39 research outputs found
Dehydroepiandrosterone supplementation improves ovarian response and cycle outcome in poor responders
No full textOzmen, Batuhan/0000-0002-4504-669X; Atabekoglu, Cem Somer/0000-0003-0264-0709; Ozkavukcu, Sinan/0000-0003-4525-9027The effect of dehydroepiandrosterone (DHEA) supplementation on cycle outcome was assessed in patients with poor ovarian response. In total, 19 poor responder patients who were scheduled to undergo a second intracytoplasmic sperm injection (ICSI)/embryo transfer cycle were enrolled and first ICSI/embryo transfer cycles were taken as the control group. All subjects were given DHEA supplementation (25 me, t.i.d.) for at least 3 months prior to their second ICSI/embryo transfer cycle. In both cycles a fixed dose of rFSH (300 IU/day) and human menopausal gonadotrophin (HMG) (75 or 150 IU/day) along with a flexible gonadotrophin-releasing hormone (GnRH) antagonist protocol were administered. A favourable decrease was noted in mean day 3 serum oestradiol concentrations after DHEA Supplementation (75.14 +/- 28.93 versus 43.07 +/- 11.77; P 17 mm follicles (3 +/- 0.7 versus 1.9 +/- 1.3; P < 0.05), MII oocytes (4 +/- 1.8 versus 2.1 +/- 1.8; P < 0.05), top quality day 2 (2.2 +/- 0.8 versus 1.3 +/- 1.1: P < 0.05) and day 3 embryos (1.9 +/- 0.8 versus 0.7 +/- 0.6; P < 0.05) were achieved in DHEA-supplemented cycles. Cycle cancellation rates were reduced (5.3% versus 42.1%; P < 0.01), and the pregnancy rate per patient and clinical pregnancy rate per embryo transfer (47.4% versus 10.5%; P<0.01 and 44.4% versus 0%; P < 0.01) were improved after DHEA supplementation. DHEA supplementation might enhance ovarian response, reduce cycle cancellation rates and increase embryo quality in poor responders
Preliminary experience with salvage weekly paclitaxel in women with advanced recurrent ovarian carcinoma
No full textPurpose of investigation: To assess the role of palliative chemotherapy with weekly paclitaxel in patients with recurrent ovarian cancer. Methods: Thirty-two patients with paclitaxel- and platinum-resistant ovarian cancer were treated with weekly paclitaxel at 80 mg/m(2) as a 1-hour intravenous infusion weekly for six weeks every eight weeks (I cycle). This schedule was considered to be given for three cycles. Evaluation of radiographically measurable disease was used in the assessment of response. CA-125 was used to classify responses only in the absence of a measurable lesion. Results: Thirty-two patients were all assessable for response. Of these, nine patients (28.1%) achieved a partial response and one patient achieved a complete response, leading to an overall response rate of 31.2%. Stable disease occurred in six patients (18.8%), and 16 patients (50%) had progressive disease. Nine patients died of progressive disease while on treatment. The median survival for the entire group was 10.5 months (range 2.5-22 months). Grade 3 or 4 leukopenia and neutropenia occurred in eight and six patients, respectively. Four of these patients developed febrile neutropenia without infection. Grade 1 and 2 peripheral neuropathies were observed in 50% of the patients without causing any premature drop out. Severe (grade 3 or 4) peripheral neuropathy was not observed. There were 11 patients with grade 1 or 2 myalgias. Conclusion: Weekly paclitaxel regimen is well tolerated with acceptable toxicity. The favorable toxicity profile and the encouraging antitumor activity observed in this study makes this regimen an option for the salvage treatment of patients with recurrent ovarian cancer
Does premature luteinization or early surge of LH impair cycle outcome? Report of two successful outcomes
No full textOzmen, Batuhan/0000-0002-4504-669X; Ozkavukcu, Sinan/0000-0003-4525-9027; Atabekoglu, Cem Somer/0000-0003-0264-0709To report two successful antagonist IVF cycles; one ending up with pregnancy despite premature luteinization (case 1, aged 35 years), and the other with the retrieval of high quality oocytes despite premature ovulation (case 2, aged 39 years). Serum LH was 36 and 47 IU/L on cycle day 7 before antagonist administration, which was then brought to 6.94 and 3.92 IU/L by antagonist administration, and kept below these levels throughout the remaining stimulation in case 1 and 2 respectively. Serum progesterone was 1.42 and 5.5 ng/mL on the day of hCG respectively. Ten metaphase II (MII) oocytes were harvested wherein 3 grade A embryos were transferred in case 1, and seven good quality MII oocytes were retrieved wherein six embryos were cryopreserved in case 2. More precise cut thresholds for both LH and progesterone are necessary for accurate prediction of the cycle outcomes
Laparoscopic management of an ovarian ectopic pregnancy after intracytoplasmic sperm injection
No full textPreliminary experience with salvage weekly paclitaxel in women with advanced recurrent ovarian carcinoma
