Longer anogenital distance in female fetus of diabetic and obese pregnant women.

OBJECTIVE: Previous studies revealed that prenatal exposure to androgen excess such as polycystic ovary syndrome (PCOS) is associated with offspring's anogenital distance (AGD) length, and AGD is a biomarker of intrauterine androgen exposure. This study aims to investigate a possible relationship of fetal AGD with maternal diabetes and obesity, and to evaluate whether AGD predicts the fetal androgen exposure related to diabetes and obesity in female fetus. This study is the first to focus on the relationship between offspring's AGD and maternal diabetes and obesity. MATERIALS AND METHODS: This is a prospective study investigating 218 pregnant women (125 in control group and 93 in study group). Fetal AGD was measured from the center of anus to the posterior convergence of the fourchette by ultrasound. Multivariate linear regression analysis was applied to assess the association of the fetal AGD length with maternal diabetes and obesity. RESULTS: The control patients had significantly shorter fetal AGD (mean:10.7 mm, P < 0.001) compared to diabetic, obese and diabetic obese patients (mean: 12.6 mm, 12.8 mm and 12.9 mm, respectively). The results of regression analysis showed that both maternal diabetes and obesity were significantly correlated with longer AGD in female fetus. The results confirmed also that offspring's AGD measurement in utero by ultrasound is feasible and reliable. CONCLUSION: The study findings suggest that both maternal diabetes and obesity are associated with intrauterine androgenic milieu during pregnancy, and fetal AGD may be used as a biomarker to predict this effect. This may provide important advantages in terms of early detection of reproductive system abnormalities related to prenatal androgen exposure.

Prediction of gestational diabetes using deep learning and Bayesian optimization and traditional machine learning techniques.

The study aimed to develop a clinical diagnosis system to identify patients in the GD risk group and reduce unnecessary oral glucose tolerance test (OGTT) applications for pregnant women who are not in the GD risk group using deep learning algorithms. With this aim, a prospective study was designed and the data was taken from 489 patients between the years 2019 and 2021, and informed consent was obtained. The clinical decision support system for the diagnosis of GD was developed using the generated dataset with deep learning algorithms and Bayesian optimization. As a result, a novel successful decision support model was developed using RNN-LSTM with Bayesian optimization that gave 95% sensitivity and 99% specificity on the dataset for the diagnosis of patients in the GD risk group by obtaining 98% AUC (95% CI (0.95-1.00) and p < 0.001). Thus, with the clinical diagnosis system developed to assist physicians, it is planned to save both cost and time, and reduce possible adverse effects by preventing unnecessary OGTT for patients who are not in the GD risk group.

A prospective study for gestational diabetes mellitus: Analysis of risk factors in Turkish women for early prediction.

OBJECTIVE: To define risk factors for the early prediction of gestational diabetes mellitus (GDM) because the risk of pre-eclampsia and preterm birth increases in mothers who are diagnosed with GDM. MATERIALS AND METHODS: A prospective study was designed and the data were collected by physicians prospectively from the patients who came to the clinic between the years 2019 and 2021; informed consent was obtained from the women. The prospective data comprised 489 patient records with 72 variables and the risk factors for early prediction of GDM were determined using logistic regression and random forest (RF), which is an advanced analysis method. RESULTS: The obtained sensitivity and specificity values are 90% and 75% for logistic regression and 71% and 90% for the RF, respectively. CONCLUSION: In this prospective study of GDM in Turkish women; age, body mass index, level of hemoglobin A1c, level of fasting blood sugar, physical activity time in first trimester, gravidity, triglycerides, and high-density lipoprotein cholesterol were confirmed to be risk factors in analysis results.

Non-invasive evaluation of meibomian gland morphology and tear film and anterior segment parameters in women with polycystic ovarian syndrome.

