Turkish Journal of Obstetrics and Gynecology最新文献

{"title":"Comparison of conventional karyotype analysis and CMA results with ultrasound findings in pregnancies with normal QF-PCR results.","authors":"Zafer Bütün, Masum Kayapınar, Gökalp Şenol, Ece Akca, Ebru Erzurumluoğlu Gökalp, Sevilhan Artan","doi":"10.4274/tjod.galenos.2025.10673","DOIUrl":"10.4274/tjod.galenos.2025.10673","url":null,"abstract":"<p><strong>Objective: </strong>In cases requiring fetal diagnostic testing, conventional karyotype analysis is initially preferred. However, quantitative fluorescent-polymerase chain reaction (QF-PCR) or fluorescent in situ hybridization methods are used alongside conventional karyotype analysis to obtain rapid results. If results cannot be obtained from conventional karyotype analysis, chromosomal microarray analysis (CMA) is a reasonable option in necessary cases. In this study, we analyzed the conventional karyotype and CMA results from pregnancies reported as having normal karyotypes by QF-PCR and assessed their correlation with ultrasound imaging results.</p><p><strong>Materials and methods: </strong>Between 2020 and 2023, pregnant women with fetal structural anomalies detected by ultrasound and magnetic resonance imaging at the Eskişehir City Hospital, Clinic of Perinatology were referred to our prenatal diagnosis center. In samples obtained using appropriate diagnostic methods, QR-PCR and conventional karyotype analysis were performed initially. Pregnancies with chromosomal anomalies detected by QF-PCR were excluded from the study. For pregnancies with normal karyotypes, CMA was applied.</p><p><strong>Results: </strong>In 203 pregnancies with a normal karyotype result from QF-PCR, 202 (99.5%) were reported as normal in conventional karyotype analysis, while 1 (0.5%) case showed deletion of chromosome 7. Among the remaining pregnancies, CMA examination revealed abnormal karyotype results in 25 (12.3%) cases. A relationship was found only between ventriculomegaly detected by ultrasound and CMA results. The prevalence of ventriculomegaly was higher in those with CMA abnormalities (16%) compared to those with normal CMA (4.5%), and this difference was statistically significant (p=0.045).</p><p><strong>Conclusion: </strong>The benefit of CMA analysis in detecting chromosomal anomalies such as copy number variations, especially in cases reported as having a normal karyotype by QF-PCR and karyotype analysis, is evident. To evaluate the relationship between ultrasound anomalies and CMA results, each community should assess its own results.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"22 2","pages":"106-113"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of lymph node metastasis in cervical cancer: A retrospective comparison of preoperative MRI and PET/CT with postoperative histopathology results.","authors":"Süleyman Özen, Ergul Demircivi, Abdulkadir Turgut, Muzaffer Sancı","doi":"10.4274/tjod.galenos.2025.27482","DOIUrl":"10.4274/tjod.galenos.2025.27482","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to assess the diagnostic performance of positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) in detecting pelvic and paraaortic lymph node involvement in cervical cancer patients by correlating imaging results with surgical pathology findings.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on cervical cancer patients treated at İstanbul Medeniyet University Prof. Dr. Süleyman Yalçın City Hospital from 2016 to 2022. Patients who underwent preoperative PET/CT or MRI imaging and subsequent lymph node dissection were included. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each imaging modality.</p><p><strong>Results: </strong>Of the 75 cases reviewed, 52 met the inclusion criteria. PET/CT had higher specificity (94.1%) than MRI (82.4%), while MRI demonstrated greater sensitivity (55.6% vs. 50%). False-negative rates were 15.3% for MRI and 17.3% for PET/CT. Receiver operating characteristic analysis indicated an area under the curve of 0.78 for PET/CT and 0.69 for MRI. No statistically significant differences in sensitivity or specificity were observed, with both modalities showing complementary strengths.</p><p><strong>Conclusion: </strong>MRI and PET/CT each contribute significantly to preoperative cervical cancer evaluation, with MRI favored for local assessment and PET/CT for nodal detection. Combining both modalities enhances diagnostic accuracy. Further prospective research is required to confirm and strengthen these results. and improve imaging strategies for clinical practice.