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Öğe Breastfeeding Throughout Pregnancy in Turkish Women(Mary Ann Liebert, Inc, 2014) Ayrim, Aylin; Gunduz, Suzan; Akcal, Banu; Kafali, HasanIntroduction: Around the world, as well as in Turkey, women breastfeed their infants as long as possible. There is, however, a strong cultural taboo against continuing breastfeeding while having a new pregnancy. The aim of this study was to evaluate the outcome of pregnancies occurring during the lactation period and to determine whether lactation throughout the pregnancy had any adverse effects. This is the first study in Turkey to provide data on the association between the practice of lactation throughout pregnancy and outcome. Subjects and Methods: One hundred sixty-five multiparous women with singleton pregnancies who were >= 18 years of age, breastfeeding the previous child, and did not have systemic disease were included. Forty-five of the 165 pregnant women continued lactating, whereas 120 did not. We compared weight gain during pregnancy, hemoglobin level alterations, pregnancy complications, neonatal weight, and Apgar scores between the two groups. Results: Lactating pregnant women gained less weight than the nonlactating group, and the decreased level of hemoglobin during pregnancy was significant in the lactating group. Between the two groups, there was no statistically significant difference in hyperemesis gravidarum, threatened abortion, preeclampsia, premature labor and birth, neonatal weight, or Apgar scores. Conclusions: Breastfeeding during pregnancy is not harmful, and health professionals should not advise weaning if overlapping occurs and should observe mother, infant, and fetus closely for negative effects, and if a negative effect occurs they should take precautions.Öğe Can hyaluronan binding assay predict the outcome of intrauterine insemination in couples with unexplained or mild male factor infertility?(Avicenna Research Institute ajmb@avicenna.ac.ir No.2 and 3, Shabo Alley,Street No.18, Velenjak Avenue,Yemen Street, Shaheed Chamran,Tehran, 19857-43413, 2015) Yildirim, Melahat; Duvan, Zehra Candan İltemir; Pekel, Aslihan; Ayrim, Aylin; Kafali, HasanBackground: The purpose of this study was to evaluate the prognostic effect of Hyaluronan Binding Assay (HBA) which has been used as a method of sperm selection for intracytoplasmic sperm injection procedure, on the outcome of intrauterine insemination (IUI) in couples with unexplained or mild male factor infertility. Methods: 77 infertile couples were enrolled in our study. On the day of IUI procedure, HBA test was performed by using fresh semen samples, and the rates of sperm binding to HBA were calculated. HBA values and semen parameters were compared. Fisher exact test was used to evaluate the relationship between HBA ratio and pregnancy status. Mann-Whitney U test was used to compare quantitative variables between pregnant and non-pregnant groups. The p<0.05 was considered statistically significant. Results: In this study, HBA ratio was 69(29.25%) and pregnancy rate was 14.29%. A significant positive correlation between HBA and total motile sperm count, inseminating sperm count, progressive motility, morphology, and sperm concentration (p<0.001, p<0.001, p:0.007, p<0.003, p:0.003 respectively) was observed. Although HBA values in pregnant group were higher than those in non-pregnant group, this result did not reach the statistically significant level (HBA: 67(20%) for nonpregnant group, 80.5(21.3%) for pregnant group). Also, no relationship between HBA values and pregnancy status was found. Moreover, there was no significant correlation between pregnancy status and HBA ratios based on the suggested cut-off value of 60 in literature (p=0.425). Conclusion: HBA does not predict the IUI outcome in couples with unexplained infertility or mild male factor infertility, but it can be used together with semen parameters to verify sperm quality. © 2015 Elsevier B.V., All rights reserved.Öğe Hearing loss after spinal anesthesia: A comparative prospective randomized cohort study(ARSMB-KVBMG aob.edit@skynet.be Avenue W. Churchill-laan 11/30 Brussels B-1180, 2016) Karabayirli, Safinaz; Uğur, Kadriye Şerife; Ayrim, Aylin; Demircioğlu, Rüveyda İrem; Ark, Nebil; Usta, Burhanettin; Kurtaran, HanifiObjective: In this comparative randomized cohort study, we aimed at evaluating the occurrence of sensorineural hearing loss after general and spinal anesthesia using both subjective and objective tests. Material and Methods: Fifty patients scheduled for elective cesarean section were approached, of which 21 patients received spinal anesthesia (group S), and 16 patients received general anesthesia (group G). In group S, a 27 G pencil point spinal needle was used. Pure tone audiometry and Distortion Product Otoacoustic Emissions (DPOAE) were performed before and 48 hours after surgery. Results: No between-group significant difference in pre and postoperative audiometric hearing threshold and pure tone average value were noticed, as well as in pre and postoperative DPOAE amplitude and signal-to-noise ratio (SNR). Conclusion: In this study, we did not observe any hearing loss after cesarean section under general or spinal anesthesia. Using the non-traumatic 27 gauge pencil point needle for performing spinal anesthesia does not seem to be associated with a risk of hearing loss, similarly to general anesthesia. © 2018 Elsevier B.V., All rights reserved.Öğe Is there any effect of demographic features on development of hyperemesis gravidarum in the Turkish population?