Presence of embryo-derived cell-free DNA (cfDNA) in spent culture medium (SCM) represents a promising non-invasive alternative to the conventional preimplantation genetic testing (PGT). The present study evaluated the feasibility of using cfDNA isolated from SCM to determine Rhesus (Rh) status through Rh blood group D antigen (RHD) gene analysis, predicting sex-linked disorders using sex determining region Y (SRY) gene detection and assessing the association between mitochondrial cfDNA (cf-mtDNA) levels and maternal age using mitochondrially encoded cytochrome b (MT-CYB) gene quantification. SCM samples collected during the IVF process were subjected to cfDNA isolation and target regions including RHD exon 7 and exon 10, SRY and MT-CYB were analyzed using droplet digital PCR. RHD gene amplification was detected in 6 of 15 samples for exon 7 and in 11 samples for exon 10, with partial concordance between exons. SRY amplification was observed in 16 of 31 samples and was largely consistent with clinical sex data. MT-CYB was detected in 19 of 31 samples, with higher cf-mtDNA/nuclear cfDNA ratios observed in women >40 years of age. A moderate positive correlation trend was noted between maternal age and MT-CYB levels (r=0.46; P=0.354). These findings demonstrate the potential applicability of SCM-derived cfDNA for non-invasive Rh and sex determination without compromising embryo integrity, while mtDNA quantification may provide additional insights into embryo quality. Overall, SCM-based cfDNA analysis exhibited promise as a complementary tool for embryo selection in IVF workflows.

Abstract Objective To compare the effectiveness of calcium ionophore–induced artificial oocyte activation (AOA) and piezoelectric stimulation in improving fertilization, embryo quality, and pregnancy outcomes in ICSI cycles of severe male factor infertility. Methods A prospective controlled study was conducted at the Istanbul University IVF Center between December 2023 and June 2025. Data collection and follow-up for all pregnancy outcomes, including live birth, were completed before July 2025. The study included 150 couples with severe male factor infertility divided into three groups: (i) Control (conventional ICSI, n = 50), (ii) ICSI + Calcium ionophore (n = 50), and (iii) ICSI + Piezoelectric (n = 50). Severe male factor infertility was defined according to WHO (2021) criteria. Oocytes were fertilized and cultured under standardized conditions. Embryo morphology was assessed on Day 3 according to the Istanbul Consensus (2011) criteria and on Day 5 using the Gardner and Schoolcraft grading system. Statistical comparisons were performed using ANOVA, Kruskal–Wallis, and chi-square tests, with p < 0.05 considered significant. The primary outcome measure was the fertilization rate, while embryo quality and clinical outcomes were evaluated as secondary outcomes. Results Fertilization rates were significantly higher in the ICSI+Piezoelectric group compared with both the control and ICSI+Calcıum ionophore groups (p < 0.0001). The proportion of good-quality (Grade I) embryos was also greater in the ICSI+Piezoelectric group (38.2%) than in the control (28.3%) and ICSI+Calcıum ionophore (29.5%) groups (p < 0.05). No statistically significant differences were observed in pregnancy outcomes, including implantation, clinical pregnancy, ongoing pregnancy, or live birth rates; however, a non-significant trend toward higher ongoing pregnancy rates was noted in the ICSI+Calcıum ionophore group. Conclusions Piezoelectric activation was associated with higher fertilization rates and improved early embryo morphology; however, these improvements did not translate into statistically significant differences in clinical pregnancy or live birth outcomes.

Poor responders pose a significant challenge in fertility treatment, leading to decreased oocyte quality and fertilization rates. Assisted oocyte activation (AOA) has emerged as a method to improve fertilization rates. This study aims to evaluate the effect of AOA on fertilization, pregnancy, and live birth rates in patients with diminished ovarian reserve. This prospective non-randomized comparative study included a cohort of infertility patients with diminished ovarian reserve, divided into three groups: the control group receiving standard treatment (Group I/Conventional ICSI), the electrical activation group undergoing piezoelectric stimulation (Group II/ICSI + Piezoelectric), and the chemical activation group treated with calcium ionophore (Group III/ICSI + Calcium Ionophore). Each group consisted of 50 patients. The effects of electrical and chemical activation applied after ICSI on fertilization, pregnancy, and live birth rates were evaluated. There were no statistically significant differences among the groups in hormone levels (FSH, LH, E2, PRL, and AMH), number of oocytes, or number of MII oocytes. Fertilization rates were significantly higher in the piezoelectric group compared to the control group (p = 0.007). Although the fertilization rate in the calcium ionophore group was higher than that in the control group, this difference did not reach statistical significance (p = 1.000). There was no statistically significant difference in fertilization rates between the piezoelectric and calcium ionophore groups (p = 0.071). Regarding pregnancy rates, the highest implantation rate was observed in the calcium ionophore group (37

