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Öğe The effect of embryo transfer technique on pregnancy and live birth rates in infertile women undergoing IVF treatment with freeze-all strategy(2022) Oral, Serkan; Şişmanoğlu, Alper; Akpak, Yasam Kemal; Çelik, Sebahattin; Yurtcu, NazanAbstract Objective: The aim of this observational retrospective cohort study was to define the effect of the embryo transfer (ET) technique on pregnancy and live birth rates. Material and Methods: Infertile women with good prognostic factors undergoing in vitro fertilization treatment with freezing all the 5th day good quality embryos and consecutive frozen ET in 468 infertile good responders with first quality 5th day embryos were chosen for this study. Logistic regression analysis was performed to determine the effect of ET on the live birth rates. Results: Of the six predictive values, four were statistically significant: The easy passage of the external catheter, ultrasonographic visualization of the bubble, leaving the embryo at the desired location, and bleeding found in the external catheter after the catheter were excluded from the cervical ostium. While the probability of pregnancy decreased by 98.1% in cases where the embryo could not be left at the expected location, it was observed that the probability of pregnancy decrease was 96.4% in cases where no bubble could be seen, and 59.2% in cases with bleeding in the external catheter. Similarly, a 74.4% decrease in the probability of pregnancy was observed in patients in whom the passage of the catheter was difficult. Even though the tip of the transfer catheter during the ET is easily seen, the blood in the external catheter decreases pregnancy chance. Conclusion: Visualizing the internal catheter and the air bubble under the ultrasound guidance with the atraumatic placing of the embryo 1–1.5 cm away from the uterine fundus is crucial for the success of ET.Öğe Prediction of gestational diabetes mellitus and perinatal outcomes by plasma zonulin levels(2022/8/22) Oral, Serkan; Çelik, Sebahattin; Akpak, Yasam Kemal; Golbasi, Hakan; Bayraktar, Burak; Unver, Gokhan; Sahin, Sami; Yurtcu, Nazan; Caliskan, CananAbstract Purpose: Zonulin has been shown to be associated with many metabolic disorders, including type 2 diabetes mellitus, metabolic syndrome, and obesity. In this study, we aimed to evaluate the association between maternal plasma zonulin levels and gestational diabetes mellitus (GDM) and its perinatal outcomes. Materials: A total of 100 pregnant women, 56 with GDM and 44 controls, were included in this prospective case-control study. Maternal plasma zonulin levels were evaluated in each trimester. The association between zonulin levels and GDM, body mass index (BMI) and adverse perinatal outcomes was evaluated. The GDM predictability of zonulin levels for each trimester was analyzed with the receiver operator curve (ROC). Results: Plasma zonulin levels were significantly higher in pregnant with GDM in all trimesters (p < 0.001; for all). Optimum cut-off values of plasma zonulin levels in predicting GDM: first trimester: 6.27 ng/mL, second trimester: 12.71 ng/mL, and third trimester: 18.38 ng/mL. BMI was significantly higher in pregnant women with GDM (30.5 vs 26.1; p < 0.001). Zonulin levels were significantly higher in pregnant women with GDM with overweight BMI [≥ 25-30 (kg/m2)] in all trimesters (p < 0.05; for all). Zonulin levels were significantly higher in pregnant women with composite adverse outcomes that included at least one of neonatal intensive care unit (NICU) admission, meconium-stained amniotic fluid, and 1st minute APGAR score < 7. Conclusion: Increased maternal plasma zonulin levels were associated with increased risk of GDM and adverse perinatal outcomes. Zonulin may be a potential marker to predict GDM risk and perinatal outcomes.Öğe Prediction of gestational diabetes mellitus and perinatal outcomes by plasma zonulin levels(Springer Science and Business Media Deutschland GmbH, 2024) Oral, Serkan; Celik, Sebahattin; Akpak, Yasam Kemal; Golbasi, Hakan; Bayraktar, Burak; Unver, Gokhan; Sahin, SamiPurpose: Zonulin has been shown to be associated with many metabolic disorders, including type 2 diabetes mellitus, metabolic syndrome, and obesity. In this study, we aimed to evaluate the association between maternal plasma zonulin levels and gestational diabetes mellitus (GDM) and its perinatal outcomes. Materials: A total of 100 pregnant women, 56 with GDM and 44 controls, were included in this prospective case–control study. Maternal plasma zonulin levels were evaluated in each trimester. The association between zonulin levels and GDM, body mass index (BMI) and adverse perinatal outcomes was evaluated. The GDM