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"22 2","pages":"129-133"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in prenatal diagnosis: Down syndrome risk assessment with the power of gradient boosting-based machine learning algorithms.","authors":"Emre Yalçın, Tarık Kaan Koç, Serpil Aslan, Süleyman Cansun Demir, İsmail Cüneyt Evrüke, Mete Sucu, Mesut Avan, Fatma İşlek Uzay","doi":"10.4274/tjod.galenos.2025.83278","DOIUrl":"10.4274/tjod.galenos.2025.83278","url":null,"abstract":"<p><strong>Objective: </strong>One of the most common chromosomal abnormalities seen during pregnancy is Down syndrome (Trisomy 21). To determine the risk of Down syndrome, first-trimester combined screening tests are essential. Using data from the first-trimester screening test, this study compares machine learning and deep learning models to forecast the risk of Down syndrome.</p><p><strong>Materials and methods: </strong>Within the scope of the study, biochemical and biophysical data of 959 pregnant women who underwent first-trimester screening tests at Çukurova University Obstetrics and Gynecology Clinic between 2020-2024 were analyzed. After cleaning missing and erroneous data, various preprocessing and normalization techniques were applied to the final dataset consisting of 853 observations. Down syndrome risk prediction was performed using different machine learning models, and model performances were compared based on accuracy rates and other evaluation metrics.</p><p><strong>Results: </strong>Experimental results show that the CatBoost model provides the highest success rate, with an accuracy rate of 95.31%. In addition, the XGBoost and LightGBM models exhibited high performance, with accuracy rates of 95.19% and 94.84%, respectively. The study also examines the effects of the class imbalance problem on model performance in detail and evaluates various strategies to reduce this imbalance.</p><p><strong>Conclusion: </strong>The findings show that gradient boosting-based machine learning models have significant potential in Down syndrome risk prediction. This approach is expected to contribute to the reduction of unnecessary invasive tests and improve clinical decision-making processes by increasing the accuracy rate in prenatal screening processes. Future studies should aim to increase the generalization capacity of the model on larger data sets and to provide integration with different machine learning algorithms.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"22 2","pages":"121-128"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of cardiovascular and cerebrovascular events in polycystic ovarian syndrome women: An updated meta-analysis of cohort studies.","authors":"Seyedeh Tarlan Mirzohreh, Arina Ansari, Hana Piroti, Reza Khademi, Yalda Jahanbani, Parvin Bastani Alamdari","doi":"10.4274/tjod.galenos.2025.04680","DOIUrl":"10.4274/tjod.galenos.2025.04680","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS), affecting 5-10% of reproductive-aged women, is linked to metabolic disturbances such as insulin resistance, obesity, and lipid imbalance, which may elevate cardiovascular disease (CVD) risk. The relationship between PCOS and clinical cardiovascular events remains unclear. This meta-analysis evaluates the association between PCOS and cardiovascular and cerebrovascular events, including myocardial infarction (MI), stroke, ischemic heart disease (IHD), and overall CVD. We conducted a systematic review and meta-analysis of observational cohort studies published up to August 2024. Studies investigating the association between PCOS and cardiovascular or cerebrovascular events were included. Hazard ratios (HR) were used to assess mortality risk, while odds ratios (OR) evaluated CVD incidence. Statistical analyses were performed using STATA software, with publication bias assessed via funnel plots. Nineteen cohort studies, involving 1,222,912 participants, were analyzed. Women with PCOS had a significantly higher risk of stroke [OR: 1.89, 95% confidence interval (CI): 1.22-2.55]. However, no significant associations were found between PCOS and overall CVD (HR: 1.80, 95% CI: 5.43-9.04), MI (HR: 2.68, 95% CI: 0.69-4.82), or IHD (HR: 2.68, 95% CI: 0.69-4.67). Additionally, there was no significant increase in cardiovascular or all-cause mortality. This meta-analysis highlights that women with PCOS are at an increased risk of stroke, but no conclusive evidence links PCOS to other cardiovascular outcomes or mortality. Clinicians should prioritize stroke prevention in this population. Further large-scale, long-term studies are needed to clarify the cardiovascular risks associated with PCOS.