Objective: to determine the effect of HUMSC administration on collagen expression in the anterior vaginal wall in menopause rats.
Materials and Methods: we conduct an experimental study with a randomized post-test only controlled group design. The samples were 40 female Winstar rat with inclusion criteria were healthy female Winstar rat that had been oovoriectomized, had never mated, aged 8 - 12 weeks, and weighed 18 - 22 grams. The umbilical cord was obtained from a voluntary donor who do not have a history of hepatitis B, hepatitis C, HIV, cytomegalovirus infection, treponema pallidum infection, or a history of other infections transmitted through the blood, placental tract and genitals. Data collection (anterior vaginal wall of the rat) is carried out in a controlled and controlled environment with the consideration that all conditions are maintained equally and can be controlled.
Results: There were 36 samples. A total of 13 menopausal rat (72%) had strong Collagen expression and 5 rat had weak-moderate Collagen expression (28%). In contrast, in the control group, 18 menopausal rat (100%) had weak-moderate Collagen expression and no menopausal rat appeared to have strong expression (0%). The administration of collagen to the anterior vaginal wall of postmenopausal rats can significantly increase the strong expression of collagen in the damaged anterior vagina of postmenopausal female rats (p<0.05).
Conclusion: Administration of HUMSC was proven to result in an increase in collagen levels in the anterior vaginal tissue of postmenopausal female rat. These results demonstrate significant therapeutic potential in the treatment of PFD.

Amaç: Bu çalışmanın amacı, azalmış over rezervi ile infertil hastaların depresyon eğilimi arasındaki ilişkiyi araştırmaktır.

Gereç ve Yöntemler: Bu kesitsel tek merkezli çalışma 106 infertil kadın ile yürütülmüştür. Hastaların depresyon eğilimini değerlendirmek için Beck Depresyon Envanteri (BDE) kullanıldı. İnfertilite ile ilgili veriler: infertilite nedenleri, infertilite tipi (primer ve sekonder), infertilite süresi, tedavi durumu (önceki yardımcı üreme teknolojileri (YÜT) tedavisi ve YÜT tedavi başarısızlığı) her hasta için kaydedildi. Over rezervi laboratuvar testleri (AMH; FSH) ve her bir overdeki antral folikül sayısını (AFC) ölçmek için transvajinal ultrasonografi kullanılarak belirlendi.

Bulgular: Beck depresyon ölçeğinden elde edilen toplam puan ile AFC, AMH, TSH, FSH, E2 ve prolaktin ölçümleri arasında anlamlı bir ilişki yoktu (p > 0,05). İnfertilite nedenine göre depresyon düzeyleri açısından gruplar arasında anlamlı bir fark bulunmamıştır (p=0,412). Ek olarak infertilite tipine (primer, sekonder) göre gruplar arasında farklılık yoktu (p=0,586). YÜT tedavisi gören (daha önce YÜT tedavisi başarısızlığı öyküsü olan) ve görmeyen hastalar arasında depresyon düzeyi için BDI ölçeğinde fark yoktur.

Sonuç: AFC ve AMH düzeyleri ile infertil hastaların depresyon durumu arasında anlamlı bir ilişki saptanmadı.

Objective: This study aimed to explore the relationship between reduced ovarian reserve and the psychological state of infertile patients.

Materials and Methods: This cross-sectional single-center study was conducted with 106 infertile women. The Beck Depression Inventory (BDI) was used to assess patients' propensity for depression. The data relating to infertility, such as causes of infertility, type of infertility (primary or secondary), the duration of infertility, and treatment status (previous assisted reproductive technologies (ART) treatment and ART treatment failure) were recorded for each patient. The ovarian reserve was determined using laboratory tests (AMH; FSH) and transvaginal ultrasonography to measure antral follicle count (AFC) in each ovary.

Results: There was no significant relationship between the total score obtained from the Beck depression scale and the AFC, AMH, TSH, FSH, E2, and prolactin measurements (p > 0.05). There was no significant difference between the groups regarding depression levels based on the cause of infertility (p=0.412). Additionally, the type of infertility (primary, secondary) did not differ between the groups (p=0.586). There were no differences on the BDI scale regarding the level of depression between patients who underwent IVF treatment (history of previous IVF treatment failure) and those who did not.

