In vitro fertilization results of GNRH antagonists and medroxyprogesterone acetate used to prevent premature LH surge during ovarian hyperstimulation.

The aim of this study was to evaluate the effects of medroxyprogesterone acetate (MPA) treatment in comparison to those of gonadotropin releasing hormone (GnRH) antagonists for the prevention of premature luteinizing hormone surges during controlled ovarian hyperstimulation (OS) and the impact of these effects on developing embryos and pregnancy outcomes. Data from 757 cycles of GnRH antagonist treatment and 756 cycles of MPA treatment were evaluated at the Akdeniz University Faculty of Medicine Assisted Reproductive Treatment Center between October 2018 and April 2022. Patient records were obtained from the electronic database of the centre and analysed. In our centre, GnRH antagonist protocols were used between 2018 and 2020, and MPA protocols were used between 2020 and 2022. We chose our study population by year. Our study is a comparative retrospective study. All methods in this study were performed in accordance with the relevant guidelines and regulations. Patients using MPA were significantly older (33.9 ± 5.6 vs. 32.6 ± 5.6, p < 0.001) and had a lower number of antral follicles (AFC) (10.7 ± 8.6 vs. 11.9 ± 10.8, p = 0.007) than those using GnRH antagonists. Both MPA (2.9%) and GnRH antagonists (2.2%) had similar effectiveness in preventing premature ovulation (p = 0.415). There was no significant difference between the two groups in terms of the number of total developed embryos (1.3 ± 1.3 vs. 1.2 ± 1.2, p = 0.765). There was no significant difference in the clinical pregnancy rates with the first ET (%35.4 vs. %30.1, p = 0.074), per total number of transfers (35.3% vs. 30.1%, p = 0.077). MPA was found to be effective at preventing premature ovulation during OS treatment, and the incidence of developing embryo and pregnancy outcomes in patients using MPA were similar to those in patients using GnRH antagonists. Therefore, the use of MPA instead of GnRH antagonists during OS may be a viable alternative for patients not scheduled for fresh ET.

Risk factors that increase recurrence in borderline ovarian cancers.

OBJECTIVE: In this study, we aimed to compare the clinical and pathological results of borderline ovarian tumor cases that were operated on in our clinic within the last 15 years and to investigate the factors affecting recurrence. MATERIALS AND METHODS: The archived files of the patients with borderline ovarian tumors, who had been operated on at the Akdeniz University Medical Faculty Gynecological Oncology Unit between 2006 and 2020 were retrospectively reviewed. A total of 48 cases were identified and included in the study. Oncological results affecting relapse were evaluated using univariate and multivariate analysis models. Disease-free survival was assessed using the Kaplan-Meier method. RESULTS: The median follow-up period of the 48 patients included in our study was 51.5 months and while the shortest follow-up was 2 months, the longest follow-up period was 164 months. The mean age of the patients was 47.6 ± 12.5 years, and the mean BMI was found to be 27.2 ± 3.7. Of the patients, 19 (39.6%) were post-menopausal, and when all stages were included, the 10-year progression free survival (PFS) was 65%, while the 10-year overall survival (OS) was 96.6%. It was observed that 8 (16.6%) patients encountered recurrence during their follow-up. The multivariate analysis of significance found for the operation type, adjuvant chemotherapy and micro-invasion in the univariate analysis of clinical pathological characteristics with regard to recurrence, fertility-sparing surgery and micro-invasion were determined to have a significant difference in recurrence (p: 0,016, p: 0,048). CONCLUSION: Borderline ovarian tumors are especially seen in young patients and although their clinical prognosis is very good, a significant difference was found in recurrence in patients who had undergone fertility-sparing surgery, in whom the micro-invasion was positive and in those receiving adjuvant chemotherapy, and disease-free survival was shorter in these patients and close follow-up of these patients is recommended.

Uterine cervical involvement of non-Hodgkin lymphoma: Rare cause of postcoital bleeding.

It should be kept in mind that non-Hodgkin lymphoma may involve uterine cervix and a multidisciplinary approach should be adopted.