The aim of this prospective cohort study was to evaluate the developmental potential of metaphase I (MI) oocytes that failed to mature following rescue in vitro maturation (IVM), and to investigate the roles of artificial oocyte activation (AOA) and meiotic spindle presence in fertilization and early embryo development. A total of 49 patients were included in the analysis. The study population was divided into 2 groups: an AOA group (28 patients, 42 MI oocytes) undergoing intracytoplasmic sperm injection (ICSI) followed by calcium ionophore-mediated activation, and a non-AOA control group (21 patients, 40 MI oocytes) undergoing ICSI without activation. Fertilization, embryo development, and clinical outcomes were compared between the groups. In addition, meiotic spindle presence was assessed using polarized light microscopy, and patients were categorized as spindle-positive or spindle-negative. Fertilization occurred in 23 of 42 MI oocytes (54.7

OBJECTIVE:To investigate the role of the protein galectin-3 (Gal-3) and its effect on fibrosis and apoptosis in testicular tissues of patients with idiopathic non-obstructive azoospermia (iNOA). DESIGN:A prospective study. SUBJECT:Male patients who needed testicular sperm extraction for assisted reproductive technology treatments. EXPOSURE:Tissue samples were obtained during microdissection testicular sperm extraction (mTESE) procedures from patients diagnosed as having azoospermia according to two semen analyses. Two groups were determined as sperm non-detected (n = 8, TESE-) and detected (n = 7, TESE+). Germ cells were morphologically evaluated using haematoxylin and eosin-stained sections and Johnsen scores. Immunohistochemical methods were used to evaluate Gal-3 expression and caspase-3-related apoptotic activity. MAIN OUTCOME MEASURES:Gal-3 positivity, apoptosis and fibrosis indexes. RESULTS:Gal-3 expression was significantly higher in the TESE- group (p = 0.024). Gal-3 showed strong positivity in Sertoli Cells and cells in the interstitial area around the seminiferous tubules in the TESE- group. CONCLUSION:This study highlights the potential role of Gal-3 in iNOA and its association with testicular fibrosis and impaired spermatogenesis. The absence of sperm retrieval was associated with increased Gal-3 expression, seminiferous tubule wall thickening, and enhanced apoptosis-related activity. These findings suggest that Gal-3 may contribute to inflammation- and fibrosis-related testicular damage in iNOA. However, further experimental and clinical studies are required to clarify the underlying molecular mechanisms of Gal-3 and determine its potential clinical significance in male infertility.

Objectives Several chemical, mechanical, or physical stimuli can be used to promote oocyte activation during ICSI cycles. Calcium ionophore is the most commun method for chemical oocyte activation and activation may be beneficial for cases of globozoospermia, low oocyte count, total fertilization failure, recurrent implantation failure (1,2). In what concern low ovarian reserve cases, a subgroup of infertile couples with relatively poor prognosis, artificial oocyte activation with calcium ionophore may improve fertilization rates, embryo number, embryo quality and pregnancy rates. This study aimed to find out whether Ca2+ ionophore improves fertilization, embryo development and pregnancy out comes in patients with low ovarian reserve. Material - Method This study is conducted at Istanbul University, Istanbul Faculty of Medicine, Department of Obstetrics and Gynecology, Reproductive Endocrinology and Infertility Unit. All IVF-ICSI cycles performed because of female factor, low ovarian reserve between November 2023 and July 2024 are included.Patients with DOR indication, who were administered calcium ionophore(GROUP I/Experimental Group, n:30) and patients who were not administered calcium ionophore (GROUP II/Control Group, n:30) were included. These patients were compared in terms of fertilization, embryo quality and pregnancy rates.Oocytes at the MII stage obtained from patients were subjected to ICSI approximately 4 hours after oocyte retrieval(OPU). After ICSI, the oocytes were incubated in a calcium ionophore solution for 20 minutes and then transferred to culture media. On the following days, fertilization rates, embryo development, and pregnancy statuses were assessed. The results were statistically evaluated using independent samples t-test and chi-square test. Statistical significance was considered as p<0.05 Results No differences were observed between the two groups in terms of female age, BMI, duration of infertility, AMH, FSH, LH, estradiol, oocyte count, oocyte maturation, and fertilization rate factors.However, the transfer of medium-quality embryos was found to be significantly higher in the DOR group without calcium ionophore application(p=0.035).The number of embryos frozen in Group I was significantly higher compared to Group II (p=0.020) (Table).No significant difference was found between the two groups in terms of clinical pregnancy and ongoing pregnancy rates. Conclusion Alternative laboratory treatments applied to patients with low ovarian reserve may yield positive results in terms of increasing the likelihood of success. Our study has shown that the application of calcium ionophore in these cases leads to better-quality embryo development and consequently an increased number of frozen embryos. Although no significant difference was observed in clinical pregnancy and ongoing pregnancy rates, increasing the number of patients in the study could yield more definitive results.

