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  • Küçük Resim
    Yayın
    A pilot investigation on possible interactions between clinical parameters and the psychology of couples undergoing IVF
    (Wiley, 2025) Aydın, Gerçek; Bülbül, Mehmet; Ergin, Elif; Aydin, Ayşe Gül; Akkaya, Cengiz; Hatırnaz, Şafak; Tinelli, Andrea
    Objective: To investigate the potential reciprocal influences between in vitro fertiliza tion (IVF) and the psychological states of patients. Materials and Methods: A prospective cohort study involved 180 couples who sought consultation for IVF. To monitor the fluctuations in the emotional states of the cou ples throughout the IVF process, questionnaires were administered on two separate occasions: the first was conducted immediately before the initiation of medication, and the second was administered promptly following the completion of embryo trans fer. The BECK inventories for anxiety and depression were employed for evaluation. Pregnancy outcomes were exclusively analyzed for women who received high-quality blastocysts, with cleavage-stage embryo transfers being excluded from consideration. Results: Pregnancy rates did not significantly differ based on the presence of height ened anxiety and/or depression among couples. Notably, a correlation was identified between severe anxiety in women before IVF and diminished rates of fertilization, as well as lower blastocyst/oocyte and blastocyst/metaphase II (M2) ratios (8.7 ± 5.0 vs. 7.5 ± 6.1, P= 0.029; 0.284 ± 0.199 vs. 0.218 ± 0.209, P= 0.001; and 0.333 ± 0.209 vs. 0.272 ± 0.232, P= 0.016, respectively). In the male cohort, elevated anxiety scores, ei ther pre- or post-IVF treatment, were found to be linked with a reduced mean oocyte count, as well as lower rates of M2, fertilization, blastocyst, and total embryo counts (P< 0.05). Conclusions: Pregnancy rates were not affected by the presence of anxiety and de pression, as they do not exert a significant impact on the implantation success of blas tocysts. However, given that fertilization rates are statistically diminished in instances of severe anxiety, which consequently results in a reduced number of blastocysts and total embryos, a decline in cumulative pregnancy rates may be anticipated.
  • Küçük Resim
    Yayın
    Considering its mechanism of action it may be logical to choose letrozole as an initial option for endometrium preparation before vitrified-warmed embryo transfer
    (Wiley, 2025) Aydın, Gerçek; Aslan, Kiper; Araç, Merve; Ergin, Elif; Kasapoğlu, Işıl; Uncu, Gürkan
    Aim: To assess the efficacy of letrozole and programmed hormone replacement therapy (HRT) cycles in terms of obstetric outcomes for women undergoing a single vitrified-warmed blastocyst embryo transfer (SVBT). Methods: This study is a retrospective study conducted in a private IVF (in vitro fertilization) clinic. A total of 324 FET cycles (letrozole group = 183, HRT = 141), consisting of primary infertile patients aged <40 years, were enrolled. The cycle characteristics, pregnancy results, and perinatal parameters were recorded. The primary outcomes of this study are pregnancy and miscarriage rates, live birth rates, whereas hypertensive disease of pregnancy (HDP), intrauterine growth restriction (IUGR) and preterm birth are the secondary outcomes. Results: Positive β-HCG rates were 53% (97/183) versus 61% (86/141), whereas clinical pregnancy rates were 47% (86/183) versus 51.1% (72/141) for the letrozole and HRT groups, respectively. For clinical miscarriage, the results were 6.5% (12/183) for letrozole versus 15.6% (22/141) for HRT groups, which were statistically significant. For live birth rate (LBR), letrozole was found to be slightly better compared to HRT 40.4% (74/183) versus 35.5% (50/141). Considering the perinatal outcomes, the parameters were comparable between the groups. Conclusions: In terms of perinatal outcomes and IVF success, letrozole was not found to be inferior to HRT. Letrozole can be utilized as a safe and effective agent, even as a first-line treatment, given the potential benefits offered by its mechanism of action and being a reasonable option for both ovulatory and unovulatory patients.
  • Kapalı Erişim
    Yayın
    Efficacy-oriented approach for medium-sized follicles: A perspective on stimulation, expectation, and triggering strategy in IVF cycles
    (Wiley, 2026) Aydın, Gerçek; Ergin, Elif; Araç, Merve; Bülbül, Mehmet; Çalışkan, Eray; Hatırnaz, Şafak; Dahan, Michael; Malvasi, Antonio; Tinelli, Andrea
    Objective: To assess the therapeutic significance of routinely aspirating mid-sized fol licles (14.0–16.9 mm) during oocyte pick-up (OPU) by looking at procedural efficiency and embryo usage in cycles with varied follicular cohorts. Methods: In vitro fertilization (IVF) cycles with follicles classified as large (≥17 mm) or mid-sized (14.0–16.9 mm) at the time of OPU were included in this prospective cohort. Each group's oocytes were extracted and treated independently while main taining rigorous traceability. Analysis was performed on embryologic results, opera tive time factors, and embryo transfer utilization across successive transfer attempts. Pregnancy outcomes and the length of the operation were investigated. Laboratory results pertaining to trigger strategies were assessed descriptively. Results: When measured per mature oocyte, oocytes from mid-sized follicles showed comparable fertilization and blastocyst development rates. However, only a small percentage of embryo transfers included embryos from mid-sized follicles, especially in the initial two transfer attempts. Large follicles had a longer total OPU duration, and cycles that resulted in miscarriage had significantly longer operative times among large-follicle-derived embryo transfers. For mid-sized follicles, there were no differ ences in the length of the procedure based on the pregnancy outcome. Conclusion: The contribution of mid-sized follicle-derived oocytes to embryo trans fer selection seems to be restricted in everyday practice, despite their reassuring laboratory competence. Procedural efficiency is a potentially significant factor in customized IVF care, as evidenced by the correlation between longer operating times and worse clinical outcomes. In certain clinical situations, a focused stimula tion and aspiration approach might be suitable without obviously jeopardizing cu mulative results.