New legislation concerning assisted reproduction treatments was introduced in Turkey in March 2010 in order to reduce the number of multiple pregnancies. This new legislation limits the number of embryos to be transferred to one under 35 years of age in the first or second treatment cycles and to two in the third or further cycles or for 35 and older ages. The aim of this multicentre study was to investigate the effect of this new law on clinical pregnancy and multiple pregnancy rates. Outcomes were compared in equal periods of 2.5 months before and after the new law, and further investigation was conducted for two different age groups: <35 and ≥ 35. The clinical pregnancy rates decreased from 39.9 to 34.5% and multiple pregnancy rates decreased from 23.1 to 5.3% (P<0.001) for the overall population. The outcomes of the <35 age group and ≥ 35 age group were also similar to that of the overall population. These results suggest that under the new legislation multiple pregnancy rates are significantly reduced without causing a significant decline in the pregnancy rates.

This retrospective study reviews intraoperative and early complications of Burch colposuspension of 360 patients. Ten patients had massive haemorrhage and 8 of them had a blood transfusion. Three patients had a haematoma. Bladder injuries were noticed in 10 patients, 3 of whom were diagnosed postoperatively. One patient had unilateral ureteral kinking. Urinary retention occurred in 20 patients for more than 10 days and 2 required catheterization for 26 and 32 days respectively. Eighteen patients had a wound infection and 4 had a wound abscess. Twenty nine patients had a urinary infection. Urinary tract injury, haemorrhage and blood transfusion were significantly more common in women having secondary surgery than those having primary surgery. Deep venous thrombosis was diagnosed in 3 patients who had a Burch colposuspension with concomitant abdominal hysterectomy. Knowledge of possible risks and complications of Burch colposuspension may help plan a better preoperative work-up of patients and may minimize the intraoperative complications and increase surgical success and patient satisfaction.

Objective: Semen parameters are directly correlated with the infertility of the male. Incidence rates of male factor infertility, azoospermia and cryptozoospermia differ according to many factors such as geographic region, age, occupation and body weight. The aim of the present study is to determine the incidence of male factor infertility, azoospermia and cryptozoospermia among patients who have been admitted to three separate infertility clinics in Turkey for infertility investigation and analyze the outcomes of these patients. Material and methods:A total of 9733 men, who have been admitted to 3 infertility clinics in Turkey due to infertility between March 2011 and October 2016, were included in the study. Male infertility, azoozpermia and cryptozoospermia incidence were calculated according to WHO criteria. Results:Male factor infertility was determined in 3114 (32%) of the patients including cases with azoospermia and cryptozoospermia. Azoospermia cases were observed in 570 (5.85%) and cryptozoospermia in 850 (8.73%) men. Azoospermic, and cryptozoospermic patients constitute 18.3%, and 27.2% of the male infertility cases. Sperm retrieval rates in diagnostic or oocyte pick-up plus testicular sperm extraction groups were found to be comparable (16.39%, and 41.3%, respectively). Conclusion:The data obtained may help to estimate the number of in vitro fertilization cycles and TESE cases, to determine social security policies, and reproductive potential, and in the light of these data to establish social insurance policies. These data will help patients to decide on treatment alternatives, and guide the urologists about the issue.Keywords: Azoospermia; cryptozoospermia; infertility. ÖZAmaç: Semen parametreleri erkek infertilitesi ile direkt ilişkilidir. Erkek faktörlü infertilite, azoospermi ve kriptozoospermi insidansı coğrafi bölge, yaş, meslek ve vücut ağırlığı gibi birçok faktöre göre değişmek-tedir. Bu çalışmanın amacı, Türkiye'de 3 farklı infertilite kliniğine infertilite nedeniyle başvuran hastalar arasında erkek faktörlü infertilite, azoospermi ve kriptozoospermi oranlarını belirlemek ve bu hastaların sonuçlarını analiz etmektir. Gereç ve yöntemler:Mart 2011 ve Ekim 2016 tarihleri arasında, Türkiye'de 3 farklı infertilite kliniğine infertilite nedeniyle başvuran 9733 erkek çalışmaya alınmıştır. Bulgular:Hastaların 3114'ünde (%32) erkek faktörlü infertilite (azoospermi ve kriptospermi vakaları dahil) belirlenmiştir. Hastaların 570'inde (%5,85) azoospermi, 850'sinde (%8,73) kriptozoospermi belirlenmiştir. Azoospermi vakaları erkek infertilite vakalarının %18,3'ünü, kriptozoospermi vakaları ise %27,2'sini oluş-turmaktadır. Azoospermik ve kriptozoospermik hastalarda tanısal ya da oosit toplama işlemi ile eşlenik testiküler sperm ekstraksiyonu gruplarının sperm bulma oranları benzer (%16,39-%41,3 sırasıyla) bulunmuştur.Sonuç: Elde edilen sonuçlar in vitro fertilizasyon siklusu ve TESE vakalarını tahmin etmede ve bu veriler ışığında sosyal güvenlik politikalarının belirlenmesine, üreme potansiyelinin ...

Sperm or testicular tissue cryopreservation is performed in cases of male infertility as a treatment for the preservation of fertility. When these sperm cells are used in assisted reproductive techniques, fertilisation rates, developmental and implantation potential of embryos decrease and the abortion rates increase. In the present work, differences of both phosphorylation and expression levels of p53 and Mitogen-activated protein kinases (MAPK) proteins were analysed in 61 individual sperm samples before and after cryopreservation. We observed that p53 protein residue at Ser 15 was phosphorylated after cryopreservation. Because MAPK pathway activations may be involved in p53 phosphorylation, MAPK/ERK, Stress-activated protein kinases (SAPK)/JNK and p38MAPK proteins were also investigated. Analysis showed that p38MAPK phosphorylations increased significantly. However, ERK and JNK expressions and phosphorylations decreased, although the differences were not statistically significant. According to our results, it may be suggested that cryopreservation process activates p53 via p38 MAPK pathway that subsequently causes apoptosis, which may be related to sperm parameters.

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