Turkish Journal of Obstetrics and Gynecology最新文献

{"title":"True empty follicle syndrome is a subtype of oocyte maturation abnormalities.","authors":"Şafak Hatırnaz, Ebru Hatırnaz, Justin Tan, Samettin Çelik, Canan Soyer Çalışkan, Alper Başbuğ, Gerçek Aydın, Ali Bahadırlı, Mehmet Bülbül, Handan Çelik, Aşkı Ellibeş Kaya, Nur Dokuzeylül Güngör, Seang Lin Tan, Mingju Cao, Michael H Dahan, Sebati Sinan Ürkmez","doi":"10.4274/tjod.galenos.2024.84031","DOIUrl":"10.4274/tjod.galenos.2024.84031","url":null,"abstract":"<p><strong>Objective: </strong>To review the outcomes of in vitro maturation (IVM) and in vitro fertilization (IVF) in women with empty follicle syndrome (EFS). The study evaluated the genetic underpinnings of EFS by analyzing mutations.</p><p><strong>Materials and methods: </strong>This retrospective case series involving 17 women with EFS over at least 2 IVF cycles was conducted. The study also employed whole-exome sequencing to analyze the genetic mutations. The treatment approaches included letrozole-primed IVM, follicle-stimulating hormone (FSH)-human chorionic gonadotrophin (hCG)-primed IVM, and conventional IVF.</p><p><strong>Results: </strong>The average female age was 31.5±4.6 years, and the duration of infertility was 7.3±3.5 years. Four patients underwent IVF. IVM oocyte collections yielded oocytes in 12 of 13 subjects. Of these, 75% (9/12) yielded MII oocytes after 48 h of IVM media incubation. Six subjects had fertilized embryos, resulting in a 40.9% intracytoplasmic sperm injection (ICSI) fertilization rate (9 embryos/22 MII oocytes). Genetic analysis revealed mutations in seven patients. This study demonstrated the partial efficacy of letrozole-primed IVM plus growth hormone and FSH-hCG primed IVM protocols. No pregnancies or live births were recorded after IVM. One ongoing pregnancy post-IVF and one spontaneous live birth were observed.</p><p><strong>Conclusion: </strong>Inter-cycle variabilities were observed in women with oocyte maturation abnormalities (OMAs). Almost all patients with EFS had oocytes collected during IVM following IVF. These oocytes have limited potential for maturation, fertilization, and live birth, as demonstrated by the low rates observed after IVM culture and ICSI. These conditions are observed in OMAs due to defects in the oocyte machinery. The proposed flowchart provides a comprehensive classification approach for various forms of EFS.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 3","pages":"142-152"},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126927","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":"Might retrigger with human chorionic gonadotropin be a solution for empty follicle syndrome after gonadotropin releasing hormone agonist trigger?","authors":"Zeynep Ece Utkan Korun, Ayşen Yücetürk, Özge Karaosmanoğlu, Yiğit Çakıroğlu, Bülent Tıraş","doi":"10.4274/tjod.galenos.2024.80439","DOIUrl":"10.4274/tjod.galenos.2024.80439","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine whether the use of human chorionic gonadotropin (hCG) as a trigger could offer a potential solution for addressing empty follicle syndrome following the administration of a trigger for gonadotropin-releasing hormone agonist.</p><p><strong>Materials and methods: </strong>A retrospective cohort analysis was conducted using data extracted from the hospital database pertaining to 415 patients who underwent in vitro fertilization (IVF) with an antagonist protocol triggered by a gonadotropin-releasing hormone (GnRH) agonist between December 2019 and January 2023 at the Acıbadem Maslak Hospital Assisted Reproductive Technologies Unit. All cases that failed to obtain oocytes and required rescue were analyzed.</p><p><strong>Results: </strong>This study analyzed 415 women who underwent IVF using GnRH agonist-triggered antagonist protocols. Among them, 6 (1.4%) had empty folicle syndrome (EFS). Patients with EFS had lower luteinizing hormone levels and fewer oocytes, embryos, and blastocysts, resulting in lower oocyte utilization rate. However, pregnancy rates were similar, with no biochemical or ectopic pregnancies observed in the EFS group.</p><p><strong>Conclusion: </strong>Use of an hCG retrigger in hyperresponders with no oocytes after GnRHa trigger may prevent cycle cancelation. Although the rates of egg utilization may decrease, oocyte maturity remains comparable. Frozen embryo transfer following hCG retrigger administration yields similar positive pregnancy test results and live birth rates.