Kesintili Aortik Ark Tip B : Ultrasonografik değerlendirme Can Ozan ULUSOY Hipoplastik Sol Kalp Sendromu – Erken Tanı Hayat Kurtarır mı? Engin YURTÇU Hidrosefaliye Yol Açan Fetal İntrakranial Arteriyovenöz Malformasyon: Olgu Sunumu Sadullah ÖZKAN Murat Levent DERELİ Gebeliğin İkinci Trimesterinde Başvuran Spontan Splenik Ven Anevrizma Rüptürü Olgusunun Yönetimi Sibel DOĞAN POLAT Şiddetli Preeklampside Postoperatif Sinus Ven Trombozu Sümeyye YILMAZ Sultan CANAN Akıllı Telefon ve Aksiyon Kamerası Yardımı ile Laparoskopik Tüp Ligasyonu Deneyimi Neşet GÜMÜŞBURUN Fetal Megasistis ve Anhidramniyoz ile Prezente Olan Posterior Üretral Valf Olgusu Nebahat UZUNAY Doruk Cevdi KATLAN Alfa-Metildopa Kullanımına Bağlı Nötropeni Olgu Sunumu Gülşan KARABAY Overin Matür Kistik Teratomu İçerisinde Gelişen Tiroid Papiller Tip Kanserine Yaklaşım- Gonca EVCİ Mesut ÖNAL Peritonit Tablosu ile Gelen Malignite Şüpheli Hastada Altta Yatan Bir Genital Tüberküloz Vakası Mesut ÖNAL Derya SEZEN Yasemin YOLERİ Non-Hodgkin Lenfoma Olgusu Eşliğinde Gebelikle İlişkili Lenfomalara Bakış Şebnem KARAGÜN Mürşide ÇEVİKOĞLU KILLI Gebelikte Otoimmün Hemolitik Anemi ile Prezente Olup Sistemik Lupus Eritematozus Tanısı Alan Olgu ve Yönetimi Zeynep ŞEYHANLI Klinik Deneyimi Nadir Bir Konu: Malign Potansiyeli Belirsiz Düz Kas Tümörü (STUMP) Olgusu Mesut ÖNAL Yasemin YOLERİ Derya SEZEN Postpartum Baş Ağrısı ve Hiponatremi ile Seyreden Bir Akut Sheehan Sendromu: Olgu Sunumu Bilgesu ÇETİNEL KAYGUN Olgu Sunumu ile Servikovaginal Ageneziler ve Yönetimi Şakir Volkan ERDOĞAN İnsidental Saptanan Ohvıra Sendromlu Olguda Kronik Pelvik Ağrıya Alternatif Yaklaşım Şeyma DAĞLITUNCEZDİ ÇAM Nadir Rastlanan Sezeryan Sonrası Miyom Rüptürü Olgu Sunumu Ömer ÜNAL Fertilite Koruyucu Cerrahi Uygulanan Erken Evre Musinöz Tip Over CA Olgusunun Literatür Eşliğinde Değerlendirilmesi Ferah KAZANCI Şilöz Asit Komplikasyonu Eşliğinde Endometrium Kanserli Hastalara Yaklaşım Zehra ÖZTÜRK BAŞARIR Fallot Tetralojisi Prenatal Tanı ve Takibi Ömer Gökhan EYİSOY Over Kanseri Cerrahisi Sonrası Lenfosel Gelişen Olgu Sevgi AYHAN Fetal Kayıplara Neden Olan Tekrarlayan İskelet Displazisi Olgusu Eşliğinde Fetal İskelet Displazilerine Bakış Yusuf DAL Non Komunike Rudimenter Hornun Laparoskopik Tedavisi Hilal KILINÇ Mesut ÖNAL Serviks Kanserinde Over Transpozisyonu Olgu Sunumu Hande Esra KOCA YILDIRIM Nadir Bir Jinekolojik Akut