Conclusion: There is no significant association between AFC and AMH levels and the depression state of infertile patients.

Amaç: Bu çalışmada, PCOS'lu kadınlarda insülin direnci olanlarda myoinositol tedavisinin (günde 4 g myoinositol + 400 mcg folik asit) metformin (ortalama 1700 mg/gün) ile karşılaştırılması ve bu iki tedavinin kombinasyonunun etkinliğinin incelenmesi amaçlanmıştır.
Materyal ve Metod: Üreme çağındaki 68 insülin direnci olan PCOS hastasının 3 aylık hasta kayıtları incelenmiştir. Oral glikoz tolerans testleri (OGTT) (75 gr) 0 ve 120 dakikada glikoz düzeylerini, prolaktin, Tiroid Uyarıcı Hormon (TSH), yüksek yoğunluklu lipoprotein (HDL), düşük yoğunluklu lipoprotein (LDL), trigliserid, total kolesterol, folikül stimüle edici hormon (FSH), luteinizan hormon (LH), total testosteron, serbest testosteron, dehidroepiandrosteron sülfat (DHEA-S) düzeylerini ölçülmüş ve tedavinin ardından 3 ay sonra değerlerle karşılaştırılmıştır.
Sonuçlar: Tüm gruplarda adet düzeni, vücut kitle indeksi (VKİ), modifiye Ferriman Gallwey skorları, OGTT'nin 0. ve 120. dakikadaki glikoz düzeyleri, total testosteron, serbest testosteron, dehidroepiandrosteron sülfat (DHEA-S) düzeylerinde istatistiksel olarak anlamlı bir iyileşme gözlenmiştir (p<0.005).
Sonuç: VKİ, modifiye Ferriman Gallwey skorları ve azalan androjen düzeyleri açısından üç grup arasında fark bulunmamıştır. Myoinositolün metformin ile kombinasyonu, metformin veya yalnızca myoinositol kadar fayda sağlamamıştır.

Purpose: The aim of this study was to compare the efficacy of myoinositol (4 g myoinositol + 400 mcg folic acid/day) with metformin (average 1700 mg/day) and the effectiveness of their combination in treating insulin-resistant PCOS in women.
Material and Method: We retrospectively analyzed the records of 68 reproductive-age PCOS patients with insulin resistance over a 3-month period. Oral glucose tolerance tests (OGTT) (75 gr) were conducted to measure glucose levels at 0 minutes and 120 minutes. Additionally, levels of prolactin, Thyroid Stimulating Hormone (TSH), high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, total cholesterol, follicle stimulating hormone (FSH), luteinizing hormone (LH), total testosterone, free testosterone, dehydroepiandrosterone sulfate (DHEA-S) were compared before and after the 3-month treatment period.
Results: Statistically significant improvements were observed in menstrual regularity, body mass index (BMI), modified Ferriman Gallwey scores, OGTT glucose levels at 0 and 120 minutes, total testosterone, free testosterone, and DHEA-S levels across all groups (p<0.005).
Conclusion: There were no significant differences in terms of BMI, modified Ferriman Gallwey scores, or androgen levels among the three treatment groups. The combination of myoinositol and metformin did not confer additional benefits compared to either treatment alone.

Background: Hydrosalpinx impairs the success of in-vitro fertilization (IVF) embryo transfer. Various surgical approaches, such as fluid aspiration or isolation of the affected Fallopian tubes, have been utilized to enhance the outcome. This study was conducted to evaluate and compare the efficacy of Laparoscopic Tubal Disconnection (LTD) versus Hydroscopic Tubal Electrocoagulation (HTE) for hydrosalpinx prior to IVF.
Methods: After obtaining ethical committee approval, we assessed 112 subfertile women due to hydrosalpinx to check their adherence to our selection criteria. Eligible patients were allocated into 2 groups (LTD vs. HTE). Both groups underwent extensive assessment prior to the operative procedure. IVF and subsequent embryo transfers were done in both groups. Live birth and pregnancy rates were evaluated.
Results: Patients who underwent LTD prior to IVF embryo transfer have significantly higher live birth (41%), clinical pregnancy (57%), and chemical pregnancy (61%) rates in the LTD group compared to the HTE group (12%, 35%, 41%, respectively). However, we could not find a significant difference between the 2 groups regarding the miscarriage (17% vs. 28%, p= 0.33) and multiple pregnancy (14% vs. 12%, p= 0.79) rates. No major complications with HTE except for a case of uterine perforation, while 2 cases of surgical complications occurred in the LTD group. Additionally, we found a significantly shorter operative time and hospital stay (0.5±0.7 days, p= 0.012) in the HTE group.
Conclusion: Laparoscopic tubal disconnection may be a more effective approach compared to hysteroscopic tubal electrocoagulation for improving birth and pregnancy rates in IVF patients with hydrosalpinx.
Keywords: hydrosalpinx, tubal infertility, IVF, embryo transfer, laparoscopy.

