Deceased donor uterus transplantation is a reasonable approach for treating uterine factor-related infertility. In case of recurrent pregnancy failures in uterine-transplant patient, presence of venous outfl ow obstruction could be checked before removing the graft. Vascular revision may increase the possibility of ongoing pregnancies.

Introduction. Many patients who were diagnosed as polycystic ovary syndrome- (PCOS-) related acne were not capable of sustaining or beginning oral contraceptive pills (OCPs) due to pill scaring, contraindications of OCP use, migraine, or smoking. In this situation, oral isotretinoin treatment may become an important option for PCOS-related acne. The aim of the study was to determine the effects of isotretinoin treatment on PCOS patients who were complicated with severe cystic acne. Materials and Methods. This study consisted of 40 female patients diagnosed as PCOS complicated with severe cystic acne. These patients were not eligible candidates for OCP use due to migraine, thrombophilia, heavy smoking, or pill scare. To establish baseline values of hormone levels, on days 2–5 of the menstrual cycle, venous blood samples were obtained. Moreover Modified Ferriman-Gallwey (mFG) score, acne score (AS), follicle count, and bilateral ovarian volumes were evaluated both before and after isotretinoin treatment. Results. Isotretinoin treatment significantly decreased Ferriman-Gallwey score, free testosterone, insulin level, hemoglobin level, acne score, and ovarian volume. Increased triglyceride and cholesterol levels were detected after treatment. Conclusion. Isotretinoin treatment may have beneficial effects on free testosterone, insulin, acne score, and Ferriman-Gallwey score. Solely isotretinoin administration may supply adequate healing in PCOS patients’ symptoms complicated with severe cystic acne who is not eligible candidates for OCP use. This trial is registered with Clinicaltrials.gov NCT02855138.

Background We investigated the roles of inflammatory cytokines and the A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) family in the etiopathogenesis of spontaneous preterm delivery by comparing the ADAMTS4, ADAMTS5, interleukin (IL)-6, and tumor necrosis factor-α (TNF-α) levels in second-trimester amniotic fluid between pregnant women with preterm birth and term controls. Methods All pregnant women who underwent second-trimester amniocentesis for genetic analysis between January 1, 2016, and January 1, 2018, were enrolled in this study. From this cohort, 22 patients who subsequently experienced spontaneous preterm delivery before 34 weeks of pregnancy formed the study group, and 22 age- and body mass index (BMI)-matched patients without preterm birth constituted the control group. Results No significant differences were observed between the preterm birth and control groups in terms of age, BMI, obstetric history of preterm delivery, gestational age at amniocentesis, or indication for amniocentesis. The mean amniotic fluid levels of ADAMTS4 and ADAMTS5 were significantly increased in the preterm birth group compared to the control group (248.3±22.6 and 182.4±19.8 pg/mL, P=0.012; and 198.6±21.6 and 159.1±21.7 pg/mL, P=0.035, respectively). Significantly increased IL-6 and TNF-α levels were also detected in the amniotic fluid of women who experienced spontaneous preterm delivery, relative to controls (142.1±16.2 and 95.8±16.4 pg/mL, P<0.001; and 139.4±12.5 and 89.6±11.2 pg/mL, P<0.001, respectively). Conclusion The results of this study imply that increased mid-trimester amniotic fluid levels of ADAMTS4, ADAMTS5, IL-6, and TNF-α play an important role in the pathophysiology of spontaneous preterm delivery.

Objective: To assess the working conditions and current challenges of the gynecology assistants in Turkey and to propose solutions within this context. Materials and methods: A survey on the problems of assistant doctors and the solution proposals they offered was executed with gynecology assistants who serve at the teaching, research and university hospitals in different regions of Turkey. Results: 60 gynecology assistants from 7 training institutions (university and teaching research hospitals) were included in the study. 75% of the participants (n:45) prefered gynecology as their first choice in the medical specialty exam. 51% of the survey participants(n:31)were satisfied with their existing conditions. The main problem was determined as severe working conditions by 43% of the participants. (n:26) Based on the answers of 42% of the participants(n:25), malpractice was observed as the leading concern following the specialty. Furthermore, setting rules on duty hours and daily leave after duty as well as arranging working hours were the common opinion of assistant doctors with regard to the solution proposals to the working conditions. Additionally, issuing assistant report cards and boosting participation in conferences and scientific research activities were other prevailing opinions of the assistant doctors when it comes to reducing training problems. Discussion: It is striking that under the current circumstances, assistant gynecologists are discontent with strenuous working environment and inadequate training. The common proposed solution is to initiate standardization in all training agencies across Turkey.

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