PURPOSE: To compare the meibomian glands (MG), non-invasive tear film break-up time (NITBUT), and corneal and anterior segment measurements in patients with polycystic ovary syndrome and healthy women. METHODS: The study included 66 polycystic ovarian syndrome (PCOS) patients and 42 healthy volunteers aged 18-35 years. The first and average NITBUT, MG loss, mean keratometry (Km), central (CCT) and thinnest (TCT) corneal thicknesses, anterior chamber depth (ACD), anterior chamber volume (ACV), irido-corneal angle (ICA), corneal volume (CV) and Ocular Surface Disease Index (OSDI) results were analyzed. RESULTS: The mean MG loss values were 29.9 ± 11.9 and 20.8 ± 11.0 in the PCOS and control groups, respectively (p < 0.001). MG loss (meiboscale ≥ 1) was determined in 64 (96.9%) eyes in the PCOS group and in 36 (85.7%) eyes in the control group. There was no significant difference between the groups in respect of NITBUT, OSDI, Km, CCT, TCT, ACD, ACV, ICA and CV values (p > 0.05, for all). CONCLUSION: MG loss is a physiological process which is distinct in PCOS patients, but does not cause tear film alterations. Further studies are needed to show the contributing factors of MGD in PCOS patients.

Is sexual dysfunction associated with periodontal status in perimenopausal women?: A pilot study.

OBJECTIVE: The current study aimed to investigate the possible relationship between periodontal status and sexual dysfunction in perimenopausal women. MATERIALS AND METHODS: This study was conducted on 106 participants. After the evaluation of the sexual functioning of participants with the Female Sexual Function Index (FSFI), their periodontal status and decayed-missing-filled teeth (DMFT) were assessed using appropriate indexes and obtained results were recorded for comparisons. Participants were divided into two groups by the periodontal status. Patients with periodontitis were grouped by the stage and the extent of the disease. Besides, participants were grouped according to the bleeding on probing (BOP) ratios for more detailed analyses. RESULTS: A negative significant correlation was observed between total FSFI scores and each of the clinical periodontal parameters. Total FSFI scores and the scores of arousal, lubrication, orgasm, satisfaction, and pain domains were significantly lower in periodontitis patients (p < .05). When the patients were grouped as having localized or generalized periodontitis or whether they had stage-I, -II, and -III periodontitis, no statistically significant differences were observed in the distribution of general sexual dysfunction parameters across the groups (p > .05). CONCLUSION: Periodontal status in perimenopausal women may be associated with sexual dysfunction.

The effects of Coronavirus disease-2019 (COVID-19) pandemic on routine antenatal care visits and complications of pregnancy.

OBJECTIVE: Routine follow-up of pregnancy is a comprehensive care process starting from planning of pregnancy that involves rational and careful use of medical, psychological, and social support. In this study, our objective was to compare the adherence rate to routine antenatal follow-up program during the COVID-19 pandemic with that of previous years among pregnant women, in an effort to shed light on health policies to be developed similar events in the future. METHODS: This retrospective cross-sectional study was carried out between March 11, 2019, when isolation measures were initiated in the context of precautionary steps taken in Turkey against the COVID-19 pandemic, and June 1, 2020, when the "normalization" was initiated. RESULTS: During the study period in 2020, the proportion of cesarean sections were higher, 61.1%, as compared to previous years (p=0.27). The stillbirths were numerically lower (1.2%, p=0.77), but the rate of spontaneous abortions was significantly higher (19.6%, p=0.009). The number of follow-up visits per pregnancy was lower than in previous years (3.8, p=0.02), although the proportion of patients visiting the outpatient units for regular controls to the overall patient group increased as compared to previous years (52.0%). CONCLUSION: During the flare-up of the COVID-19 pandemic (i.e. between March and June 2020), the rate of obstetric/neonatal morbidity and mortality except spontaneous abortion was not significantly higher as compared to the corresponding period in previous years. However, considering the potential increase in the risk of obstetric complications during a pandemic, specialized management programs targeting basic pregnancy follow-up services should be developed.

Levels of anxiety sensitivity, somatosensory amplification and alexithymia in patients with unexplained infertility.

