Browsing by Author "Yildizhan, B."

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Ovarian Stimulation in Obese and Non-Obese Polycystic Ovary Syndrome Using a Low-Dose Step-Up Regimen With Two Different Starting Doses of Recombinant Follicle-Stimulating Hormone
(Sage Publications Ltd, 2008) Yildizhan, R.; Adali, E.; Kolusari, A.; Kurdoglu, M.; Yildizhan, B.; Sahin, H. G.; Kamaci, M.
Sixty-seven infertile women with polycystic ovary syndrome (PCOS) were divided into two groups, obese and non-obese, according to their body mass index. Waist-to-hip ratio, insulin resistance, total testosterone and dehydroepiandrosterone sulphate levels were significantly elevated in obese, compared with non-obese, patients. Both groups were treated with a low-dose step-up protocol of recombinant follicle-stimulating hormone (rFSH) with a starting dose of 50 IU/day and, every third day, a 25-IU increase in the dose until the appropriate dose was achieved for each individual, up to a maximum of 175 IU/day. In the obese group only, repeat therapy commenced in the second ovulatory cycle in women who had not become pregnant, however a starting dose of 75 IU/day was then used, with incremental and maximum dose as before. The results of the starting dose of 75 IU/day rFSH were compared with the results of a 50 IU/day rFSH starting dose in the obese group. A starting dose of 50 IU/day rFSH in a low-dose step-up regimen was found to be effective, safe and well-tolerated for inducing follicular development in non-obese infertile women with PCOS. However, for obese PCOS patients, a starting dose of 75 IU/day rFSH is recommended.
Serum Retinol-Binding Protein 4, Leptin, and Plasma Asymmetric Dimethylarginine Levels in Obese and Nonobese Young Women With Polycystic Ovary Syndrome
(2011) Yildizhan, R.; Ilhan, G.A.; Yildizhan, B.; Kolusari, A.; Adali, E.; Bugdayci, G.
Objective: To evaluate retinol-binding protein 4 (RBP4), leptin, and asymmetric dimethylarginine (ADMA) levels in young women with polycystic ovary syndrome (PCOS) and to investigate their relationship with each other and with clinical, metabolic, and hormonal parameters. Design: Clinical study. Setting: University hospital. Patient(s): Fifty-seven young women with PCOS (obese [n = 27] and nonobese [n = 30]) and 27 age-matched healthy controls. Intervention(s): History and physical examination, peripheral venous blood sampling. Main Outcome Measure(s): Asymmetric dimethylarginine, RBP4, leptin, LH, FSH, DHEAS, total T, E2, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglyceride (TG), and homeostasis model assessment insulin resistance index (HOMA-IR). Result(s): Obese women with PCOS had significantly higher HOMA-IR, DHEAS, leptin, RBP4, and ADMA levels. Leptin levels were significantly increased in nonobese subjects with PCOS. Leptin and ADMA levels were positively correlated with HOMA-IR in PCOS. There was no correlation between RBP4 and HOMA-IR. Leptin, RBP4, and ADMA levels are positively correlated in PCOS. Conclusion(s): [1] Young obese women with PCOS have increased ADMA, RBP4, and leptin levels, and they are positively correlated with each other. [2] The increased levels of leptin are independent of obesity, and leptin seems to have an association with IR. [3] Levels of RBP4 may not reflect IR in PCOS. © 2011 by American Society for Reproductive Medicine.
Transvaginal Ultrasonography and Saline Infusion Sonohysterography for the Detection of Intra-Uterine Lesions in Pre- and Post-Menopausal Women With Abnormal Uterine Bleeding
(Sage Publications Ltd, 2008) Yildizhan, B.; Yildizhan, R.; Ozkesici, B.; Suer, N.
This prospective study investigated 79 pre- and 25 post-menopausal women with abnormal uterine bleeding who underwent conventional transvaginal ultrasonography (TVS) and saline infusion sonohysterography (SIS) and compared the results with histopathological findings obtained by dilatation and curettage, hysteroscopy or hysterectomy. Histological examination revealed normal endometrial histology in 28 patients, intracavitary polyps in 46 patients, submucosal fibroids in 18 patients, intramural fibroids in six patients and endometrial hyperplasia in six patients. The sensitivity and specificity of TVS in detecting endometrial polyps were 65.2% and 87.9%, respectively, compared with 91.3% and 93.1% for SIS. The sensitivity and specificity of TVS in detecting uterine fibroids were 95.8% and 95.0%, respectively, versus 91.6% and 98.7% for SIS. These results show that SIS is a satisfactory method of identifying lesions and that it is easy and cost-effective, and improves on the diagnostic utility of TVS. SIS is also a less invasive alternative to hysteroscopy, so should result in less morbidity in the evaluation of abnormal uterine bleeding in women.