Amaç: İn vitro fertilizasyon (İVF) ve embriyonik manipülasyonlar yoluyla gebe kalan kadınlarda hormon kullanımı, pulmoner hipertansiyon olasılığı da dahil olmak üzere yenidoğanların sağlığıyla ilgili endişeleri artırmıştır. Bu nedenle bu çalışma, term İVF yenidoğanlarında pulmoner arter basıncını değerlendirmeyi amaçlamıştır. Gereç ve Yöntemler: Bu prospektif kesitsel çalışma Mart 2013 ile Ekim 2017 arasında gerçekleştirilmiştir ve 160 İVF yenidoğanı (grup 1) 160 doğal yolla olan yenidoğanla (grup 2) karşılaştırmaktadır. Her iki gruptaki yenidoğanlar, gebelik ve yenidoğan yaşı açısından eşleştirilmiş sezaryen ile doğan yenidoğanlardı. Yenidoğanlar üç-yedi günlük idi, 37-39 hafta ve 6 günlük tam dönem gebelik yaşına sahipti ve yenidoğanların doğum ağırlığı normal sınırlarda (2500-4000 g) idi. Sistolik pulmoner arter basıncı (SPAB), triküspit yetersizlik jetinin pik akış hızını temel alan gerçek zamanlı ekokardiyografi kullanılarak tahmin edildi. Bulgular: İki grup arasındaki ortalama SPAB açısından anlamlı bir fark gözlendi (p<0,001). Her ne kadar gestasyonel yaşın SPAB'yi düşürücü etkisi grup 1'de daha fazla ve istatistiksel olarak anlamlı olsa da, doğumdan sonra PAB'de kademeli azalma bu grupta daha yavaş gözlenmiştir. Ayrıca, her iki grupta da gebelik yaşının SPAB'yi düşürücü etkisi yenidoğan yaşına göre daha belirgindi. Ayrıca, her iki grupta da SPAB ile yenidoğan ağırlığı arasında anlamlı bir ters korelasyon gözlendi; ancak bu korelasyonun grup 1'de daha kuvvetli olduğu görüldü. Sonuç: Çalışmamız, İVF'yi yenidoğanlarda pulmoner hipertansiyon insidansında artış ile ilişkili bulmuştur. Bu nedenle, İVF yenidoğanlarında pulmoner
The aim of this study was to compare the effects of single-dose methotrexate (MTX) and salpingectomy on ovarian reserve in women with ectopic pregnancy in the late post-treatment period. A total of 181 patients were included in the study; 56 of them received a single-dose of MTX, 45 of them had undergone salpingectomy treatment for ectopic pregnancy in the previous 12-18 months, and 80 healthy women constituted an age-matched control group. The anti-müllerian hormone (AMH), follicle stimulating hormone (FSH) and oestrogen (E) levels, as well as antral follicle counts (AFC) of the patients were evaluated. The average age was similar in both groups (p = 0.094) and there was no statistically significant difference in the smoking status of the patients (p = 0.949). None of the three groups displayed a significant difference in terms of AFC (p = 0.528), AMH (p = 0.147), FSH (p = 0.393) and E levels (p = 0.117). In the treatment of ectopic pregnancy neither the single-dose MTX application nor the salpingectomy had any permanent detrimental effect on the ovarian reserve; serum AMH levels and AFC are unaltered in the long term following single-dose MTX or salpingectomy.
Objective: There are many predisposing factors associated with vaginismus, but there is lack of data in the literature regarding which and how of these factors influence the success rate of treatment. Our aim is to investigate the effects of factors that are considered as predisposing factors for vaginismus on treatment prognosis and success rate, with cognitive-behavioral therapy and desensitization exercises after sexual therapy.Methods: Patients with vaginismus were divided into three groups. Group 1: patients who successfully completed vaginal penetration exercises after sexual therapy and experienced vaginal sexual intercourse; Group 2: patients who started penetration exercises but could not reach success; Group 3: patients who discontinued treatment before starting exercises. Demographic and sexual parameters were compared between the groups.Results: There were statistically significant differences between the groups in terms of history of vaginismus in relatives (4.3%, 23% and 35.7%, p=0.047, respectively), the unsuccessful therapy history (69%, 61% and 21.4%, p=0.014, respectively), and anal and/or oral sex ratios (47.8%, 7.7% and 57.1%, p=0.019, respectively). Mean number of sessions were significantly higher in patients saying, "It is my fault" than among those perceiving it as a common problem (10.6±2.9 ve 7.5±5.7, p=0.042, respectively), and in patients with sexual disorder in their male partners than those not having any problem (13.3±3.7 ve 8.2±3.7, p=0.013, respectively). Conclusion:Patients are more resistant to treatment if they have a history of vaginismus among relatives or when one of the couple say, it is his or her fault.
Routine removal of cervical polyps, although not mandatory, seems clinically prudent because pathological evaluation is needed to confirm the diagnosis and to rule out other possibilities. 10.9% of postmenopausal patients and 7.8% of premenopausal patients were diagnosed with any endometrial pathology accompanying cervical polyp. Therefore, cervical polyps can be a sign of endometrial disease, especially in postmenopausal women with cervical polyp endometrium should be evaluated more carefully.
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