(Tubitak Scientific & Technological Research Council Turkey, 2013) Kamalak, Zeynep; Kosus, Nermin; Kosus, Aydm; Hizli, Deniz; Ayrim, Aylin; Kurt, GoncaAim: To assess the effect of maternal demographic variables on development of hyperemesis gravidarum (HG) in pregnant Turkish women. Materials and methods: Two hundred consecutive women with HG were defined as the study group, and 200 consecutive pregnant women without any signs or symptoms of HG matched for age, parity, and gestational age were defined as the control group. Personal information, including lifestyle, educational level, occupation, and economic status were obtained via questionnaire. Results: The number of abortions was higher but parity was lower in the HG group. The time interval between 2 pregnancies was significantly shorter in the HG group than in the control group. HG developed in all women who had HG in a previous pregnancy. HG was significantly higher in women who graduated from high school or university. Level of monthly income and communication within the family have an effect on development of HG. Logistic regression analysis showed that the most important parameters for prediction of HG were education level, age at marriage, and previous history of abortus. Conclusion: Living conditions, life standards, communication, and experiences in previous pregnancies might affect development of HG.Öğe Pittsburgh Sleep Quality Index scores and their relationship with body measurements in late menopause patients(Tubitak Scientific & Technological Research Council Turkey, 2014) Ayrim, Aylin; Aktepe Keskin, Esra; Ozol, DuyguBackground/aim: With an increase in life expectancy, women live about one-third of their lives in the postmenopausal period. Our aim was to investigate the findings regarding quality of sleep and sleep apnea in postmenopausal women and research the relationship between sleep complaints and body measurements. Materials and methods: The Pittsburgh Sleep Quality Index (PSQI) was administered to all participants and their height, weight, and neck circumferences were measured. Results: A total of 206 patients (mean age: 61.4 +/- 8.8 years) were included. Their mean weight gain after menopause was 8.1 +/- 12.8 kg, and their mean neck circumference and body mass index was 39.7 +/- 2.6 cm and 33.4 2.1, respectively. The rate of patients who snored each night increased from 3.4% to 13.2% (P = 0.000) after menopause. The rate of self-reported poor sleep quality was found in 57.8% of patients according to the PSQI global score (>= 5). The prevalence of sleep medication usage increased from 5.8% to 11.2% with menopause. Although body measurements were a little lower in patients with a total PSQI score of less than 5, this difference was insignificant. Conclusion: The prevalence of self-reported poor sleep quality was high in the postmenopausal period and the prevalence of snoring increased significantly with weight gain after menopause.Öğe The effect of coasting on intracytoplasmic sperm injection outcome in antagonist and agonist cycle(Royan Institute (ACECR) info@celljournal.org, 2017) Iltemir Duvan, Zehra Candan; Namlı Kalem, Muberra; Onaran, Yüksel Arikan; Keskin, Esra Aktepe; Ayrim, Aylin; Pekel, Aslihan; Kafali, HasanBackground: Coasting can reduce the ovarian hyperstimulation syndrome (OHSS) risk in ovulation induction cycles before intracytoplasmic sperm injection (ICSI). This study aimed to investigate the effect of gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist protocols to controlled ovarian hyperstimulation (COH) cycles with coasting on the parameters of ICSI cycles and the outcome. Materials and Methods: In a retrospective cohort study, 117 ICSI cycles were performed and coasting was applied due to hyperresponse, between 2006 and 2011. The ICSI outcomes after coasting were then compared between the GnRH agonist group (n=91) and the GnRH antagonist group (n=26). Results: The duration of induction and the total consumption of gonadotropins were found to be similar. Estradiol (E2) levels on human chorionic gonadotropin (hCG) day were found higher in the agonist group. Coasting days were similar when the two groups were compared. The number of mature oocytes and the fertilization rates were similar in both groups; however, the number of grade 1 (G1) embryos and the number of transferred embryos were higher in the agonist group. Implantation rates were significantly higher in the antagonist group compared to the agonist group. Pregnancy rates/embryo transfer rates were higher in the antagonist group; however, this difference was not statistically significant (32.8% for agonist group vs. 39.1% for antagonist group, P>0.05). Conclusion: The present study showed that applying GnRH-agonist and GnRH-antagonist protocols to coasted cycles did not result in any differences in cycle parameters and clinical pregnancy rates. © 2017 Elsevier B.V., All rights reserved.Öğe The Effect of Coasting on Intracytoplasmic Sperm Injection Outcome in Antagonist and Agonist Cycle(Royan Inst, 2017) Duvan, Z. Candan Iltemir; Kalem, Muberra Namli; Onaran, Yuksel; Keskin, Esra Aktepe; Ayrim, Aylin; Pekel, Aslihan; Kafali, HasanBackground: Coasting can reduce the ovarian hyperstimulation syndrome (OHSS) risk in ovulation induction cycles before intracytoplasmic sperm injection (ICSI). This study aimed to investigate the effect of gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist protocols to controlled ovarian hyperstimulation (COH) cycles with coasting on the parameters of ICSI cycles and the outcome. Materials and Methods: In a retrospective cohort study, 117 ICSI cycles were performed and coasting was applied due to hyperresponse, between 2006 and 2011. The ICSI outcomes after coasting were then compared between the GnRH agonist group (n=91) and the GnRH antagonist group (n=26). Results: The duration of induction and the total consumption of gonadotropins were found to be similar. Estradiol (E-2) levels on human chorionic gonadotropin (hCG) day were found higher in the agonist group. Coasting days were similar when the two groups were compared. The number of mature oocytes and the fertilization rates were similar in both groups; however, the number of grade 1 (G1) embryos and the number of transferred embryos were higher in the agonist group. Implantation rates were significantly higher in the antagonist group compared to the agonist group. Pregnancy rates/embryo transfer rates were higher in the antagonist group; however, this difference was not statistically significant (32.8% for agonist group vs. 39.1% for antagonist group, P > 0.05). Conclusion: The present study showed that applying GnRH-agonist and GnRH-antagonist protocols to coasted cycles did not result in any differences in cycle parameters and clinical pregnancy rates.