OBJECTIVE: In this study, we aimed to focus on the psychological aspect of unexplained infertility by comparing their psychological features to those of infertile patients with a known causes and fertile patients. PATIENTS AND METHODS: Sixty unexplained infertility patients, 50 infertile patients with a known cause and 56 fertile patients were included in the study. Patients were evaluated using socio-demographic data form, Toronto Alexithymia Scale (TAS-20), Somatosensory Amplification Scale (SAS) and Anxiety Sensitivity Index (ASI-3). RESULTS: No significant differences in the levels of alexithymia, somatosensory amplification and anxiety sensitivity were detected between the groups (P > .05). When the correlation of clinical scale scores with each other was analysed in the whole group of infertile patients regardless of the cause, a weak positive correlation was found between anxiety sensitivity and difficulty in identifying feelings. CONCLUSION: In our study, it has been found out that; regardless of the knowledge of the aetiology of infertility, the levels of alexithymia, somatosensory amplification and anxiety sensitivity of infertile cases did not differ from those of fertile women. However, it has been shown that as the difficulty in identifying emotions increases in infertile cases, anxiety sensitivity, which may cause psychological infertility, also increases.

The level of depression, anxiety, and sleep quality in pregnancy during coronavirus disease 2019 pandemic.

AIM: We aimed to evaluate the mental health and sleep quality of pregnant women in different trimesters during coronavirus disease 2019 (COVID-19) pandemic and investigate the effect of quarantine and new lifestyle changes that come into our lives with pandemic with on this subject. METHODS: It was conducted on pregnant women (n = 149) who attended routine pregnancy prenatal visit during their pregnancy weeks. The data were collected using sociodemographic and clinical data form, Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) to evaluate maternal depression and anxiety. RESULTS: A significant correlation was observed between the week of gestation and depression, anxiety, and defective sleep scores (p < 0.001). A moderate positive correlation was found between the week of gestation and depression (r: 0.628). A high level of positive correlation was found between the week of gestation and defective sleep quality and anxiety scores (r: 0.858, r: 0.754). A statistically significant increase in depression, anxiety, and defective sleep quality was found in the group staying in home quarantine (p = 0.002). CONCLUSION: This study showed that the COVID-19 pandemic can cause depression, anxiety, and serious sleep disorders in pregnant women. The depression and anxiety scores of pregnant women in home quarantine were also found to be higher than the group not in quarantine. As the week of gestation progresses, mental health symptoms worsen and sleep quality deteriorates.

The effects of Coronavirus disease-2019 (COVID-19) pandemic on routine antenatal care visits and complications of pregnancy

SUMMARY OBJECTIVE: Routine follow-up of pregnancy is a comprehensive care process starting from planning of pregnancy that involves rational and careful use of medical, psychological, and social support. In this study, our objective was to compare the adherence rate to routine antenatal follow-up program during the COVID-19 pandemic with that of previous years among pregnant women, in an effort to shed light on health policies to be developed similar events in the future. METHODS: This retrospective cross-sectional study was carried out between March 11, 2019, when isolation measures were initiated in the context of precautionary steps taken in Turkey against the COVID-19 pandemic, and June 1, 2020, when the "normalization" was initiated. RESULTS: During the study period in 2020, the proportion of cesarean sections were higher, 61.1%, as compared to previous years (p=0.27). The stillbirths were numerically lower (1.2%, p=0.77), but the rate of spontaneous abortions was significantly higher (19.6%, p=0.009). The number of follow-up visits per pregnancy was lower than in previous years (3.8, p=0.02), although the proportion of patients visiting the outpatient units for regular controls to the overall patient group increased as compared to previous years (52.0%). CONCLUSION: During the flare-up of the COVID-19 pandemic (i.e. between March and June 2020), the rate of obstetric/neonatal morbidity and mortality except spontaneous abortion was not significantly higher as compared to the corresponding period in previous years. However, considering the potential increase in the risk of obstetric complications during a pandemic, specialized management programs targeting basic pregnancy follow-up services should be developed.