predictability of zonulin levels for each trimester was analyzed with the receiver operator curve (ROC). Results: Plasma zonulin levels were significantly higher in pregnant with GDM in all trimesters (p < 0.001; for all). Optimum cut-off values of plasma zonulin levels in predicting GDM: first trimester: 6.27 ng/mL, second trimester: 12.71 ng/mL, and third trimester: 18.38 ng/mL. BMI was significantly higher in pregnant women with GDM (30.5 vs 26.1; p < 0.001). Zonulin levels were significantly higher in pregnant women with GDM with overweight BMI [≥ 25–30 (kg/m2)] in all trimesters (p < 0.05; for all). Zonulin levels were significantly higher in pregnant women with composite adverse outcomes that included at least one of neonatal intensive care unit (NICU) admission, meconium-stained amniotic fluid, and 1st minute APGAR score < 7. Conclusion: Increased maternal plasma zonulin levels were associated with increased risk of GDM and adverse perinatal outcomes. Zonulin may be a potential marker to predict GDM risk and perinatal outcomes. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Öğe Predictive and Prognostic Value of Plasma Zonulin for Gestational Diabetes Mellitus in Women at 24–28 Weeks of Gestation(2022/12) Yılmaz Zehra; Oral, Serkan; Yurtcu, Nazan; Akpak, Yasam Kemal; Çelik, Sebahattin; Caliskan, CananObjective We aimed to examine the predictive and prognostic value of plasma zonulin for gestational diabetes mellitus (GDM) in women at 24–28 weeks of gestation. Methods This retrospective study was carried out with pregnant women with GDM (n=98) and normal glucose tolerance (control group) (n=132). GDM was diagnosed according to American Diabetes Association (ADA) criteria with a one-step 75-g OGTT at 24–28 gestational weeks. Their serum zonulin levels measured during one-step 75-g OGTT and perinatal outcomes were compared, and the cut-off value of plasma zonulin for the prediction of GDM was calculated with receiver operating characteristic curve analysis. Results Plasma zonulin level was significantly higher in women with GDM compared to controls (28.8±24.9 and 7.3±11.3 ng/mL, respectively). According to logistic regression analysis, plasma zonulin levels and GDM were statistically significant. The plasma zonulin cut-off value was>45.2 ng/mL. The rate of cesarean section, the rate of meconium in the amniotic fluid, and the need for admission to the neonatal intensive care unit significantly differed between women with GDM and controls. Conclusion In pregnant women with GDM, plasma zonulin increases, and with the cut-off level of>45.2 ng/mL, it can predict GDM with values of sensitivity and specificity levels significantly higher in pregnant women with GDM, suggesting that it can be used as a tool for its screening and early diagnosis.Öğe Predictive value of pregnancy of follicular fluid fetuin-A and -B levels in infertile women after intra-cytoplasmic sperm injection(Wiley, 2022) Yurtcu, Nazan; Oral, Serkan; Celik, Sebahattin; Caliskan, Suleyman Tumer; Alagoz, Murat; Dahan, Michael H.Aim We aimed to investigate the value of follicular fluid fetuins-A and -B to predict successful IVF and pregnancy outcomes in infertile women with poor, normal, and high ovarian reserve. Methods The follicular fluid of 96 infertile women who underwent intra-cytoplasmic sperm injection (ICSI) procedure was analyzed. Fetuins-A and -B levels were examined and compared in those who could achieve pregnancy and those who could not. Receiver operating characteristic curve analyzes were used to determine cut-off and statistically significant associations for fetuins-A and -B. Results Follicular fluid fetuin-A levels were higher in cases with weak ovarian reserve (OR) (p < 0.05) and higher in patients who did not achieve clinical pregnancy (p < 0.05). Conversely, the follicular fluid fetuin-B levels were lower in cases with poor OR (p < 0.05) and were lower in patients who did not achieve a clinical pregnancy (p < 0.05). A follicular fluid fetuin-A concentration <= 19.12 ng/mL had a sensitivity and specificity of 94.74% and 93.1%, respectively, at predicting clinical pregnancy. While the follicular fluid fetuin-B concentration >24.7 ng/mL had sensitivity and specificity of 71.1% and 51.7%, respectively, for clinical pregnancy prediction. Conclusion Overall, high levels of follicular fluid fetuin-A may be independently associated with unsuccessful IVF irrespective of OR grouping. A low level of follicular fetuin-B was also associated with failed IVF. The sensitivity and specificity were found to be higher for fetuin-A in predicting clinical pregnancy. Therefore, the follicular fluid fetuin-A may be more predictive for successful IVF and clinical pregnancy outcomes than follicular fluid fetuin-B.