Amaç: Adenomyozis, östrojen bağımlı kronik inflamatuar bir durumdur. D vitamini, kronik hastalıklardaki immün düzenleyici etkilerinin yanı sıra normal hücre büyümesinin düzenlenmesinde de rol oynar. Çalışmamızda histopatolojik olarak adenomyozis tanısı koyulan hastaların serum 25-OH vitamin D düzeyleri ile klinik ve laboratuvar parametreler arasındaki olası ilişkileri değerlendirmeyi amaçladık. Materyal ve metot: Çalışmamızda Ocak 2019 - Kasım 2022 tarihleri arasında histerektomi yapılan ve histopatolojik olarak adenomyozis tanısı konulan 168 kadın ile adenomyozis tanısı konulmayan 168 kadın retrospektif olarak değerlendirildi. Başvuru sırasında demografik, klinik ve labaratuvar verileri kaydedildi. Dismenorenin şiddetini değerlendirmek için her hastada vizüel analog skala puanı(VAS) hesaplandı. Bulgular: Adenomyozis grubunda vizüel ağrı skoru ortalaması 6, kontrol grubu vizüel ağrı skoru ortalaması ise 3 saptanmış olup gruplar arasında anlamlı fark saptanmıştır(p<0.001). Adenomyozis grubunda hastaların mean platelet volüme değeri 8.6 fL, kontrol grubundakilerin ise 7,2 fL saptanmış olup, adenomyozis grubunda anlamlı yüksek saptanmıştır (p<0.001). Adenomyozis grubunda hastaların CA-125 değeri 63,5 U/mL, kontrol grubundakilerin ise 15.6 U/mL saptanmış olup, adenomyozis grubunda anlamlı yüksek saptanmıştır (p<0.001). Adenomyozis grubunda hastaların 25-OH-D vitamin seviyesi 12,6 ng/ml, kontrol grubundakilerin ise 19.1 ng/ml saptanmış olup, kontrol grubunda anlamlı yüksek saptanmıştır. Sonuç: Literatürdeki çalışmalar ile uyumlu olarak, çalışmamız düşük D vitamini düzeyleri ile adenomyozis arasındaki ilişkiyi güçlü bir şekilde desteklemektedir. Çalışmamız, adenomyozisde gen ekspresyonları ve sitokinleri içeren, hücresel ve sinyal yollarının düzenlenmesinde D vitamininin rolünü öne süren çalışmalarla tutarlı olmuştur. Bununla birlikte D vitamininin adenomyozisdeki terapötik etkinliğini değerlendiren veriler şüpheli olduğundan ileri çalışmalara ihtiyaç vardır.

Objective: Adenomyosis is a chronic inflammatory illness that depends on estrogen.As well as its immune regulatory effects in chronic diseases,vitamin-D also plays roles in regulating normal cell growth.In the present study,the purpose was to evaluate the possible relationships between 25-OH-vitamin-D levels and clinical, laboratory parameters in patients who were diagnosed with adenomyosis histopathologically.Materials and methods: A total of 168 females with a hysterectomy history between January 2019-November 2022 and were histopathologically diagnosed with adenomyosis and 168 women who were not diagnosed with adenomyosis were evaluated retrospectively in the present study.The demographic, clinical, laboratory data were recorded at the time of admission.Visual Analogue Scale(VAS) were calculated for each patient to evaluate the severity of dysmenorrhea.Results: There was a significant difference between the groups in terms of VAS: the adenomyosis group scored an average of 6,whereas the control group scored an average of 3(p<0.001).The average platelet volume value of the patients was 8.6fL in the adenomyosis group,and that of the control Group was 7.2fL,and it was detected to be significantly elevated in the adenomyosis group(p<0.001).The CA-125 value of the patients was 63.5U/mL in the adenomyosis group, and that of the control Group was 15.6U/mL,and it was detected to be significantly rised in the adenomyosis group(p<0.001).The 25-OH-vitamin-D level of the patients was 12.6ng/ml in the adenomyosis group,and that of the control Group was 19.1ng/ml, and it was detected to be significantly elevated in the control Group.Conclusion: The current investigation provides compelling evidence for the association between low vitamin-D levels and adenomyosis,which is in line with other research in the field.The current study's findings are in line with other research that suggests vitamin-D regulates cellular and signaling networks, including those that control cytokines and gene expression during adenomyosis.However,further studies are needed since data assassing the therapeutic efficacy of vitamin-D in adenomyosis are questionable.