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 3","pages":"135-141"},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126924","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 placental bed uterine in L-NAME-induced early-onset preeclampsia (EO-PE) like the rat model.","authors":"Fitriana Fitriana, Soetrisno Soetrisno, Sri Sulistyowati, Dono Indarto","doi":"10.4274/tjod.galenos.2024.99132","DOIUrl":"10.4274/tjod.galenos.2024.99132","url":null,"abstract":"<p><strong>Objective: </strong>Preeclampsia (PE) is the leading cause of maternal death worldwide and is associated with long-term morbidity in both mothers and newborns. Animal modeling is considered a functional source for understanding PE pathogenesis, diagnostic standards, and therapeutic approaches.</p><p><strong>Materials and methods: </strong>This study aimed to demonstrate and evaluate the use of N-nitro-L-arginine methyl ester (L-NAME) in a Wistar rat model under conditions similar to PE. A total of 12 rats were divided into 4 groups, each consisting of 3 members, including the pregnant control group and treatment groups administered low-dose (PE 25 mg/kg L-NAME/day), medium-dose (PE 50 mg/kg L-NAME/day), and high-dose L-NAME (PE 75 mg/kg L-NAME/day) L-NAME from gestational day 4 to 19. Measurements included blood pressure, creatinine, and proteinuria levels, placental histological changes, and placental tissue hypoxia-inducible factor 1-alpha, and plasma endothelial nitric oxide synthase levels.</p><p><strong>Results: </strong>The results showed that intervention with L-NAME at 75 mg/kg body weight/day (PE3) induced PE earlier than that with 50 mg/kg body weight/day L-NAME.</p><p><strong>Conclusion: </strong>The model conditions also support further research into PE pathogenesis.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 3","pages":"180-189"},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126920","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":"Association between Mir-499, Mir-27a, and Mir-146a polymorphisms and their susceptibility to recurrent spontaneous abortion; <i>in silico</i> analysis.","authors":"Gholamreza Bahari, Mohsen Taheri, Mojgan Mokhtari, Mahdiyeh Moudi, Mahdi Majidpour, Hossein Shahraki Ghadimi","doi":"10.4274/tjod.galenos.2024.74419","DOIUrl":"10.4274/tjod.galenos.2024.74419","url":null,"abstract":"<p><strong>Objective: </strong>Recurrent spontaneous abortion (RSA) is defined as two or more pregnancy losses before 24 gestational weeks, accounting for 1-3% of fertile couples. A vast majority of single-nucleotide polymorphisms (SNPs) in some <i>microRNA</i> (<i>miRNA</i>) genes can change the miRNA-mRNA interaction and are associated with the risk of RSA. This study was designed to better elucidate the association between miR-27a, miR-499, and miR-146a polymorphisms and RSA risk.</p><p><strong>Materials and methods: </strong>SNP genotyping of miR-27a (rs895819), miR-499 (rs3746444), and miR-146a (rs2910164) was performed using polymerase chain reaction (PCR)-restriction fragment length polymorphism and tetra amplification-refractory mutation system PCR in 98 patients with RSA and 105 healthy subjects.</p><p><strong>Results: </strong>Our results showed that the miR-499 rs3746444 and miR-27a rs895819 polymorphisms were significantly associated with RSA risk, whereas no significant differences were observed between the rs2910164 polymorphism and RSA susceptibility.</p><p><strong>Conclusion: </strong>We proposed that the miR-499 rs3746444 and miR-27a rs895819 polymorphisms were correlated with RSA in our population, but the miR-146a rs2910164 variant was not associated with the risk of RSA.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 3","pages":"158-165"},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126918","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 effects of growth hormone supplementation in poor ovarian responders undergoing In vitro fertilization or Intracytoplasmic sperm injection: A systematic review and meta-analysis of randomized controlled trials.","authors":"Faezeh Zakerinasab, Qumars Behfar, Reza Parsaee, Fariba Arbab Mojeni, Arina Ansari, Niloofar Deravi, Reza Khademi","doi":"10.4274/tjod.galenos.2024.59944","DOIUrl":"10.4274/tjod.galenos.2024.59944","url":null,"abstract":"<p><p>To evaluate the effect of growth hormone (GH) supplementation on outcomes of in vitro fertilization (IVF) or Intracytoplasmic sperm injection (ICSI) for women with poor ovarian response. Relevant randomized controlled trials (RCTs) were obtained through search in several databases including PubMed, Scopus, Clinicaltrials.gov, Google Scholar, and Cochrane Library. Outcome