The management of poor responders in IVF has always been a big problem. The ideal approach has yet to be formulated. In this study we aim to compare two alternative stimulation protocols. A total of 48 poor responder patients described from previous cycles were included and grouped into two: group I consisted of 24 patients in 24 cycles in which leuprolide acetate (40 microg s.c. per day) was initiated on cycle day 2 followed by exogenous gonadotrophins on cycle day 3; group II consisted of 24 patients in 24 cycles in which ovarian stimulation included gonadotrophin-releasing hormone (GnRH) antagonist (cetrorelix, 0.25 mg daily during late follicular phase) administration. While only the oestradiol concentrations on the day of HCG were lower in group II compared with group I, the clinical pregnancy and implantation rates among groups did not show any significance. The impact of these two regimens in ovarian stimulation of poor responders seem to be same and to establish these results further randomized studies with larger sample sizes are required.

Concern about the use of gonadotrophin-releasing hormone (GnRH) agonists in ovarian stimulation of poor responder IVF patients has arisen from the claim that GnRH agonists might have a direct deleterious effect through their receptors on the ovary. In this study, we compared two ovarian stimulation protocols in which no GnRH agonists were used. In all, 40 patients with a poor response in previous treatment cycles were included. They were divided into two groups: group I (n = 20) received ovarian stimulation for 20 cycles, without the addition of either GnRH agonist or antagonist; while group II (n = 20) patients received ovarian stimulation for 20 cycles, including the administration of a GnRH antagonist (Cetrorelix, 0.25 mg daily) during the late follicular phase. There was no statistically significant difference between the groups for mean age, duration of infertility, baseline FSH concentration, cancellation rate, number of ampoules of gonadotrophin used, number of mature oocytes retrieved, oestradiol concentrations on the day of injection of human chorionic gonadotrophin (HCG), fertilization rate and number of embryos transferred. The clinical pregnancy and implantation rates in group II appeared higher than in group I, but were not significantly different (20 and 13.33% compared with 6.25 and 3.44% respectively). The addition of GnRH antagonists to ovarian stimulation protocols might be a new hope for poor responder IVF patients, but this report is preliminary and further controlled randomized prospective studies with larger sample sizes are required.

The purpose of this study was to assess the usefulness of sonohysterography in the detection of abnormalities of the uterine cavity in infertile patients, compared with other diagnostic methods. Transvaginal ultrasonography, sonohysterography, hysterosalpingography and finally hysteroscopy were performed in 37 patients with primary and 25 patients with secondary infertility. Suspected uterine anomalies were also confirmed by laparoscopy. Transvaginal ultrasonography and hysterosalpingography were able to detect 36.3 and 72.7% of uterine pathologies respectively. Sonohysterography was able to detect all the anomalies except for a single endometrial polyp (90.3%). However, there was no significant difference between the diagnostic capabilities of these methods. We recommend the use of sonohysterography as an easy, cheap and noninvasive method for the diagnosis of intrauterine pathologies in infertile patients.

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Günümüzde artan nüfus ve endüstrileşmeyle beraber, enerji tüketimi hızla artmaktadır. Günümüzde artan enerji talebini karşılayabilecek olan kömür rezervlerinin verimli işletilip, enerjide dışa bağımlılığın azaltılması için bilimsel ve teknolojik yöntemler kullanılmalıdır. Bu bağlamda, çevresel faktörleri de dikkate almak suretiyle etkin, verimli ve sürdürülebilir üretim yapmak ve çalışmalara hız verilmesi gerekmektedir. Türkiye Kömür İşletmeleri (TKİ) sekiz ayrı işletmeden oluştuğu için bu işletmelerin performanslarının değerlendirilmesinde kullanılmak üzere belirlenen kriterler her bir işletme için farklı değerler almaktadır. Böyle bir durumda da Çok Kriterli Karar Verme (ÇKKV) yöntemlerinin uygulanması tercih edilmektedir. Bu çalışmada; Türkiye Kömür İşletmeleri'ne ait sekiz işletmenin AHP temelli MULTIMOORA ve COPRAS yöntemleri ile performans değerlendirmesi amaçlanmıştır. 2008-2012 yıllarını kapsayan analizler için toplam satış, faaliyet karı, rezerv durumu, çalışan kişi sayısı, dekapaj miktarı, yatırım harcamaları ve üretim miktarı kriterleri dikkate alınmıştır.