No full textPurpose of investigation: To assess the role of palliative chemotherapy with weekly paclitaxel in patients with recurrent ovarian cancer. Methods: Thirty-two patients with paclitaxel- and platinum-resistant ovarian cancer were treated with weekly paclitaxel at 80 mg/m(2) as a 1-hour intravenous infusion weekly for six weeks every eight weeks (I cycle). This schedule was considered to be given for three cycles. Evaluation of radiographically measurable disease was used in the assessment of response. CA-125 was used to classify responses only in the absence of a measurable lesion. Results: Thirty-two patients were all assessable for response. Of these, nine patients (28.1%) achieved a partial response and one patient achieved a complete response, leading to an overall response rate of 31.2%. Stable disease occurred in six patients (18.8%), and 16 patients (50%) had progressive disease. Nine patients died of progressive disease while on treatment. The median survival for the entire group was 10.5 months (range 2.5-22 months). Grade 3 or 4 leukopenia and neutropenia occurred in eight and six patients, respectively. Four of these patients developed febrile neutropenia without infection. Grade 1 and 2 peripheral neuropathies were observed in 50% of the patients without causing any premature drop out. Severe (grade 3 or 4) peripheral neuropathy was not observed. There were 11 patients with grade 1 or 2 myalgias. Conclusion: Weekly paclitaxel regimen is well tolerated with acceptable toxicity. The favorable toxicity profile and the encouraging antitumor activity observed in this study makes this regimen an option for the salvage treatment of patients with recurrent ovarian cancer
Laparoscopic removal of dysgenetic gonads containing a giant seminoma, in an adult patient with testicular feminization syndrome
No full textLive birth after Laser Assisted Viability Assessment (LAVA) to detect pentoxifylline resistant ejaculated immotile spermatozoa during ICSI in a couple with male Kartagener’s syndrome
No full textAbstract Primary ciliary dyskinesia (PCD) is a rare, autosomal recessive disease with abnormalities in the structure of cilia, causing impairment of muco-ciliary clearance with respiratory tract infections, heterotaxia and abnormal sperm motility with male infertility. Here, with a comprehensive literature review, we report a couple with an infertility history of 9 years and three unsuccessful IVF treatments, where male partner has Kartagener’s Syndrome, a subtype of PCD, displaying recurrent respiratory infections, dextrocardia and total asthenozoospermia. His diagnosis was verified with transmission electron microscopy and genetic mutation screening, revealing total absence of dynein arms in sperm tails and homozygous mutation in the ZMYND10, heterozygous mutations in the ARMC4 and DNAH5 genes. Laser assisted viability assay (LAVA) was performed by shooting the sperm tails during sperm retrieval for microinjection, following detection of pentoxifylline resistant immotile sperm. Live births of healthy triplets, one boy and two monozygotic girls, was achieved after double blastocyst transfer
Unexpected pregnancy despite extremely decreased estradiol levels during ovarian stimulation
No full textObjectiveTo report two patients with ongoing pregnancies despite a dramatically sharp decrease in E2 levels after coasting.DesignCase report.SettingReproductive endocrinology and assisted reproduction unit of university hospital.Patient(s)One 30-year-old and one 25-year-old woman, both with unexplained infertility, in whom E2 levels increased up to 6345 and 14,275 pg/mL during ovarian hyperstimulation and decreased by 79.5% and 75.5%, respectively, after coasting.Intervention(s)Two IVF treatments during which coasting was performed after high E2 levels were observed. IVF cycles were carried out despite abrupt E2 decrease.Main Outcome Measurement(s)Development of ovarian hyperstimulation syndrome (OHSS) or fertilization, cleavage, implantation, and pregnancy rates.Result(s)Two embryos (one grade A and one grade B) were transferred into the 30-year-old patient and three embryos (all grade A) were transferred into the 25-year-old patient. Neither woman developed OHSS. Two pregnancies on going at gestational weeks 20 and 14, respectively.Conclusion(s)Coasting is practiced to avoid severe complications of ovarian hyperstimulation during IVF cycles and is achieved by withholding gonadotropins. The aim of coasting is to lower E2 levels to a safer range; however, there has been no consistency with respect to the time of coasting or the safety rates of E2 decrease. We believe that high rates of E2 decrease after coasting do not have deleterious effects on implantation
Hysteroscopic management of vaginal septum in a virginal patient with uterus didelphys and obstructed hemivagina
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