Periodontal and caries status in unexplained female infertility: A case-control study.

BACKGROUND: The aim of this study was to investigate the possible association between maternal periodontal disease and dental caries that affect oral health and unexplained infertility. METHODS: This cross-sectional case-control study included 50 fertile women and 50 women with unexplained infertility aged 21 to 39 years. Dental and periodontal parameters were examined to evaluate the oral health of the participants. According to the new periodontal disease classification, periodontitis severity was determined. RESULTS: In infertile women, the number of advanced caries lesions, the percentage of bleeding on probing (BOP), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were higher (P < 0.05). The DMFT and mean plaque index (PI) were not statistically different between the two groups. The PISA and PESA values were higher in women with unexplained infertility than in fertile women (P = 0.005 and P = 0.002, respectively). In multivariate analysis showed that association of DMFT and BOP variables with periodontitis was found to be significant for all women included in the study and for infertile women only (P = 0.000 and P = 0.012 for DMFT, respectively; P = 0.000 and P = 0.016 for BOP, respectively). CONCLUSION: The chronic inflammatory environment caused by periodontitis and advanced carious lesions in women with unexplained infertility should be of great concern as it may have a role in the etiology of infertility.

Hyperandrogenism in polycystic ovary syndrome affects psychological well-being of adolescents.

AIM: Polycystic ovary syndrome (PCOS) is a common endocrinological disorder in reproductive age and criterion have recently been revised for adolescent age group. Research regarding effects of PCOS on psychological well-being is limited; and majority of the studies are conducted in adult patients. We aimed to examine psychological effects of PCOS in adolescents who are diagnosed using latest criterion. METHODS: Cases were divided into PCOS and control groups according to their clinical, ultrasonographical and biochemical features. Beck depression inventory (BDI), State & Trait Anxiety Inventory (STAI-I/II), Self-Confidence Scale (SCS), Multidimensional Peer-Victimization Scale (MPVS) and Social Anxiety Scale for Adolescents (SAS-A) were used in psychiatric evaluation. RESULTS: There were no statistically significant differences between groups regarding psychiatric scale scores. However, several biochemical parameters (dehydroepiandrosterone sulfate, 17-hydroxyprogesterone) and clinical (Ferriman-Gallwey score [FGS]) of hyperandrogenism affected certain indicators of psychological well-being such as social anxiety, low self-esteem and peer victimization. In some psychiatric scales, biochemical indicators were found correlated while clinical indicators were not. CONCLUSION: Similar psychiatric scale scores between groups may indicate preliminary stages for adolescent PCOS in which endocrinological, physical and social factors have not yet reached their full potential for their effect on emergence of psychological problems; thus making this age group critical for interventions of prevention measures. In addition, while examining the effects of PCOS on psychological well-being, biochemical parameters of hyperandrogenism might be as effective as physical manifestations (FGS); and high levels of biochemical parameters of hyperandrogenism might also affect psychological state.

Protective effect of edaravone against radiation-induced ovarian injury: a histopathological and immunohistochemical evaluation in an experimental rat model.

PURPOSE: We aimed to evaluate the protective effect of edaravone on radiation-induced ovarian damage in an experimental rat model. METHODS: Thirty-two Wistar albino female rats were randomly divided into four groups. Group 1: control, no treatment, and radiation was applied throughout the study; Group 2: sham, only radiation was applied; Group 3: 45 mg/kg edaravone and radiation were applied; Group 4: 450 mg/kg edaravone and radiation were applied. Edaravone was administered intraperitoneally 30 min before radiotherapy (5 Gy). Two days after radiation exposure, the rats were sacrificed and the ovaries were removed. Histologic changes under light microscopy and immunoreactivity for anti-caspase-3 were noted and compared between the four groups. RESULTS: There was a statistically significant difference in follicle counts, vascular congestion, edema, cytoplasmic vacuolization, hemorrhage, and interstitial cell degeneration between the groups. Radiation causes deterioration in most histopathological parameters. Administration of edaravone at different doses seems to reverse these alterations and alleviate the injury. Antioxidant defense mechanisms appear to be enhanced by edaravone as shown by histopathologically and decreased apoptosis by reducing the expression of anti-caspase-3 activity as demonstrated immunohistochemically. CONCLUSION: This is the first study evaluating the protective effects of edaravone on radiation-induced ovarian damage. Edaravone decreased the follicular apoptosis and attenuates the radiation-induced ovarian damage in rats.