measures included live birth rate, clinical pregnancy rate, cycle cancelation rate, number of retrieved oocytes, number of transferred embryos, total dose of gonadotropin, duration of gonadotropin treatment, and peak estradiol level. Additionally, a meta-regression analysis was carried out to determine any potential linear relationships between these outcomes and IVF success. After analyzing 18 RCTs comprising of 1870 patients, the study found that GH supplementation improved the number of retrieved oocytes [standardized mean difference (SMD), 0.65; 95% confidence interval (CI), 0.29-1.00] and transferred embryos group (SMD, 0.80, 95% CI, 0.39, 1.21) as well as peak E2 level (SMD, 1.20; 95% CI, 0.59, 1.81). While reduced the total dose and duration of gonadotropin treatment (SMD, -0.82, 95% CI, -1.25, -0.39, and SMD, -0.63, 95% CI, -1.04, -0.22, respectively). The meta-regression analysis found no linear relationship between clinical pregnancy, live birth rate, or cycle cancelation rate and the outcomes measured (p>0.1). Based on the available evidence, GH supplementation appears to improve the outcomes of IVF or ICSI in women with poor response. However, there is a need for further RCTs with larger sample sizes to determine the cost-effectiveness of adding GH to conventional protocols of IVF/ICSI for treating infertility in women with poor ovarian response.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 3","pages":"208-218"},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126926","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":"Negative effects of ethanol on ovarian reserve and endometrium thickness: An animal study.","authors":"Enes Karaman, Mehmet Emin Ayağ","doi":"10.4274/tjod.galenos.2024.89439","DOIUrl":"10.4274/tjod.galenos.2024.89439","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the effect of ethanol on the ovarian reserve and endometrium of rats by evaluating anti-Müllerian hormone (AMH) levels and follicle counts.</p><p><strong>Materials and methods: </strong>We performed histological follicle counting and AMH measurements to evaluate ovarian reserve. The study included 16 Wistar albino rats evenly distributed into two groups of eight rats each. The rats in the intervention group (group 1) were administered ethanol at a daily dose of 2.5 g/kg via oral gastric lavage for 30 days, whereas the control group (group 2) received water as a placebo via oral gastric lavage for the same period. At the end of 30 days, the animals were sacrificed, and 2 mL blood samples were collected for AMH measurements. Laparotomy was performed to remove the ovaries and uterus.</p><p><strong>Results: </strong>Despite the lack of a meaningful distinction in the quantity of primordial and primary follicles between the two groups, a substantial disparity was observed in the overall follicle count and AMH levels. Specifically, the intervention group exhibited significantly lower total follicle counts and AMH levels than the control group (p≤0.001). The researchers also found that the endometrium of ethanol-treated rats was significantly thinner than that of control rats (p≤0.001).</p><p><strong>Conclusion: </strong>This study concluded that ethanol consumption can negatively affect reproductive ability and the success of in vitro fertilization treatment by reducing ovarian reserve and thinning the endometrium.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 3","pages":"175-179"},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126925","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":"How safe is high-intensity focused ultrasound? An intriguing solution for obstetric and gynecological diseases: A systematic review.","authors":"Mostafa Maged Ali, Chileshe Raphael Mpehle, Esther Olusola, Phuti Khomotso Ratshabedi, Ebtehal Ali Helal Farag","doi":"10.4274/tjod.galenos.2024.55058","DOIUrl":"10.4274/tjod.galenos.2024.55058","url":null,"abstract":"<p><p>High-intensity focused ultrasound (HIFU) is a non-surgical and noninvasive treatment modality that depends on external ultrasound energy sources that induce focused mass ablation and protein degeneration in the treatment area via thermal energy penetration under the intact skin. We aim in our study to collectively evaluate the safety of HIFU for the treatment of different obstetric and gynecological diseases in the literature. We searched PubMed, Scopus, and Science Direct databases, without restriction on date or language, from the inception of these databases until January 20, 2024. We also examined the references of the included studies in