Batın Nedeni; Postmenopozal Uterus Rüptürü Selma Atiye KOLCU Torakoamniyotik Şant Takılan Fetal Plevral Efüzyon Olgusu Sevim TUNCER CAN İkinci Trimesterde Uterin Rüptür: Olgu Sunumu Asya ÖZCAN Empty Folikül Sendromu Olgusu Üzerinden Oogenez ve Ovülasyon Burçin KARAMUSTAFAOĞLU BALCI Ayşe ALTUN Erken Gebelikte Masif Kanama ile Seyreden Plasenta Previa Perkreata Bedri SAKCAK Prenatal Dönemde Tanı Alan Büyük Arter Transpozisyonu ve VSD Birlikteliği Betül KEYİF Sezaryen İle Doğum Sonrası Utero-Kutanöz Fistül Olgu Sunumu Betül TOKGÖZ ÇAKIR Gebelikte Kaşıntı: Pemfigoid Gebelik Olgu Sunumu Bilgesu ÇETİNEL KAYGUN Zeynep ÇANKAYA Nadir Olgu Sunumu: Gebelikte İntestinal Endometriozis Burcu AYDIN BOYAMA Endometriyal Polip Zemininde Gelişen Endometriyum Kanseri Büşra DEMİR ÇENDEK Tubaovaryan Abse’ye Bağlı Cilt Fistülü Gelişen Hastaya Yaklaşım Ayşe Zehra ÖZDEMİR Cansu ÜN Fournier Gangreni Elçin TELLİ Gebelikte Görülen Supraventriküler Taşikardi Olgusu ve Yönetimi Emin Levent AKSOY İntrauterin İnterrupted Aortik Ark Tespit Edilen Olgu Sunumu Emre YALÇIN Spontan Karın İçi Kanama ile Komplike Olan On Dört Haftalık Sezaryen Skar Gebeliği Erdoğan GÜL Pelvik Kitlelerin Ayırıcı Tanısında Nadir Bir Olgu: Castleman Hastalığı Fatih KILIÇ Sezaryen Sonrası Rest Plasenta Olguları ve Yönetimi İlknur Merve AYAZOĞLU Nadir Görülen Bir Olgu: Postpartum Dönemde Görülen Pyoderma Gangrenozum Merve KESKİN PAKER Hilal USLU YUVACI Unilateral Tubaovaryan Agenezi ve Kontralateral Tubaovaryan Torsiyon, Vaka Sunumu Mehmet Faruk ÖLÇENOĞLU Merve ÖLÇENOĞLU Nadir Görülen Bir Teratom Olgusu Fetiform Kistik Teratom Mesut BALA Abdullah ACAR Prenatal Rabdomyoma İle Tanı Alan Tuberoskleroz Olgusu Nazan VANLI TONYALI Korona Virüs Enfeksiyonu Sonrası Sezaryen ile Doğum ve Ardından Ovariyan Ven Trombozu ve Yönetimi Nurettin TÜRKTEKİN Salpenjektomi Öyküsü Olan Hastada, İn Vitro Fertilizasyon İle Oluşan İpsilateral Kornual Ektopik Gebelik Yönetimi: Olgu Sunumu Özgür Ozan CEYLAN Ümran KILINÇDEMİR TURGUT Elli Dört Yaşındaki Bir Kadında Dev Uterin Leiomyom Özlem KOŞAR CAN Endometriozis Ramazan ADAN Sezaryen Skar Gebeliği Ramazan ÖZYURT Fetal Genitoüriner Sistem + Gastrointestinal Sistem Komplike Anomalisi: Olgu Sunumu Revan Sabri ÇİFTÇİ Primigravid Hastada Termde Uterus Rüptürü Sultan CANAN Kornual Ektopik Gebelik Odağına Metotreksat Enjeksiyonu-Olgu Sunumu Jule ERİÇ HORASANLI Ülfet SENA METİN

