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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.
  • 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.
  • Küçük Resim
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    Endometrial sampling in the absence of hysteroscopy: Insights from more than 1000 dilatation and curettage cases
    (Wiley, 2025) Şentürk, Şenol; Aydın, Gerçek; Can Bayrak, Çiğdem; Hatırnaz, Şafak; Stojković, Marta; Sparic, Radmila; Pecorella, Giovanni; Tinelli, Andrea
    Objectives: The aim of this epidemiological study is to present the distribution of histopathological results of endometrial biopsies performed for indications in women and their relationship with symptoms. Methods: A retrospective analysis was conducted on patients with abnormal uterine bleeding (AUB) assessed by endometrial biopsy between January 2020 and July 2022. Analyzing the distribution and association of patients' demographic traits, biopsy motivations, and histopathologic findings was the main goal of the study. Results: A total of 1216 patients were included in the study, and their average age was 48.48 ± 8.79 years. AUB was found to be the most common reason for biopsy (n= 616; 50.7%). The most common diagnosis among the histologic findings (320; 26.3%) was endometrial polyp. The most common symptoms among individuals with premalignant and malignant diseases were AUB, endometrial thickening, and postmenopausal hemorrhage. Additionally, it was determined that 21 (6.3%) postmenopausal patients had inadequate material. Conclusions: The most common histologic diagnosis from the procedure was endometrial polyp. It is important to make sure that the sample taken includes the entire uterine cavity because postmenopausal women may have insufficient biopsy samples. This is especially true if a hysteroscopy with biopsy cannot be performed (for a variety of reasons). In fact, suspect endometrial cancers should be thoroughly evaluated by hysteroscopy in patients with postmenopausal bleeding, endometrial thickness, and atypical uterine bleeding.