Background and introduction: The association between occupational exposure during pregnancy and the subsequent development of asthma in their children has always been a matter of debate and the results of cohort studies on this issue have been controversial. The best of our knowledge, this is the first systematic review and meta-analysis that aims to evaluate the risk of developing subsequent asthma in children based on maternal occupational exposure in the gestation period.
Materials and Methods: In order to retrieve eligible studies, an advanced literature search was performed up to August 10,2023 from the following databases: PubMed, Scopus, and Google Scholars. The title and abstract of related articles were screened hence the full texts there reviewed. Data extraction was conducted, hence the included articles where analysis to assess the mention association
Results: From total of 10 cohort studies with a total record of 5372 it was found that there's no significant relationship between maternal occupational exposure to asthmogens during pregnancy and later asthma in children. The pooled odds ratio of asthmatic children in patients with maternal occupational exposure to asthmogens during pregnancy was 1.03 (95% Confidence interval,0.97-1.09) I2= 13% P=0.62
Conclusion It was concluded that there's no significant association between maternal occupational exposure and future asthma in children. However, future large scaled studies are still required to support these results.

Objectives: To evaluate clinical outcomes of laparoscopic and hysteroscopic surgical approaches in the treatment of symptomatic isthmocele and identify their associated factors.
Materials and Methods: Forty-six patients with symptomatic isthmocele diagnosed using transvaginal saline infusion sonohysterography were enrolled in this prospective cohort study. Patients underwent either laparoscopic or hysteroscopic isthmoplasty based on their residual myometrial thicknesses and fertility desires and were subsequently followed by clinical and ultrasonographic examinations.
Results: Twenty-two patients underwent laparoscopy, while twenty-four patients underwent hysteroscopic surgery. At baseline, there was no significant difference in mean age and years since the last cesarean section between the two groups. However, the hysteroscopy group had higher mean parity and previous C/Ss (p = 0.00, 0.03). The most common symptoms were abnormal uterine bleeding, infertility, and dysmenorrhea. The mean baseline residual myometrial thickness was significantly higher in the laparoscopy group (p = 0.00) and only the laparoscopic surgery led to a significant residual myometrial thickness increase in patients (p = 0.00). Both procedures significantly reduced abnormal uterine bleeding (p = 0.00), but only laparoscopy reduced infertility (p = 0.00), and hysteroscopy reduced dysmenorrhea (p = 0.03). Hysteroscopy showed better symptom resolution in younger patients (p = 0.01), while age did not affect laparoscopy outcomes.
Conclusion: Both approaches showed similar effectiveness in resolving abnormal uterine bleeding, with laparoscopy excelling in infertility resolution and hysteroscopy in dysmenorrhea resolution.

Kaf basıncı, tüp boyutu ve entübasyon süresi, stenoz için en önemli risk faktörleridir. COVID-19 pandemisi sırasında, entübe takip ettiğimiz 14 gebe hastamızın dördünde trakeal stenoz tespit ettik. Bu hastaların tamamı pron pozisyona alınmış ve üç hasta reintube edilmişti. Gebelik sırasında üst havayolu ile ilgili fizyolojik değişiklikler pron pozisyonun komplikasyonlarıyla birleştiğinde, trakeal stenozun diğer hastalara göre gebe hastalarda daha erken ve daha sık görülebileceğini gözlemledik. Bu nedenle, entübe takip edilen gebe hastalarda kaf basıncına özen gösterilmeli, reentübasyondan kaçınılmalı, pron pozisyon dikkatli uygulanmalı ve trakeal stenoz akılda tutulmalıdır.