Objectives: Social isolation and lockdowns made telemedicine to gradually penetrate daily practice. Telemedicine has been used successfully in many areas of medicine such as psychiatry but is new in obstetrics and gynecology. This study aimed to investigate whether a telemedicine model would be feasible in choosing patients who needed face-to-face visits during the pandemic. Materials and Methods: Telephone calls were conducted with patients with endometriosis who were admitted to our endometriosis clinic before the pandemic. The primary outcome was to appropriately triage the patients who could postpone their routine visit without any risk and those who needed an in-clinic appointment. Results: Seventy-nine patients were included in the study. Among 58 patients who could be reached, 55 accepted to participate in the study. The mean length of the telephone calls was 8.17 min. Nine patients required an in-clinic appointment (16.4%), whereas 46 (83.6%) patients were managed with the phone call. Compliance with hormonal agents for the treatment of endometriosis-associated pain was 11/17 (64.7%). The most commonly asked questions by patients were about cervical screening, fertility cryopreservation, and the medical treatment options of endometriosis. Conclusion: Telemedicine visits can never replace in-clinic practice but can help with a considerable degree of efficacy in the management of patients with endometriosis.

Purpose To evaluate the expressions of caspase-3 and cytochrome c and heat shock protein 70 (Hsp70) in granulosa cells (GCs) from women with normal ovarian reserve (NOR) and diminished ovarian reserve (DOR) undergoing intracytoplasmic sperm injection (ICSI). Methods GCs were collected from 117 infertile women during oocyte retrieval. Patients were classified into four groups as follows: DOR-COC score of 0, DOR-COC score of I, NOR-COC score of 0, and NOR-COC score of I. The caspase-3, cytochrome c, and Hsp70 analyses were performed immunohistochemically in GCs. The ICSI outcomes were evaluated prospectively. Results The clinical pregnancy and live birth rates were higher in DOR-COC score of I (15, 30.6%; 14, 38.9%) and NOR-COC score of I (19, 38.77%; 19, 52.7%) groups, compared with DOR-COC score of 0 (12, 24.4%; 3, 6.1%) and NOR-COC score of 0 (3, 6.1%; 0%) groups (p = 0.0001; 0.00002), respectively. Caspase-3 and cytochrome c expression levels were higher in DOR-COC score of 0 (23, 65.7%; 25, 71.4%) and NOR-COC score of 0 groups (19, 61.3%; 20, 64.5%), compared with DOR-COC score of I (8, 32%; 9, 36%) and NOR-COC score of I groups (7, 26.9%; 8, 30.8%) (p = 0.00297; p = 0.002), respectively. Lower expression levels of Hsp70 were found in DOR-COC score of 0 (11, 31.4%) and NOR-COC score of 0 groups (10, 32.3%), compared with DOR-COC score of I (16, 64%) and NOR-COC score of I groups (20, 76.9%) (p = 0.001), respectively. Hsp70 expression levels were positively correlated with the number of day 3 good-quality embryo and negatively correlated with estradiol levels in the DOR group. Conclusion Our data suggest that COC score of 0 is associated with increased expression levels of apoptotic proteins, decreased expression levels of anti-apoptotic protein, and poor ICSI clinical outcomes in women with and without DOR.

Objective It has been identified that endometrium specific microRNAs have different expression levels in endometrial tissues and maternal serum during endometrial cycle. The aim of this study was to analyze microRNA expression levels in recurrent implantation failure patients and healthy controls endometrial samples for enlightening the aetiopathogenesis of the disease. The second aim was to search for a potential noninvasive molecular biomarker in early diagnosis and treatment of Recurrent Implantation Failure (RIF) patients. Methods Endometrium and serum samples in two different phases (PP; proliferative phase and SP; secretory phase) from the same cases (RIF; n = 12 and Control; n = 8) were obtained. The expression levels of the microRNA by RT-qPCR method were measured. The expression levels of the healthy controls and study group were compared. Lastly performed target genes analysis of significantly dysregulated miRNA by target analyze databases for obtained related biological pathways. Results This study showed that has-miR-145, has-miR-23b, has-miR-31 and has-miR-30b were significantly up-regulated in PP and down-regulated in SP endometrium samples. In serum samples, has-miR-145 and hsa-miR-23b were significantly down-regulated in both of PP and SP. Target gene and pathway analysis for dysregulated miRNAs identified important, validated and predicted genes for the implantation process. Conclusions This study is the first study to obtain endometrium and serum samples in two different phases from the same cases and measure the candidate miRNAs expression. Our finding suggests that expression level of four candidate miRNAs may be involved in RIF development in women. Furthermore, these miRNAs can be potential biomarker for early diagnosis of RIF patients.