Saliva resistin as a screening marker of gestational diabetes mellitus.

OBJECTIVE: The aim of this study was to evaluate the resistin concentrations in saliva; which is a noninvasive and stress-free diagnostic sample, and to investigate the significance of salivary resistin concentrations in screening GDM. METHODS: This cross-sectional case-control study included 41 newly diagnosed GDM patients and 40 healthy pregnant. The participants were consecutively included in the study among eligible pregnant women; who were in the age range from 18 to 40 years of age and at the gestational age between 24 and 28 weeks. The levels of serum and salivary resistin were determined using an enzyme-linked immunosorbent assay method. RESULTS: Maternal serum resistin and salivary resistin concentrations were significantly higher in the patients with GDM compared to the individuals in the control group. The data were evaluated by the receiver-operator curve analysis; which revealed that serum and saliva resistin concentrations were moderately successful markers to differentiate subjects with GDM from healthy pregnant women. CONCLUSIONS: The results indicate that the determination of saliva resistin levels at the gestational age between 24 to 28 weeks may be used as an alternative, stress-free, and noninvasive technique that may be used in GDM screening.

COVID-19 Pregnant Patient Management with a Case of COVID-19 Patient with An Uncomplicated Delivery.

Pregnancy has always been a concern in epidemics all over the world. While coronavirus (COVID-19) disease ravages the world, it is a big curiosity how pregnant women will be affected by this disease. There are a few published case series and commentary of COVID-19 occurring during pregnancy. In this study, we discussed how to manage this disease in pregnant women. A 38-week pregnant, 37-year-old woman whose father passed away from COVID-19 admitted to the hospital with dyspnea, nonproductive cough, and fever. She had positive radiological features for COVID-19, and her rapid antibody test was positive. Lopinavir-ritonavir combination and azithromycin treatments were given, and the patient's symptoms regressed with treatment. The patient was taken to cesarean by providing isolation conditions, and she had a healthy baby with an uncomplicated delivery. There are no certain data about whether COVID-19 infection is worse in pregnant patients or not. On the basis of the limited data in the literature, we cannot see intrauterine transmission from infected mother to baby. However, we know that there would be serious pulmonary complications for the infected mother. Fortunately, the severe acute respiratory syndrome coronavirus 2 infection did not progress more severely in pregnant women than in the normal population compared with the previous severe acute respiratory syndrome outbreak.

Protective effects of nebivolol on ovarian ischemia-reperfusion injury in rat.

AIM: Ovarian torsion is a common gynecological emergency of reproductive ages, occurring at rates of 2.7-7.4%. This study aimed to evaluate the antioxidant effects of Nebivolol (NEB) and histopathological changes in experimental ischemic (I) and ischemic-reperfusion (I/R) injury in rat ovaries. METHODS: Forty-eight adult female rats were randomly separated into six groups as group 1 (control) receiving an oral saline solution for 3 days; group 2 (I) that underwent ischemia for 3 h with the application of atraumatic vascular clips; group 3 (I/R); group 4 (I + NEB) receiving 10 mg/kg NEB by oral gavage 30 min prior to the ischemia induction; group 5 (I/R + NEB) receiving 10 mg/kg NEB, and group 6 (control + NEB) receiving oral 10 mg/kg NEB for 3 days before ischemia induction followed by consequent reperfusion. Ovarian tissue damage was scored by histopathological analysis. Ovarian tissue malondialdehyde (MDA) and glutathione (GSH) levels were measured biochemically. RESULTS: The levels of MDA and tumor necrosis factor-alpha (TNF-α), and TUNEL assay positivity scores increased in the I and I/R groups. GSH levels decreased in all case groups (P < 0.05). The oral administration of NEB (10 mg/kg) to the I- and I/R-groups reduced the levels of MDA and TNF-α and TUNEL assay immunopositivity scores (P < 0.05). GSH levels increased in the treatment groups. CONCLUSION: The current experimental ovarian torsion study suggests a protective role for NEB against I and I/R injury in rat ovaries. NEB may be a novel agent for decreasing ovarian I/R injury.