Cuff pressure, tube size and duration of intubation are the most important risk factors for stenosis. During the COVID-19 pandemic, we identified tracheal stenosis in four of our 14 intubated pregnant patients. All of these patients were placed in the prone position, and three patients were reintubated. When the physiological changes in the upper airway during pregnancy are combined with the complications of the prone position, tracheal stenosis may occur earlier and more frequently in pregnant patients than in other patients. Therefore, special attention should be paid to cuff pressure in intubated pregnant patients, re-intubation should be avoided, the prone position should be carefully applied, and tracheal stenosis should be kept in mind.

An international randomized trial comparing radical hysterectomy and(RH)vs simple hysterectomy(SH) in patients with low-risk early-stage cervical cancer recently published in NEJM by Plante et al. and we read it with great interest. Although the literature does not include any relevant randomized trials, early-stage cervical cancers are traditionally treated using the radical hysterectomy (RH) technique pioneered by Ernst Wertheim and others >100 years ago. Nowadays, efforts to reduce the complications and morbidity associated with RH, and improve patient quality of life post surgery are ongoing; therefore, we appreciate the SHAPE Trial researchers’ efforts to improve our knowledge of this topic and improve patient outcomes. The SHAPE Trial researchers performed a non-inferiority trial that included 130 centers in 12 countries, comparing simple hysterectomy (SH) and RH in patients with low-risk cervical cancer (lesions ≤2 cm with limited stromal invasion). They noted that, “SH was not inferior to RH with respect to the 3-year incidence of pelvic recurrence and was associated with a lower risk of urinary incontinence or retention”. It is well known that each year almost 600,000 cases of cervical cancer occur worldwide, of which nearly 80% are in undeveloped or developing countries. Although the researchers wrote that their results cannot be generalized to developing countries, as practicing gynecologic oncologists from a developing country we also think that some patients with cervical tumors <2 cm might benefit from and urgently need less radical surgery, especially in low resource settings in which there is limited or no screening or radiotherapy facilities, nor operative infra-structure or trained gynecologic oncologists. In contrast to what was written, we strongly think that clinicians in developing and undeveloped countries can make good use of the SHAPE Trial findings; however, before we can reach a definitive conclusion, we have some criticisms and concerns about the Trial, as detailed below, that we think must be addressed.

An international randomized trial comparing radical hysterectomy and(RH)vs simple hysterectomy(SH) in patients with low-risk early-stage cervical cancer recently published in NEJM by Plante et al. and we read it with great interest. Although the literature does not include any relevant randomized trials, early-stage cervical cancers are traditionally treated using the radical hysterectomy (RH) technique pioneered by Ernst Wertheim and others >100 years ago. Nowadays, efforts to reduce the complications and morbidity associated with RH, and improve patient quality of life post surgery are ongoing; therefore, we appreciate the SHAPE Trial researchers’ efforts to improve our knowledge of this topic and improve patient outcomes. The SHAPE Trial researchers performed a non-inferiority trial that included 130 centers in 12 countries, comparing simple hysterectomy (SH) and RH in patients with low-risk cervical cancer (lesions ≤2 cm with limited stromal invasion). They noted that, “SH was not inferior to RH with respect to the 3-year incidence of pelvic recurrence and was associated with a lower risk of urinary incontinence or retention”. It is well known that each year almost 600,000 cases of cervical cancer occur worldwide, of which nearly 80% are in undeveloped or developing countries. Although the researchers wrote that their results cannot be generalized to developing countries, as practicing gynecologic oncologists from a developing country we also think that some patients with cervical tumors <2 cm might benefit from and urgently need less radical surgery, especially in low resource settings in which there is limited or no screening or radiotherapy facilities, nor operative infra-structure or trained gynecologic oncologists. In contrast to what was written, we strongly think that clinicians in developing and undeveloped countries can make good use of the SHAPE Trial findings; however, before we can reach a definitive conclusion, we have some criticisms and concerns about the Trial, as detailed below, that we think must be addressed.