In humans and most animals, maternal inheritance of mitochondria and mitochondrial DNA (mtDNA) is considered as an universal assumption. Recently, several lines of evidence suggest that different species seem to employ distinct mechanisms to prevent the inheritance of paternal mtDNA. There are few studies in the literature on the molecular basis of sperm mtDNA elimination in mammals and paternal mtDNA transmission in humans. Endonuclease G (ENDOG) is a mitochondrial nuclease encoded by nuclear ENDOG gene. The critical importance of ENDOG gene on paternal mitochondrial elimination (PME) has been previously demonstrated in model organisms such as C.elegans and D. melanogaster. However, its mechanism in human is still unclear. Therefore, we aimed to evaluate whether nuclear ENDOG gene copy number could be a potential marker of paternal mtDNA transmission or not. Male factor infertility patients diagnosed with different infertility subgroups such as azoospermia, oligoteratozoospermia, astheno-teratozoospermia were included in this study: 13 infertile men and 25 healthy men as control group. Quantitative real-time polymerase chain reaction (qPCR) analysis and dual-color Fluorescence in situ hybridization (FISH) method were used to compare the groups. FISH method was applied to verify qPCR results and two signals were observed in nearly all patients. ENDOG gene copy number data were evaluated by comparing them with entire human mtDNA next-generation sequencing (NGS) analysis results obtained through bioinformatics and proteomics tools. Mitochondrial whole genome sequencing (WGS) data allowed determination of novel and reported variations such as single nucleotide polymorphisms (SNPs), multiple nucleotide polymorphism (MNP), insertion/deletion (INDEL). Missense variants causing amino acid substitution were filtered out from patients' mtDNA WGS data. Relative copy number of target ENDOG gene in male infertility patients [0.49 (0.31 – 0.77)] was lower than healthy controls [1.00 (0.66 – 1.51)], and statistical results showed significant differences between the groups (p < 0.01). A total of 38 missense variants were detected in the genes encoding the proteins involved in the respiratory chain complex. Moreover, we detected paternal mtDNA transmissions in the children of these patients who applied to assisted reproductive techniques. In conclusion, this study reveals that ENDOG gene may be an important factor for the PME mechanism in humans. To the best of our knowledge, this is the first study in humans about this topic and assessment of ENDOG gene sequencing and gene expression studies in a larger sample size including patients with male factor infertility would be our future project.

Objective: The management of multiple pregnancies is still a challenge. The aim of this study was to compare the outcome of triplet pregnancies managed expectantly or by multifetal pregnancy reduction to twins. Study design: For this retrospective, comparative and monocentric study, the medical files of all women with triplets who admitted to our institution over a 13-year period were examined. Women requesting multifetal pregnancy reduction to have twins formed the study group, and women with triplets who wished to continue their pregnancies formed the control group. Main outcome measures were durations of pregnancies presented as number of weeks gestation, abortion rates, term and preterm birth rates, fetal loss and live birth rates. Results: During the study period, 171 women with triplets admitted to our institution. One hundred fifty one patients are included in this study. Forty-five women carrying triplets wished to continue their pregnancies and 106 women requested multifetal pregnancy reduction to have twins. Fetal reduction of triplets to twins was associated with a significantly lower incidence of birth before 34th gestational week and higher incidence of late preterm and term birth rates without changing live birth rates. Conclusion: Multifetal pregnancy reduction of triplet pregnancies to twins resulted in a later gestational age at birth compared with the triplet gestations managed expectantly. (C) 2021 Elsevier B.V. All rights reserved.

Objective: Aim of this study was to define the relationship between RIF (Recurrent Implantation Failure) and endometrial mtDNA copy number. Study Design: A total of 50 women of reproductive age including twenty-five patients clinically diagnosed with RIF and twenty-five fertile women as healthy controls were recruited into the study. Endometrial biopsy samples were obtained with a pipelle at the 20-24 days of the menstrual cycle of each participant. Total genomic DNA samples were isolated from endometrial tissues; MT-ND1 (mitochondrially encoded NADH dehydrogenase I) and MT-CO2 (mitochondrially encoded cytochrome C oxidase II) target genes were amplified by droplet digital PCR (ddPCR). Nuclear GAPDH (Glyceraldehyde-3-Phosphate Dehydrogenase) gene was also used for study normalization. The study has been conducted between February 2019 and June 2019. Result(s): Droplet digital PCR results were analyzed in "QuantaSoft" software. The concentration amount (copies/mu l) of each participant's mitochondrial gene was normalized according to the GAPDH gene concentrations as nuclear reference. mtDNA amounts were compared between RIF patients and healthy controls. Normalized data was statistically evaluated using Mann-Whitney U test and ROC curve analysis. Conclusion(s): It was concluded that the mitochondrial target gene (MT-ND1 and MT-CO2) copy number amount of RIF patients was higher than the one obtained from the healthy group in endometrial tissues. It is thought that higher mtDNA copy number at the RIF group may be related to increased oxidative stress in the endometrium. This stress factors may influence receptivity negatively and cause implantation failure. The receptivity of the endometrium is associated with the number of mtDNA copies and difference can be used as a biomarker for receptivity analysis. (C) 2020 Elsevier Masson SAS. All rights reserved.