the Mendeley archive for eligible articles. We found a total of 706 studies. After the screening and selection process, 56 participants were included. Our dichotomous outcomes were pooled in our single-arm meta-analysis as risk ratio (RR) and with 95% confidence interval (CI) while our continuous outcomes were pooled as mean change and 95% CIs. Fixed- or random-effects models were applied depending on the heterogeneity detected. Our systematic review and meta-analysis included 56 studies including 11.740 patients. Depending on the Society of Interventional Radiology (SIR) classification for adverse effects. The results of this meta-analysis for the type A category that did not require clinical intervention found that pain in the treatment site estimated RR with 95% CI: 0.61 (0.33, 0.89), abnormal vaginal discharge 0.16 (0.073, 0.24), low-grade fever (<38 °C) 0.005 (0.002, 0.009). Sensory abnormalities of the lower limbs were examined in 3390 individuals and observed in only 19 patients who experienced gradual relief of symptoms within one month after treatment. Regarding SIR type B, 99 of a total of 6.437 patients had small vesicles and superficial burns with pooled RR and 95% CI: 0.012 (0.007, 0.018). In terms of groin or perianal and lower abdominal pain, our RRs with 95% CIs were 0.1 (0.067, 0.13) and 0.38 (0.25, 0.51). However, vaginal bleeding was detected in only 32 out of a total of 3.017. Major adverse events like lumber disc herniation, thrombocytopenia, and renal failure, were unmentionable. Additionally, our included studies did not record any deaths. HIFU, either alone or in combination with oxytocin or any other enhancing agent, is safe for patients with different gynecological and obstetric diseases. In terms of efficacy, it showed promising results compared with traditional treatment lines. To our knowledge, we are the first and most comprehensive meta-analysis in the literature that has studied the different safety outcomes related to HIFU as a treatment modality for different obstetric and gynecological diseases with a very large sample size, making our evidence strong and less attributed to errors.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 3","pages":"190-207"},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126922","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":"Hysteroscopic tubal electrocoagulation versus laparoscopic tubal disconnection for the management of hydrosalpinx and subsequent pregnancy outcomes: A randomized clinical trial.","authors":"Ramadan Ahmed Hashish, Ahmed Mohammed Saeed, Adel Aly Elboghdady, Ahmed Soliman","doi":"10.4274/tjod.galenos.2024.36931","DOIUrl":"10.4274/tjod.galenos.2024.36931","url":null,"abstract":"<p><strong>Objective: </strong>Hydrosalpinx impairs the success of in vitro fertilization (IVF) embryo transfer. Various surgical approaches, such as fluid aspiration or isolation of the affected fallopian tubes, have been used to enhance the outcome. This study was conducted to evaluate and compare the efficacy of laparoscopic tubal disconnection (LTD) and hydroscopic tubal electrocoagulation (HTE) for hydrosalpinx before IVF.</p><p><strong>Materials and methods: </strong>After obtaining ethical committee approval, we assessed 112 women who were subfertile due to hydrosalpinx to check their adherence to our selection criteria. Eligible patients were allocated into two groups (LTD vs. HTE). Both groups underwent extensive assessment before the operative procedure. IVF and subsequent embryo transfers were performed in both groups. Live birth and pregnancy rates were evaluated.</p><p><strong>Results: </strong>Patients who underwent LTD prior to IVF embryo transfer had significantly higher live birth (41%), clinical pregnancy (57%), and chemical pregnancy (61%) rates in the LTD group than in the HTE group (12%, 35%, 41%, respectively). However, we could not find a significant difference between the two groups regarding the miscarriage (17% vs. 28%, p=0.33) and multiple pregnancy (14% vs. 12%, p=0.79) rates. No major complications with HTE were observed, except for a case of uterine perforation, whereas two cases of surgical complications occurred in the LTD group. Additionally, we found a significantly shorter operative time and hospital stay (0.5±0.7 days, p=0.012) in the HTE group.</p><p><strong>Conclusion: </strong>LTD may be a more effective approach compared with hysteroscopic tubal electrocoagulation for improving birth and pregnancy rates in patients with IVF and hydrosalpinx.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 2","pages":"64-69"},"PeriodicalIF":1.