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    Bilateral adnexal torsion due to postmenopausal hydatidiform mole
    (WILEY-BLACKWELL, 2011) Ozdemir, Suna; Balci, Osman; Gorkemli, Huseyin; Koyuncu, Tuba; Turan, Gulay
    Occurrence of gestational trophoblastic neoplasia (GTN) and adnexal torsion is rare in postmenopause. We report a 58-year-old postmenopausal woman with adnexal torsion caused by hydatidiform mole. The patient was admitted to our clinic complaining of acute abdominal pain, nausea and vomiting lasting one day. Ultrasonography showed an enlarged uterus including hypo/hyperechogenous cystic areas in the endometrial cavity and bilateral adnexal masses. beta-HCG level was investigated and determined as 157.000 IU/l, because of the suspicion of GTN in ultrasonography. Doppler sonography revealed enlarged left adnexa with absence of vascular flow. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. beta-HCG decreased to normal ranges in the fourth postoperative week. The resected uterus contained an endometrial, cystic, grapelike tumor. The ovaries were enlarged bilaterally with necrotic appearance. Histopathology revealed complete hydatidiform mole and theca lutein cysts. To our knowledge, the present case is the first hydatidiform mole associated with bilateral adnexal torsion caused by theca lutein cysts in postmenopausal period.
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    Clinical and metabolic effects of medroxyprogesterone acetate and ethinyl estradiol plus drospirenone in women with polycystic ovary syndrome
    (WILEY, 2008) Ozdemir, Suna; Gorkemli, Huseyin; Gezginc, Kazim; Ozdemir, Mustafa; Kiyici, Aysel
    Objectives: To investigate the effects of treatment with medroxyprogesterone acetate (MPA), 10 days per month for 6 months, on lipid and carbohydrate metabolism in women with polycystic ovary syndrome (PCOS). Methods: Sixty-three women with PCOS were randomized to receive MPA or ethinyl estradiol plus drospirenone. Results: There were no changes in lipid or carbohydrate metabolism in the MPA group, but serum levels of luteinizing hormone (P < 0.001) and total testosterone (P < 0.003) significantly decreased, as did the free androgen index (P < 0.02) and acne (P < 0.03) and seborrhea (P < 0.04) scores. In the ethinyl estradiol plus drospirenone group lipid and hormone values significantly increased whereas acne, seborrhea, hair Loss, and Ferriman-Gallwey scores decreased. There was no statistically significant change in the total cholesterol to high-density cholesterol ratio in either group. Conclusion: Treatment of PCOS patients with MPA provided good menstrual cycle control, beneficial changes in hormonal values associated with hyperandrogenism, and no significant changes in lipid or carbohydrate metabolism. (c) 2008 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All, rights reserved.
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    Compared effects of surgical and natural menopause on climacteric symptoms, osteoporosis, and metabolic syndrome
    (WILEY, 2009) Ozdemir, Suna; Celik, Cetin; Gorkemli, Huseyin; Kiyici, Aysel; Kaya, Bugra
    Objective: To compare the effects of surgical (ie, earlier) and natural (ie, later) menopause oil climacteric symptoms, osteoporosis. and metabolic syndrome. Method: The study was conducted with 94 women who underwent hysterectomy and bilateral oophorectomy and 95 women who were older than 40 years and in natural menopause. None had received hormone theraphy or osteoporosis treatment. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III. Results: The rates of hot flushes (P=0.001), sweating (P=0.001), poor memory (P=0.04), change in sexual desire (P=0.04), and osteoprosis (diagnosed in the hip bone, P=0.005) were significantly higher among the women in Surgical menopause, but the rate of metabolic syndrome was similar in the 2 groups (47.8% and 40%; P=0.28). Conclusion: Compared with natural menopause, surgical menopause was found to be associated with highter rates of climacteric symptoms and osteoporosis but not of of metabolic syndrome. Crown Copyright (C) 2009 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics. All rights reserved.
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    Long-Term Effects of Valproic Acid on Reproductive Endocrine Functions in Turkish Women with Epilepsy
    (KARGER, 2009) Gorkemli, Huseyin; Genc, Bulent Oguz; Dogan, Ebru Apaydin; Genc, Emine; Ozdemir, Suna
    The long-term effects of valproic acid (VPA) on reproductive endocrine functions in women with epilepsy (WWE) were studied. Serum reproductive hormone concentrations, clinical findings and ovarian morphology were analyzed in 71 WWE who had been receiving antiepileptic drugs (AED) for a minimum of 2 years. Of the 71 WWE, polycystic ovarian syndrome (PCOS) (p = 0.011) and menstrual irregularities (p = 0.009) were found to be more prevalent in women receiving VPA treatment when compared to women on non-VPA treatment. There was no statistically significant dose or duration-related rise of risk for patients who developed PCOS and menstrual irregularities and those who were not on long-term VPA therapy. The lack of a duration-related reproductive dysfunction in this patient population may support the hypothesis of early occurring VPA-associated metabolic and endocrine changes. Copyright (C) 2009 S. Karger AG, Basel
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    A new approach to chromosomal abnormalities in sperm from patients with oligoasthenoteratozoospermia: detection of double aneuploidy in addition to single aneuploidy and diploidy by five-color fluorescence in situ hybridization using one probe set
    (ELSEVIER SCIENCE INC, 2008) Durakbasi-Dursun, Hatice Gul; Zamani, Ayse Gul; Kutlu, Ruhusen; Gorkemli, Huseyin; Bahce, Muhterem; Acar, Aynur
    Objective: To determine the frequencies of disomy, nullisomy, total aneuploidy, and diploidy in the sperms of infertile men. Design: A controlled prospective study. Setting: Assisted reproductive technology (ART)/IVF Unit and Department of Medical Biology and Genetics, Meram Medical Faculty, Konya, Turkey. Patient(s): Infertile men with oligoasthenoteratozoospermia (OAT) and normal fertile donors. Intervention(s): After slide preparation from semen samples, sperm nuclei were analyzed for chromosomes 13, 18, 21, X, and Y by five-color fluorescence in situ hybridization. Main Outcome Measure(3): The sperm aneuploidy (disomy and nullisomy) and diploidy rates were determined according to the number of signals detected for each probe in infertile and fertile men. Results: Patients with OAT had a significantly higher incidence of disomy (except chromosome 18 and XX disomy), nullisomy (except chromosome 18), and diploidy than normal fertile controls. In addition to double disomy, double nullisomy and disomy+nullisomy were observed in patients with OAT, but none of these were seen in controls. Conclusion(s): In this study patients with OAT had an increased rate of sperm aneuploidy and diploidy. This finding suggest that patients with OAT may be at an increased risk of producing aneuploid and triploid offsprings. For this reason, it may be very, important to perform the sperm fluorescence in situ hybridization in patients with OAT. Thus, a more informative genetic counseling might be given to couples with male factor infertility who are at an increased risk of having Aneuploid offsprings and triploid conceptions before intracytoplasmic sperm injection (ICSI). (Fertil Steril (R) 2008;89:1709-17. (c) 2008 by American Society for Reproductive Medicine.).