Aim: Our aim is to summarize the clinical signs, symptoms, treatment andprognosis of pregnant women with COVID-19 comparing with non pregnant women with COVID-19 at similar age interval.Method: A retrospective study was conducted by reviewing the medical records of all symptomatic pregnant women infected with COVID-19 between March 15 and May 31, 2020. Pregnant women (n=21) who applied to tertiary hospital during the same time period and with covid-19 diagnosis formed our working group, and control group (n=90) consisted of women who were symptomatic of reproductive age and not pregnant. Seven pregnant women and fifteen non pregnant women were excluded due to being asymptomathic and SARS- CoV-2 positive. COVID-19 infection was diagnosed with computed tomography (CT) scans. For laboratory confirmation with PCR, patients were asked to give nasopharyngeal swab samples and tested for SARS-CoV-2 with the blood-based immunoassay kit launchedprovided by Bio-Rad Laboratories.Results: Between March 15 to May 31, 2020, there were 21 pregnant women and 90 non-pregnant women who have confirmed infection for COVID-19. Seven pregnant women and 15 non-pregnant women were SARS-CoV-2 positive and asymptomatic; they are not included in the study. Fourteen pregnant women and 75 non-pregnant women are included in the study. There were no statistically significant difference between groups concerning the incidence of the symptoms (p> 0.05). Early stage is characterized by the ground glass opacities (GGO), which is common in Covid-19 disease, located in the peripheral and subpleural area. In what concerns the severity of the clinical course; the need for hospitalization, the length of hospital stay, the need for mechanical ventilation were statistically significantly higher in pregnant group. All the two groups were prescribed Hydroxychloroquine and antivirals at a similar rate but the use of antibiotics and low molecular weight heparin was statistically significantly higher in pregnant group.Conclusion and Suggestions: We found that COVID-19 infection hassimilar clinical characteristics and a similar rate of pneumonia in pregnant women. But more studies are needed in the field to define a definitive outcome.

Recurrent implantation failure (RIF) is diagnosed when good-quality embryos repeatedly fail to implant after transfer in several in vitro fertilization (IVF) treatment cycles. Different expression profiles in maternal mRNAs could be referring to many diseases including RIF. This study aimed to reveal significantly dysregulated selected genes expression between healthy fertile women and RIF patients in the implantation window days of the natural menstrual cycle. MME, WWC1, TNC, and FOXP3 genes were chosen as target genes regarding their possible relations with the implantation process. Pathways with these genes were identified and the relationship between these pathways and RIF was investigated. In this study, the endometrial biopsy samples were collected in the secretory phase (cycle day 20–24) of the menstrual cycle from RIF patients (n = 34) and healthy fertile controls (n = 34). After “Pathway and network-oriented GWAS analysis” (PANOGA) and “Kyoto Encyclopedia of Genes and Genomes” (KEGG) pathway analysis; “Membrane Metalloendopeptidase” (MME), “WW and C2 Domain Containing 1” (WWC1), “Tenascin C” (TNC) and “Forkhead Box P3” (FOXP3) genes were chosen as target genes by regarding their possible relation with implantation process. Detection of differences in mRNA expressions between the control group and RIF patients has been performed with the droplet digital PCR (ddPCR) method. Results of the study showed that MME and WWC1 genes expression levels are significantly (p < 0,05) up-regulated 4.9 and 5.2 times respectively and TNC gene expression level is significantly (p < 0,05) down-regulated 9 times in the RIF samples compared to the control group. However, no statistically significant difference was observed between the patient group and the control group in the expression of the FOXP3 gene (p < 0.05). Changes are observed in the expression of the renin-angiotensin system pathway in which the MME gene is involved in the implantation process. The increase in MME gene expression can be speculated to cause implantation failure by restricting the invasion of trophoblast cells. Increasing WWC1 gene expression in the Hippo signaling pathway inhibits “Yes-associated protein 1” (YAP) expression, which is a transcriptional cofactor. Inhibition of YAP protein expression may impair the implantation process by causing the failure of endometrial decidualization. The TNC gene is located in the focal adhesion pathway and this pathway reduces cell adhesion on the endometrial surface to facilitate the attachment of the embryo to the endometrium. The reason for implantation failure might be that the intercellular connections are not suitable for implantation as a result of decreased expression of the focal adhesion pathway in which the TNC gene is effective. Considering the relations between the pathways of the target genes and the implantation process, changes in the expression of target genes might be a cause of RIF.