The role of serum interleukin-37 levels, inflammation and blood pressure in patients with preeclampsia.

AIM: Preeclampsia is one of the major causes of perinatal, fetal, and maternal mortality and morbidity. The aim of this study was to investigate the association of serum interleukin 37 (IL 37) with preeclampsia. METHODS: 39 women with preeclampsia were included as the study group. 38 healthy, and normotensive pregnant women, at similar gestational week with similar gravidity volunteered as the control group. Clinical findings, biochemical parameters, maternal and perinatal outcomes, and the serum concentrations of IL37 were compared between the groups. The relationship of IL 37 concentrations with clinical findings and blood pressure outcomes were also investigated. RESULTS: Maternal serum IL 37 concentrations were significantly higher in patients with preeclampsia compared to the healthy pregnant women in the control group (p = .005). IL 37 positively correlated systolic blood pressure (BP) (r = 0.344, p = .002), and diastolic BP (r = 0.332, p = .003). IL 37 was identified as an independent predictor of preeclampsia. CONCLUSIONS: Serum IL 37 concentrations were higher in preeclamptic patients compared to healthy pregnant women. Furthermore, IL 37 concentrations achieved success in identifying preeclampsia with hypertension. Increased IL 37 activity may have a role in the pathophysiology of preeclampsia.

Evaluation of periodontal status in different phenotypes of polycystic ovary syndrome in untreated patients of early reproductive age: A case-control study.

AIM: A few studies demonstrated an increased risk of periodontal disease in patients with polycystic ovary syndrome (PCOS). The aim of this study was to evaluate the periodontal status in women of reproductive age who were recently diagnosed with different phenotypes of PCOS. METHODS: This prospectively designed cross-sectional case-control study included 116 consecutive subjects with PCOS and 90 healthy volunteers, aged between 18 and 24, who were admitted to the gynecology polyclinic between April 2018 and December 2018. All subjects of PCOS diagnosed using the Rotterdam criteria were subdivided into four phenotypes based on clinical, biochemical and ultrasonographic parameters according to the guidelines of the National Institutes of Health. The same dentist investigated periodontal parameters including plaque index, gingival index, bleeding on probing (%), probing depth, clinical attachment loss and the decayed, missing, filled teeth index. RESULTS: Probing depth, a periodontal parameter, was higher in all sub-phenotypes of the PCOS group compared to the control group. There was no difference in other periodontal parameters. CONCLUSION: Periodontal probing depth, which is an important parameter in the diagnosis of periodontal diseases, was higher in all phenotypic subgroups of PCOS in early reproductive age.

Evaluation of serum apelin-13 and apelin-36 concentrations in preeclamptic pregnancies.