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296992","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":"Maternal occupational exposure to asthmogenic during pregnancy and the future risk of asthma in children: A meta-analysis.","authors":"Parmida Seraj Ebrahimi, Matineh Ardestani Bala, Zahra Mashhadi Tafreshi, Hana Piroti, Mehrsa Mostafaei, Bita Ghahremani, Faezeh Shaverdi, Alireza Imani Porshokouh, Niloofar Deravi, Mohadeseh Poudineh, Minoo Roostaie","doi":"10.4274/tjod.galenos.2024.50497","DOIUrl":"10.4274/tjod.galenos.2024.50497","url":null,"abstract":"<p><p>The association between maternal occupational exposure during pregnancy and the subsequent development of asthma in their children has always been a matter of debate, and the results of cohort studies on this issue have been controversial. The current study is the first systematic review and meta-analysis aimed at evaluating the risk of developing subsequent asthma in children based on maternal occupational exposure during the gestation period. To retrieve eligible studies, an advanced literature search was performed up to August 10, 2023 from the following databases: PubMed, Scopus, and Google Scholars. The title and abstract of related articles were screened; hence, the full texts were reviewed. Data extraction was conducted; hence, the included articles were analyzed to assess the mention association. From a total of 10 cohort studies with a total record of 5372, it was found that there is no significant relationship between occupational exposure to asthmogenic during pregnancy and later asthma in children. The pooled odds ratio of asthmatic children in patients with maternal occupational exposure to asthmogenic during pregnancy was 1.03 (95% confidence interval, 0.97-1.09) I2= 13% p=0.62. It was concluded that there is no significant association between maternal occupational exposure and future asthma in children. However, future large-scale studies are required to support these results.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 2","pages":"123-130"},"PeriodicalIF":1.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296996","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":"Comparison of laparoscopic and hysteroscopic surgical treatments for isthmocele: A prospective cohort.","authors":"Reyhane Hosseini, Mohammadamin Parsaei, Nahid Rezaei Ali-Abad, Sepand Daliri, Zahra Asgari, Zahra Valian, Nasrin Hajiloo, Samira Mirzaei, Mina Bakhshali-Bakhtiari","doi":"10.4274/tjod.galenos.2024.54006","DOIUrl":"10.4274/tjod.galenos.2024.54006","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical outcomes of laparoscopic and hysteroscopic surgical approaches for treating symptomatic isthmocele and identify their associated factors.</p><p><strong>Materials and methods: </strong>Forty-six patients with symptomatic isthmocele diagnosed using transvaginal saline infusion sonohysterography were enrolled in this prospective cohort study. Patients underwent either laparoscopic or hysteroscopic isthmoplasty based on their residual myometrial thicknesses and fertility desires and were subsequently followed by clinical and ultrasonographic examinations.</p><p><strong>Results: </strong>Twenty-two patients underwent laparoscopy and 24 underwent hysteroscopic surgery. At baseline, there was no significant difference in the mean age and years since the last cesarean section between the two groups. However, the hysteroscopy group had a higher mean parity and previous cesarean sections (p=0.00, 0.03). The most common symptoms were abnormal uterine bleeding, infertility, and dysmenorrhea. The mean baseline residual myometrial thickness was significantly higher in the laparoscopy group (p=0.00), and only laparoscopic surgery led to a significant increase in residual myometrial thickness in patients (p=0.00). Both procedures significantly reduced abnormal uterine bleeding (p=0.00), but only laparoscopy reduced infertility (p=0.00) and hysteroscopy reduced dysmenorrhea (p=0.03). Hysteroscopy showed better symptom resolution in younger patients (p=0.01), whereas age did not affect laparoscopy outcomes.</p><p><strong>Conclusion: </strong>Both approaches showed similar effectiveness in resolving abnormal uterine bleeding, with laparoscopy excelling in infertility resolution and hysteroscopy excelling in dysmenorrhea resolution.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 2","pages":"70-77"},"PeriodicalIF":1.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296986","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}