or calcium ionophores has been suggested, although spontaneous activation of the oocyte after ICSI has been reported in some cases. We report a successful pregnancy in a couple in which the male partner had globozoospermia with microdeletions in the Y chromosome with no further assisted activation after ICSI. During the diagnostic study of the husband, increased numerical chromosome abnormalities after fluorescent in-situ hybridization (FISH) and microdeletions in …

Predictive Value Of The Hemizona Assay For Pregnancy Outcome In Patients Undergoing Controlled Ovarian Hyperstimulation With Intrauterine Insemination., Murat Arslan, Mahmood Morshedi, Ebru Arslan, Steve Taylor, Arzu Kanik, E. Duran, Sergio Oehninger

Eyup Hakan Duran

OBJECTIVE: The hemizona assay (HZA) is an established functional test that examines in vitro sperm-zona pellucida binding capacity with high predictive power for fertilization outcome in IVF. The objective of this study was to evaluate the value of the HZA as a predictor of pregnancy in patients undergoing controlled ovarian hyperstimulation (COH) and intrauterine insemination (IUI). DESIGN: Prospective clinical study. SETTING: Academic center. PATIENT(S): Eighty-two couples with unexplained or male factor infertility that underwent 313 IUI cycles. INTERVENTION(S): Basic semen analysis and HZA were performed within three months of starting COH/IUI therapy. MAIN OUTCOME MEASURE(S): Hemizona index (HZI) and clinical …

The Impact Of A Gonadotropin-Releasing Hormone Antagonist On Gonadotropin Ovulation Induction Cycles In Women With Polycystic Ovary Syndrome: A Prospective Randomized Study, L. Stadtmauer, A. Sarhan, Eyup Duran, H. Beydoun, S. Bocca, B. Pultz, S. Oehninger

Eyup Hakan Duran

OBJECTIVE: To evaluate the effect of the gonadotropin-releasing hormone antagonist Ganirelix on gonadotropin ovulation induction (OI) in patients with polycystic ovary syndrome (PCOS). DESIGN: Prospective, randomized, controlled study. SETTING: Academic infertility center. PATIENT(S): Ninety-eight anovulatory women with PCOS undergoing 154 gonadotropin OI cycles. INTERVENTION(S): Patients were treated with recombinant FSH alone (group 1) or in conjunction with Ganirelix when the leading follicle was >/=13 mm (group 2) versus from the beginning of stimulation (group 3), followed by IUI. MAIN OUTCOME MEASURE(S): Per cycle clinical pregnancy rate (CPR), live-birth rate (LBR), total gonadotropin dose, days of stimulation, serum LH and peak …

Intrauterine Insemination: A Systematic Review On Determinants Of Success., E. Duran, Mahmood Morshedi, Thinus Kruger, Sergio Oehninger

Eyup Hakan Duran

Intrauterine insemination (IUI) is a frequently indicated therapeutic modality in infertility. Here, a systematic review of the literature was performed to examine the current status of clinical and laboratory methodologies used in IUI and the impact of female and male factors on pregnancy success. Emphasis was centred in questioning the following: (i) the value of IUI against timed intercourse; (ii) IUI application with or without controlled ovarian hyperstimulation; (iii) timing and frequency of IUI; and (iv) impact of various parameters (male/female) on the prediction of pregnancy outcome. The odds of multiple pregnancy occurrence and its risk factors, as well as …

Cumulative Exposure To High Estradiol Levels During The Follicular Phase Of Ivf Cycles Negatively Affects Implantation., Murat Arslan, Silvina Bocca, Ebru Arslan, E. Duran, Laurel Stadtmauer, Sergio Oehninger

Eyup Hakan Duran

PURPOSE: To investigate the effect of the cumulative exposure to estradiol (E(2)) during the follicular phase on IVF outcome.

METHODS: Patients were stimulated with recombinant FSH after GnRH agonist suppression and had a day 3-embryo transfer. Estrogen exposure was determined as the area under the curve (AUC) for serum E(2) levels measured from the first day of stimulation through the day after hCG administration.

RESULTS: E(2) AUC thresholds for 10th and 90th percentiles were 4704 pg/ml and 16338 pg/ml, respectively. The pregnancy and implantation rates were highest in the 10th-90th percentile group, and were statistically higher in this group than …

A Logistic Regression Model Including Dna Status And Morphology Of Spermatozoa For Prediction Of Fertilization In Vitro, Eyup Duran, T. Gurgan, S. Gunalp, M. Enginsu, H. Yarali, A. Ayhan

Eyup Hakan Duran

To determine predictive values of routine semen analysis, sperm morphology evaluation using strict criteria and DNA status for in-vitro fertilization (IVF), 66 consecutive couples undergoing IVF in a university hospital IVF programme were prospectively investigated. Semen samples from 66 men were evaluated by routine semen analysis, morphology evaluation using strict criteria and acridine orange staining for determination of DNA status. A new technique is described for acridine orange scoring which consisted of evaluation of two smears per case, with and without heat treatment. Resistance to heat-provoked denaturation was determined by the difference between two evaluations. A logistic regression model was …

Does Insulin Secretion In Patients With One Abnormal Glucose Tolerance Test Value Mimic Gestational Diabetes Mellitus?, Tolga Ergin, Arda Lembet, E. Duran, Esra Kuscu, Tayfun Bagis, Esra Saygili, Sertac Batioglu

Eyup Hakan Duran

OBJECTIVE: The purpose of this study was to investigate the insulin response to a 3-hour oral glucose tolerance test and to compare the insulin levels in the gestational diabetes mellitus and single abnormal test value groups with a nondiabetic control group. STUDY DESIGN: One hundred ten Turkish women with uncomplicated pregnancy participated in this prospective controlled study between 24 to 28 weeks of gestation. A 100-g 3-hour oral glucose tolerance test was given, and glucose and insulin plasma levels were assayed. The subjects were classified according to established criteria. Early-phase insulin secretion was assessed by the insulinogenic index. Total insulin …