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"22 2","pages":"170-185"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of deep infiltrative endometriosis surgery and surgical method on sexual function in females.","authors":"Ufuk Atlıhan, Onur Yavuz, Hüseyin Aytuğ Avşar, Can Ata, Selçuk Erkılınç, Tevfik Berk Bildacı, Ferruh Acet, Burak Ersak, Ali Cenk Özay","doi":"10.4274/tjod.galenos.2025.46066","DOIUrl":"10.4274/tjod.galenos.2025.46066","url":null,"abstract":"<p><strong>Objective: </strong>Sexual function and quality of life are significantly reduced in endometriosis patients, particularly those with deep infiltrative endometriosis (DIE). The purpose of this study was to compare the effects of endometriosis excision and excision techniques on sexual function among individuals with DIE to those of healthy females in an objective manner.</p><p><strong>Materials and methods: </strong>Our study included 140 individuals who were diagnosed as having DIE and reported dyspareunia in our clinic between January 2018 and 2024, and 70 patients who presented to our family planning clinic. The preoperative and 6-month post-surgery scores of the female sexual function index (FSFI), quality of sexual experience scale (QSES), and visual analog scale (VAS) values of all patients who described preoperative dyspareunia were examined retrospectively from the patient files.</p><p><strong>Results: </strong>In our study, the FSFI score of healthy groups was seen to be significantly greater than the pre-surgery and post-surgery groups (p<0.001 and p<0.001, respectively). The QSES scores of the healthy group were found to be significantly higher than the pre-surgery and post-surgery groups (p<0.001 and p<0.001, respectively). The VAS dyspareunia values of the healthy group were discovered to be significantly lower than the pre-surgery and post-surgery groups (p<0.001 and p<0.001, respectively). The FSFI and QSES scores of the post-surgery group were significantly higher than those of the pre-surgery group (p<0.001 and p<0.001, respectively). The VAS dyspareunia score of the post-surgery group was seen to be significantly lower than that of the pre-surgery group (p<0.001). The FSFI and QSES scores of patients who underwent laparotomy were discovered to be significantly greater than that of individuals who underwent laparoscopic surgery (p<0.001 and p=0.01, respectively).</p><p><strong>Conclusion: </strong>The surgical approach may have a positive effect on both organ dysfunction and sexual function in women with DIE; this issue should be considered carefully.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"22 2","pages":"147-153"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of ovarian cyst types on ovarian reserve after three-dimensional laparoscopic cystectomy.","authors":"Sabahattin Anıl Arı, Çağdaş Şahin, Ali Akdemir, Ahmet Mete Ergenoğlu, Ahmet Özgür Yeniel, Mustafa Coşan Terek, İsmail Mete İtil, Teksin Çırpan","doi":"10.4274/tjod.galenos.2025.38259","DOIUrl":"10.4274/tjod.galenos.2025.38259","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to compare the effects of three-dimensional (3D) laparoscopic ovarian cystectomy on ovarian reserve according to different types of ovarian cysts.</p><p><strong>Materials and methods: </strong>Participants who underwent surgical treatment for ovarian cysts between 2018 and 2020 were included in this study. Anti-müllerian hormone (AMH) and follicle-stimulating hormone (FSH) levels were measured before surgery and six months postoperatively. All procedures were performed under general anesthesia using 3D laparoscopy. Participants were classified into three groups based on histopathological findings: group 1, endometriomas; group 2, mature cystic teratomas (dermoid cysts); and group 3, serous or mucinous cystadenomas.</p><p><strong>Results: </strong>A total of 51 women were included in the study. No significant differences were observed between the groups in terms of perioperative variables such as operation time, intraoperative blood loss, postoperative hemoglobin decrease, and maximum cyst diameter. There were also no significant differences among the groups in preoperative AMH (p=0.97) and FSH (p=0.22) levels. Postoperative AMH levels were significantly lower than preoperative values in both the endometrioma group (p<0.001) and the dermoid cyst group (p=0.004). The reduction in AMH levels was more pronounced in the endometrioma group compared to the other groups. Postoperative FSH levels tended to increase in all groups compared to preoperative levels; however, this increase was not statistically significant (p=0.092).