AIM: Recent studies suggest that apelin can be a novel potential therapeutic mediator to improve the diagnosis, and treatment of preeclampsia. This study aimed to investigate the association of serum apelin-13 and apelin-36 with preeclampsia and to detect their relationship with preeclampsia-associated perinatal morbidity. METHODS: Forty-four women with preeclampsia were included as the study group. Forty-four healthy pregnant women, at similar gestational week with similar gravidity, formed the control group. The clinical findings, biochemical indicators, maternal and perinatal outcomes, and the serum concentrations of apelin-36 and apelin-13 were evaluated. The levels of apelin-13 and apelin-36 were determined with commercial kits using a competition-based enzyme-linked immunosorbent assay method. RESULTS: The mean gestational age at sampling was 35.77 ± 2.515 weeks in the preeclamptic group, 36.45 ± 2.057 weeks in the control group (P = 0.270). Maternal serum apelin-36 and apelin-13 concentrations were significantly lower in patients with preeclampsia compared to the individuals in the control group (P = 0.030 and P = 0.005, respectively). The optimal cut-off points of apelin-36 and apelin-13 measurements for discriminating between preeclampsia and controls were evaluated by the receiver-operator curve analysis. The results showed that apelin-13 and apelin-36 are moderately successful markers to differentiate subjects with preeclampsia from healthy pregnant women. The concentrations of apelin-13 and apelin-36 in both groups were not statistically different in cases with and without adverse fetal/neonatal outcomes. CONCLUSION: In conclusion, we investigated serum apelin-13 and apelin-36 concentrations in preeclamptic patients and demonstrated markedly lower maternal concentrations compared to healthy pregnant women.

Asprosin: a novel peptide hormone related to insulin resistance in women with polycystic ovary syndrome.

Asprosin associated with insulin resistance is a newly discovered peptide hormone. The peptide promotes hepatic glucose production. Polycystic ovary syndrome (PCOS) is a metabolic disorder. Insulin resistance plays a vital role in the pathogenesis of the disease. The aim of this study was to discover the association between insulin resistance and asprosin in women with PCOS. We recruited 78 subjects with PCOS and 78 age-matched and body mass index (BMI)-matched controls into this cross-sectional study. Circulating asprosin levels were validated using ELISA method. We also determined metabolic and hormonal parameters of the involved subjects. We found that circulating asprosin levels were elevated in women with PCOS with respect to controls. Asprosin levels showed a positive correlation with insulin resistance, BMI, and free androgen index (FAI). Moreover, subjects with the highest tertile of asprosin levels represented increased odds of having PCOS as compared to those subjects with the lowest tertile asprosin levels. Increased asprosin levels resulted to high possibility of having PCOS risk associated with insulin resistance.

Pregnancy outcome of laparoscopic tubal reanastomosis: retrospective results from a single clinical centre.

Objective Tubal sterilization is a widespread method of contraception. Post-sterilization regret is encountered, despite careful consideration prior to the procedure. Two treatment options are available for women after having had tubal sterilization: microsurgical reversal and IVF treatment. Recent improvements in laparoscopy have allowed tubal reanastomosis to be performed. This study aimed to evaluate the reproductive outcome after laparoscopic tubal reanastomosis and surgical features of the patients. Methods From June 2007 to January 2010, 27 patients with bilateral tubal ligation who underwent laparoscopic tubal reanastomosis were evaluated retrospectively. Tubal sterilization was performed by Pomeroy's technique during caesarean section in all of the patients. Before surgery, all of the patients were evaluated for possible other causes of infertility and the results of the evaluation were normal. Results The mean age of the patients was 31.8 years (range, 27-38 years). The mean interval between sterilization and reversal was 5.1 years (range, 1-14 years). Bilateral reversal was achieved in 24 patients. The operation time ranged from 85 to 140 minutes with a mean time of 105 minutes. All of the patients were discharged on the next day. There were no postoperative complications. Overall pregnancy, intrauterine pregnancy, and ectopic pregnancy rates were 55.5% (15/27), 51.8% (14/27), and 3.7% (1/27), respectively. Of the 14 intrauterine pregnancies, one ended with abortion at 6 weeks' gestation (1/14). The mean interval from surgery to pregnancy was 270 days (range, 147-420 days). Conclusion Laparoscopic tubal reanastomosis has the advantages of fewer complications, less postoperative discomfort, a smaller incisional scar, a shorter recovery time, and earlier resumption of normal activities. This technique has a satisfactory pregnancy rate in selected patients who desire reversal of tubal sterilization.