Objective: To evaluate the possible association of two single nucleotide polymorphisms (SNPs) including PD-1.3 (+7146G/A-rs11568821) and PD-1.5 (+7785C/T-rs2227981) with endometrial cancer (EC) susceptibility. In addition, the correlations between these SNPs and available clinicopathologic characteristics of EC patients were investigated.
Materials and Methods: This case-control study included 147 women with pathologically confirmed EC and 258 age- and ethnic-matched healthy women between June 2019 and May 2022. Genomic DNA was extracted, and genotyping of PD-1.3 (rs11568821) and PD-1.5 (rs2227981) SNPs was carried out. Haplotype analysis was also performed. Differences in allele and genotype distributions were assessed using Pearson's chi-square test with Yates correction. An unconditional logistic regression model was used to calculate the 95% confidence interval (CI) and odds ratio (OR).
Results: There were no remarkable differences in allele and genotype distributions of PD-1.3 (rs11568821) and PD-1.5 (rs2227981) between EC patients and healthy controls. However, there was a remarkable difference in AC haplotype between EC patients and the control group. No association was also found between the investigated SNPs and clinicopathologic features of EC.
Conclusion: Our results indicated that the aforementioned SNPs were not associated with the risk of EC in the Iranian population.

Objective: Endometriosis is a common condition among women and can cause complications such as abdominal pain, dysmenorrhea, and infertility. One of the potential causes of this disease is autoimmunity. However, the evidence regarding the role of autoimmunity is conflicting and inconclusive. The aim of this study is to investigate whether autoantibodies, a sign of autoimmunity, are present in people suffering from endometriosis.
Materials and methods: Relevant studies up to April 14, 2023 were identified by systematically searching Scopus, PubMed, Web of Science, Embase, and Google Scholar. This meta-analysis includes all qualified case-control studies of human populations that analyze the association between serum autoantibodies and endometriosis patients. The odds ratios and 95% confidence intervals were computed. Additionally, heterogeneity and publication bias were examined, and subgroup analyses were performed based on region and target antigens.
Results: Forty-one studies were included, comparing 2825 Endometriosis patients to 4158 healthy controls. The meta-analysis findings indicated a significant association between the presence of autoantibodies in the serum and an increased susceptibility to endometriosis (OR: 4.242, CI 95%: 3.824-4.706, P< 0.001). Also, it has been found that there is a significant correlation between the presence of endometriosis and the serum levels of anti-nuclear antibodies (ANA), B2 glycoprotein 1, CA125, carbonic anhydrase I, cardiolipin, endometrial, laminin-1, smooth muscle, and syntaxin autoantibodies. Upon further analysis, it has been found that the serum levels of these autoantibodies are higher in patients with endometriosis from North America, compared to those from other regions (P= 0.001).
Conclusion: The study has revealed a significant correlation between serum autoantibodies and susceptibility to endometriosis, highlighting autoimmunity as a potential cause.

Objective:
Endometriosis is a prevalent condition in women that causes pelvic pain and fertility issues due to the growth of endometrial tissue outside the uterus during menstrual cycles. Since steroid hormones play a crucial role in the development and growth of endometriosis lesions, researchers have investigated several effective drugs that target hormones for treating this disease. One such drug is Bazedoxifene, but despite several animal studies, there has yet to be a comprehensive evaluation of their combined results.
Materials and Methods:
A systematic search was conducted across several databases (Embase, PubMed, Scopus, and Web of Sciences) to identify the studies investigating the effectiveness of bazedoxifene on animal models of endometriosis. Meta-analysis was performed using the size of endometriosis implants before and after drug administration in case and control groups, along with the p-value of the associations. Begg's and Egger's tests were used to assess publication bias.
Results:
This research included four eligible studies consisting of 45 endometrial animal models and 35 control subjects. The meta-analysis shows that bazedoxifene significantly reduces the size of endometriosis implants in animal models when compared to the control group (OR: 0.122, 95% CI: 0.050-0.298, P < 0.001). Detailed investigation determined that there is no significant heterogeneity between the studies (I2=38.81, and P-value of the Q test=0.179). However, according to Egger's test, the study showed publication bias (P= 0.035).
Conclusion:
This study found that bazedoxifene is a promising treatment option for endometriosis in animal models. However, more research on animals and humans is needed to confirm these results.