</p><p><strong>Conclusion: </strong>3D laparoscopic cystectomy for the removal of endometriomas and dermoid cysts significantly reduces ovarian reserve. In contrast, laparoscopic cystectomy for serous or mucinous cysts appears to have no significant impact on ovarian reserve.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"22 2","pages":"134-140"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a correlation between the severity of symptoms and vitamin D levels in pregnancy with hyperemesis gravidarum?","authors":"Neslihan Bayramoğlu Tepe, Denizhan Bayramoğlu, Reyhan Gündüz, Hüseyin Çağlayan Özcan, Hilmi Taşdemir, Tanyeli Güneyligil Kazaz","doi":"10.4274/tjod.galenos.2025.73848","DOIUrl":"10.4274/tjod.galenos.2025.73848","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the relationship between serum vitamin D levels and the severity of symptoms in individuals with hyperemesis gravidarum (HG).</p><p><strong>Materials and methods: </strong>A cohort of eighty patients exhibiting vomiting three or more times daily, positive ketones on complete urinalysis, and oral feeding difficulties were recruited. Symptom severity was assessed using the 8-question Rhodes index, categorizing patients into non-symptomatic, mild, moderate, and severe groups. Serum vitamin D levels were measured using venous blood samples; a deficiency was defined as less than 10 ng/mL, an insufficiency as 10-20 ng/mL, and a normal level as more than 20 ng/mL.</p><p><strong>Results: </strong>The distribution of symptom severity revealed 14 (17.5%) with mild, 38 (47.5%) with moderate, and 28 (35%) with severe symptoms. Groups showed no significant differences in demographic or obstetric characteristics except for ketone positivity rates (p<0.05). There was a significant difference in vitamin D levels between the severity groups: mild symptoms (32.12±4.02 ng/mL), moderate symptoms (19.98±6.37 ng/mL), and severe symptoms (8.11±3.06 ng/mL) (p<0.001). Vitamin D and the Rhodes index mean score showed a significant negative relationship (r=-0.844, p=0.001). With 96.4% sensitivity and 89.5% specificity, receiver operating characteristic analysis showed that symptom intensity rose when blood vitamin D levels were less than 11.54 ng/mL.</p><p><strong>Conclusion: </strong>These results highlight a negative relationship between the severity of HG symptoms and serum vitamin D levels. Screening pregnant women with nausea, vomiting, and severe symptoms for serum vitamin D deficiency is recommended. Appropriate pre-pregnancy treatment should be initiated for those deficient or insufficient in serum vitamin D to potentially alleviate HG symptom severity and frequency.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"22 2","pages":"114-120"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the potential of nifedipine and resveratrol to enhance ovarian viability in conjunction with detorsion treatment: A rat ovarian torsion model study.","authors":"Aydan Sezgin, Asiye Aslı Emniyet Sert, Gülnur Take Kaplanoğlu, Cengiz Karakaya, Erhan Demirdağ, M Funda Cevher Akdulum, Mehmet Erdem, Ahmet Erdem, Mesut Öktem","doi":"10.4274/tjod.galenos.2025.30161","DOIUrl":"10.4274/tjod.galenos.2025.30161","url":null,"abstract":"<p><strong>Objective: </strong>Evaluating the therapeutic effect of detorsion, resveratrol, and nifedipine on ovarian viability assessed by biochemical, histopathological and immunohistochemical parameters and markers of oxidative stress.</p><p><strong>Materials and methods: </strong>Twenty-four Sprague-Dawley rats were included in 4 groups, namely: sham operation, ischemia-reperfusion (I/R), I/R+10 mg/kg nifedipine (NIF), I/R+100 mg/kg resveratrol (RSV). In the study groups, bilateral 720º ovarian torsion was performed and continued for 3 hours, followed by detorsion for another 3 hours. Thirty minutes before the detorsion, NIF and RSV groups received respective treatments. Adnexectomy was performed, and evaluations were made for the expression of anti-müllerian hormone (AMH), vascular endothelial growth factor receptor 2 (VEGFR-2), markers of oxidative stress, and follicle counts. Blood AMH levels were measured.</p><p><strong>Results: </strong>No change in AMH levels was detected. Although the expression of AMH was significantly reduced following I/R alone, it remained similar to the control group in the NIF group. Meanwhile, the RSV group exhibited slightly lower expression than the control, although it was still higher than that observed with the I/R injury group. VEGFR-2 staining was similar in the I/R and NIF groups, but reduced in the RSV group. Markers of oxidative stress were similar between groups. Primordial follicle count was lower in the untreated I/R injury group compared to the control group (p<0.05). The NIF group had more secondary follicles than the I/R injury and RSV groups (p<0.05).