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Öğe Effects of the etonogestrel contraceptive implant (Implanon®) on bone metabolism during lactation: a prospective study(Bmj Publishing Group, 2017) Duvan, Candan Iltemir; Onaran, Yuksel; Keskin, Esra Aktepe; Yuce, Ebru; Yanik, Burcu; Kafali, Hasan; Turhan, Nilgun OzturkAim To evaluate the effects of the etonogestrel contraceptive implant (Implanon (R)) on bone metabolism in lactating women using markers for bone formation and resorption. Study design This single-centre, prospective cohort study was conducted in Turgut Ozal University Medical Faculty Obstetrics and Gynecology Department with healthy lactating women aged between 24 and 38 years to compare the effect on bone metabolism of 6 months' use of either the implant or a non-hormonal contraceptive method. The study group (n=25) used an implant and the control group (n=25) used a non-hormonal contraceptive intrauterine device inserted 40 days' postpartum. Bone metabolism differences at the time of insertion and after 6 months were assessed quantitatively by biochemical analysis of serum and urine samples. Results At baseline, serum levels of bone metabolism parameters were similar for the two groups. In the implant group, serum alkaline phosphatase (ALP) levels decreased (p=0.004) and total protein levels increased (p=0.045) at 6 months. In the control group, serum levels of bone metabolism parameters did not change at 6 months compared to baseline. However, serum levels of phosphorus (p=0.013) and ALP (p=0.003) decreased at 6 months compared to baseline. Conclusion Six months' postpartum use of Implanon was found to have no deleterious impact on bone turnover in healthy lactating women.Öğe Is the level of maternal serum prohepcidin associated with preeclampsia?(Taylor & Francis Inc, 2015) Duvan, Candan Iltemir; Simavli, Serap; Keskin, Esra Aktepe; Onaran, Yuksel; Turhan, Nilgun Ozturk; Koca, CemileObjective: The objective of the study was to compare pro-hepcidin, hemoglobin (Hb) concentration, hematocrit (Hct), C-reactive protein (CRP), IL-6 and iron status parameters in preeclamptic (PE) and healthy pregnant women, and to examine the relationship between serum pro-hepcidin levels and iron parameters of preeclampsia (PE). Methods: In a prospective controlled study, we collected serum from women with normal pregnancy (n = 37) and from women with PE (n = 30) at the Department of Obstetrics and Gynecology at Turgut Ozal University between February 2010 and January 2013. Pro-hepcidin, hemoglobin (Hb) concentration, hematocrit (Hct), CRP, IL-6 and iron status parameters were measured in all patients and compared between groups. Results: Levels of serum prohepcidin in PE and control groups were similar and amount 69.4 +/- 19.7 and 71.9 +/- 22.1 ng/ml, respectively. The difference was not statistically significant (p: 0.694). On the other hand, the study group had a statistically lower iron binding capacity (IBC), total iron binding capacity, transferin, total protein, albumin levels (p<0.05). No significant differences were found among prohepcidin, Hb concentration, Hct, iron, ferritin, IL-6, urea and creatine in both the groups. Conclusion: In pregnancies complicated by PE with normal values of hemoglobin and hematocrit, serum prohepcidin concentrations are similar to those observed in healthy pregnant women. The analysis revealed no significant correlations between prohepcidin level and serum iron, serum ferritin or transferrin in the PE.Öğe Oxidant and antioxidant status of human breast milk during lactation period(Springer France, 2015) Yuksel, Sevda; Yigit, Ayse Arzu; Cinar, Miyase; Atmaca, Nurgul; Onaran, YukselDue to the oxidative stress conditions at birth, newborn needs some immunological and antioxidative protection after birth. The present study was conducted to point out the oxidant and antioxidant activity of human breast milk throughout the lactation. For this purpose, the levels of malondialdehyde, nitric oxide, lactoferrin, superoxide dismutase, and catalase was determined in colostrum, transition milk, and mature milk. Milk samples were collected from 20 volunteer mothers at 24-48 h of delivery and 7 and 14 days after delivery. The skimmed milk was used for determination of the levels of malondialdehyde, nitric oxide, and lactoferrin and the activities of the catalase and superoxide dismutase enzymes. As the lactation period proceeded, the malondialdehyde level increased and the levels of nitric oxide and lactoferrin as well as the activities of catalase and superoxide dismutase decreased. Colostrum has a high antioxidant capacity, and these antioxidants decrease during the lactation period owing to the changing need of the growing infant. The results of this study revealed the importance of breastfeeding immediately after the birth to take the advantage of colostrum.Öğe Prohepcidin in maternal circulation: is it related to spontaneous preterm labor?(Tubitak Scientific & Technological Research Council Turkey, 2014) Onaran, Yuksel; Aktepe Keskin, Esra; Iltemir Duvan, Zehra Candan; Simavli, Serap Aynur; Koca, Cemile; Kafali, Hasan; Turhan, NilgunBackground/aim: To investigate whether spontaneous preterm labor (PTL) with intact membranes is associated with changes in maternal serum prohepcidin concentrations. Materials and methods: The study consisted of patients with spontaneous PTL with intact membranes (n = 25), a control group of healthy pregnant women between the 24th and 37th gestational weeks (n = 22), and uncomplicated term pregnancies in spontaneous labor (n = 19). Blood samples were collected from patients at the time of clinical diagnosis. Levels of prohepcidin, hemoglobin, serum ferritin, serum iron, unsaturated iron binding capacity, total iron binding capacity, transferrin and transferrin saturation, C reactive protein, and interleukin-6 were measured. Results: Patients with spontaneous PTL had significantly lower maternal serum prohepcidin concentrations than term delivery and control subjects. Conclusion: Maternal serum prohepcidin concentration is lower in patients with spontaneous PTL compared to term delivery and control subjects. This suggests that measuring maternal serum prohepcidin concentrations in PTL may be a feasible method for understanding etiologic causes of spontaneous preterm delivery, but, before suggesting this as a course of action, low levels of prohepcidin in patients with PTL need to be more fully investigated.Öğe Relationship between oxidant and antioxidant activity in hyperemesis gravidarum(Taylor & Francis Ltd, 2014) Onaran, Yuksel; Kafali, Hasan; Duvan, Candan Iltemir; Keskin, Esra; Celik, Hakim; Erel, OzcanObjective: To evaluate oxidant and antioxidant activity in patients with hyperemesis gravidarum (HG) by using serum total antioxidant activity (TAO), total free sulfhydryl (-SH), ceruloplasmin and lipid hydroperoxide (LOOH) levels. Materials and methods: In a cross-sectional trial, blood samples were collected from patients with HG (n = 25) and healthy pregnant women (n = 25) as control group. Serum TAO activities, -SH levels and LOOH levels and ceruloplasmin levels were measured. Results: Serum TAO activity was found to be significantly lower (p = 0.003) in patients with HG compared with controls. However, serum -SH levels, LOOH levels and ceruloplasmin levels did not change significantly in patients with HG compared to controls. Conclusion: Presence of oxidative stress in HG patients depends more on reduced antioxidant activities than increased oxidative stress.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.