Betatrophin, which regulates glucose metabolism, is primarily expressed in liver and fat tissue. We aimed to investigate betatrophin levels in patients with polycystic ovary syndrome (PCOS) that is the most common endocrine pathology in women of reproductive age. A total of 69 women were included in this prospective study: 35 patients with PCOS (18 obese and 17 lean) and 34 healthy controls (17 obese and 17 lean). Patients who met the criteria were compared regarding betatrophin levels and other hormonal values. Serum betatrophin level did not differ between obese PCOS patients and obese controls, and lean PCOS patients and lean controls; while significantly increased in obese PCOS patients and controls compared to lean PCOS patients and controls. Total testosterone and androstenedione were significantly higher in patients with PCOS than in controls both in the obese and lean groups, while sex hormone-binding globulin was significantly lower in patients with PCOS than in controls both in the obese and lean groups. However, remaining hormone values were similar between groups. Betatrophin level was significantly increased in obese patients compared to lean patients independent to the presence of PCOS.

Objective: The ideal controlled ovarian stimulation protocol for patients with poor ovarian response (POR) is not clear yet, and is the subject of many studies. Aromatase inhibitors have been introduced as a new treatment modality in controlled ovarian stimulation as they were found to elevate follicular sensitivity to gonadotropins (Gn). The aim of this study was to evaluate whether it is possible to reduce the required Gn dose by adding letrozole to the treatment without compromising success. Material and Methods: Patients who underwent in vitro fertilization treatment between 2014 and 2015 in our department and who were classified as poor responder patients according to Bologna criteria were recruited and randomized. In the first group, 33 patients were treated with 150 IU Gn in combination with letrozole 5 mg /day for the first five days of the stimulation. In the second group, 27 patients were treated with 300 IU Gn. Results: Amoung the groups there were no statistically significant difference in duration of ovulation stimulation, duration of antagonist use, number of retrieved oocytes, number of transferred embryos, implantation, cycle cancelation, chemical, clinical and ongoing pregnancy rates (all p>0.05). Gn use was significantly higher in 300 IU Gn alone group compared to 150 IU Gn in combination with letrozole group (1354 ± 468 IU versus 2555 ± 725 IU, p<0.05). Conclusion: The addition of letrozole yields comparable pregnancy outcomes with significantly low doses of Gn, so may be regarded as an effective adjuvant agent in POR patients.

Introduction: Available data suggest that there is an association between endometriosis and a group of disorders including autonomic nervous system irregularities. A deeper understanding of relationship between endometriosis and autonomic nervous system is needed as it may lead to novel discoveries on the causes or consequences of endometriosis. In this study, we analyzed the prevalence of migraine in patients with endometriosis. Methods: In this cross-sectional study, medical records of women were reviewed through January 2013 to December 2017. Women with laparoscopically proven endometriosis (n = 185) were compared with those without endometriosis (n = 168). The 3-item screening questions (ID Migraine™) test was used to screen migraine. Data were analyzed using SPSS v25 (IBM Corporation). The χ2 test was used for analyzing the nominal parameters and group comparisons. Pearson χ2 was used to study the association between endometriosis and migraine. Results: The mean age was 31.86 ± 4.49 years of the endometriosis group and 28.95 ± 5.11 years of the controls (p = 0.408). The two pre-screening questions of ID Migraine test were answered positively by 86 patients of the endometriosis group (75.4%) and by 53 patients of the control group (54.6%) (p = 0.001). Of these patients, 51 (44.7% of endometriosis group) and 26 (26.8% of control group) were diagnosed as having migraine using 3-item Migraine questionnaire (p = 0.007). Conclusion: This study showed that the prevalence of migraine was significantly higher in patients with endometriosis. Because there is a strong correlation, patients with endometriosis should be screened for headache and migraine to increase the benefits of care.