</p><p><strong>Conclusion: </strong>Nifedipine and resveratrol treatments did not influence AMH levels and antioxidant-oxidant system parameters in rats exposed to I/R injury. However, nifedipine had a positive effect on AMH expression and secondary follicle count, and resveratrol decreased the expression of VEGFR-2 in tissues, which can be an indicator of their clinical potential.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"22 2","pages":"154-162"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexpected hypo-responders in in vitro fertilization: The impact of higher gonadotropin doses on oocyte yield.","authors":"Emre Pabuccu, Bilge Pınar Keskinsoy, Gular İsrafilova, Deniz Han Deniz, Recai Pabuccu","doi":"10.4274/tjod.galenos.2025.97727","DOIUrl":"10.4274/tjod.galenos.2025.97727","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed the impact of increased initial gonadotropin doses on ovarian stimulation (OS) outcomes in unexpected hypo-responders [Patient-Oriented Strategies Encompassing Individualized Oocyte Number (POSEIDON) 1-2 group] with suboptimal mature oocyte yield, despite normal ovarian reserve markers, during their first OS cycle.</p><p><strong>Materials and methods: </strong>Conducted at a referral infertility clinic, this observational study included women who retrieved fewer than nine oocytes during their first OS cycle despite gonadotropin doses of 150-225 international unit (IU)/day starting from cycle day two. Women who underwent a second OS cycle following unsuccessful conception were included. Gonadotropin doses were increased to 225 or 300 IU recombinant follicle-stimulating hormone (FSH) (recFSH) based on body mass index. Each patient served as her own control, with first and second OS cycles compared in terms of oocyte yield, follicular output ratio (FORT), and follicle-to-oocyte index (FOI).</p><p><strong>Results: </strong>Among 289 unexpected hypo-responders (12% prevalence), the mean age was 34.2 years, and the mean anti-müllerian hormone level was 3.4 ng/mL. The stimulation duration was similar between cycles (11.2 days). The second OS cycle showed significant improvements in total oocytes, metaphase II oocytes, FORT, FOI, cleavage-stage embryos, and blastocysts (p<0.05).</p><p><strong>Conclusion: </strong>Increasing gonadotropin doses in subsequent cycles improves oocyte yield and embryological outcomes in unexpected hypo-responders (POSEIDON 1-2) with normal ovarian reserve markers.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"22 2","pages":"141-146"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of secretome in restoring ovarian function: A systematic review and meta-analysis of <i>in vivo</i> studies in mice with premature ovarian insufficiency.","authors":"Stella Kawilarang, I Gede Eka Wiratnaya, I Wayan Putu Sutirta Yasa, I Nyoman Gede Budiana","doi":"10.4274/tjod.galenos.2025.57485","DOIUrl":"10.4274/tjod.galenos.2025.57485","url":null,"abstract":"<p><p>To evaluate the efficacy of secretomes in restoring ovarian function in premature ovarian insufficiency (POI) in a mouse model, researchers emphasizing their potential as a novel, cell-free therapy. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and included studies from four databases through December 2023. The bias risk was assessed using the tool for animal studies, which is Systematic Review Centre for Laboratory Animal Experimentation risk-of-bias. Outcomes, including the hormonal levels of estradiol (E2), anti-müllerian hormone (AMH), and follicle-stimulating hormone (FSH) were analyzed, with statistical comparisons made between the secretome-treated and control groups. Four studies encompassing sixty mice were included. The meta-analysis showed a significant increase in E2 levels in the secretome group [mean difference (MD)=37.45, 95% confidence interval (CI): 5.78 to 69.11; p=0.02]. No significant difference in AMH levels was observed; however, a sensitivity analysis resulted in the difference becoming statistically significant (MD=1.83, 95% CI: 0.95 to 2.71; p<0.0001). Moreover, the analysis revealed a significant reduction in FSH levels in the secretome group (MD=-36.80, 95% CI: -61.91 to -11.69; p=0.004) even after the sensitivity analysis. Our findings demonstrated enhanced outcomes with secretome therapy in the management of POI. Further research, particularly involving human subjects, is necessary to validate these findings.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"22 2","pages":"163-169"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}