Background: Homeobox genes A10 (HOXA10) and A11 (HOXA11), members of the abdominal B gene family, are responsible for embryonic survival and implantation. This study was planned to investigate whether endometrial injury alters the expression of both transcripts in women with implantation failure. Methods: A total of 54 women with implantation failure were divided into two equal groups as experimental (scratching) and sham (no scratching). Participants in the scratching group were exposed to endometrial injury in the mid-luteal phase, and those in the sham group were exposed to endometrial flushing. The scratching group, but not the sham group, underwent prior endometrial sampling. A second endometrial sampling was performed on the scratching group in the mid-luteal phase of the following cycle. The mRNA and protein levels of the HOXA10 and 11 transcripts were determined in endometrial samples collected before and after injury/flushing. Participants in each group underwent IVF/ET in the cycle after the second endometrial sampling. Results: Endometrial injury caused a 60.1-fold (p < 0.01) increase in HOXA10 mRNA and a 9.0-fold increase in HOXA11 mRNA (p < 0.02). Injury resulted in a significant increase in both HOXA10 (p < 0.001) and HOXA11 protein expression (p < 0.003). There was no significant change in HOXA10 and 11 mRNA expressions after flushing. Clinical pregnancy, live birth, and miscarriage rates of the both groups were similar. Conclusions: Endometrial injury increases homeobox transcript expression at both mRNA and protein levels.

Objective: To investigate the changes in serum ghrelin and leptin levels in patients with clomiphene-resistant polycystic ovary syndrome (PCOS). Materials and Methods: Thirty-five patients who could not achieve ovulation or pregnancy despite using 150 mg/day of clomiphene citrate (CC) participated in the study. Thirty-five patients who were compatible with the study group in terms of age and body mass index (BMI) but did not have clinical and laboratory findings of PCOS constituted the control group. On the third day of the cycle, in addition to the basal hormone profile, ghrelin and leptin levels were also measured. Patients in both groups went to IVF/ICSI. Basal hormone values, leptin, ghrelin, metabolic, demographic parameters, and clinical pregnancy rates were correlated. Results: Patients in both groups were recorded to be similar in terms of age (29.4 +/- 0.11 vs 28.5 +/- 7.30), BMI (24.3 +/- 3.07 vs 23.8 +/- 1.55), and infertility time (6.14 +/- 4.30 vs 6.03 +/- 1.28). Serum ghrelin levels of the PCOS group were significantly lower than the control group (0.48 +/- 2.21 vs 1.19 +/- 4.02) Serum leptin levels of the PCOS group were significantly higher than the control patients (45.6 +/- 304 vs 16.5 +/- 0.32). Serum leptin levels and BMI (r=0.65, p<0.01) A positive correlation was found between luteinizing hormone (LH) (r=0.53, p<0.02), and insulin resistance (r=0.74, p<0.03). There was a negative (r=-0.76, p<0.03) correlation between serum ghrelin and LH. A positive and significant correlation was found between serum ghrelin, testosterone, mature oocre, and implantation rates. Conclusion: Serum ghrelin correlates with fertility outcomes in women with CC-resistant PCOS undergoing IVF/ICSI.

To investigate whether prior endometrium spectroscopy predicts the success of embryo transfer in patients with recurrent implantation failure (RIF). Twenty women with RIF who were scheduled for IVF-ET and six fertile women were included the study. All women with RIF and fertile controls underwent endometrium spectroscopy before embryo transfer. A multi-voxel spectroscopy sequence was used for the detection of choline (Cho), creatine (Cr), lactate, and lipids. Women with RIF were divided into two subgroups as successful (n = 8) and unsuccessful RIF (n = 12) according to both Cho and Cr metabolite characteristics and whether pregnancy was achieved. Associations between the metabolite intensities of the RIF subjects and the implantation rate (IR) and clinical pregnancy rate (CPR) were assessed. While 8 of 20 RIF cases became pregnant, pregnancy could not be achieved in 12 cases. The common spectroscopy finding in all 8 cases who conceived was high Cho and low lactate. The main metabolite change detected in 12 patients who could not conceive was the increase in lactate and lipid signals. The cutoff value of Cho, Cr, lactate and lipid were 1.01 ppm, 1.44 ppm, 0.86 ppm and 1.22 ppm respectively in patients who achieved pregnancy following ET. A positive and significant correlation was found between Cho and Cr intensities and IR or CPR. Receptive endometrium represents some specific metabolites in spectroscopy that can be used for prediction of the success or failure of embryo transfer in women suffering implantation failure.

To investigate the impact of laparoscopic ovarian drilling (LOD) on the expression of endometrial NFκB p65 (Rel A) in women with clomiphene-resistant polycystic ovary syndrome (PCOS). The study group comprised 25 normal-weight women with PCOS undergoing LOD and 14 control women without PCOS. Endometrial NF-κB p65 levels evaluated before and after LOD following immunohistochemical staining. The semiquantitative method was used to evaluate the intensity of NF-κB p65 levels. NF-κB p65 was found to higher in the endometrium of patients with PCOS compared to controls. LOD leads to significant down-regulation in endometrial NF-κB p65 expression. NF-κB p65 expression of PCOS and fertile control were similar after LOD. After LOD, H-score values decreased approximately 3-fold. The H-score of the control subjects was lower than the preoperative and postoperative H-score values of the control women with ovarian cyst. Expression of endometrial NF-κB p65 did not change following ovarian cystectomy. The laterality of the ovarian cyst did not cause any change in preoperative H-score values. By downregulating the endometrial NF-κB p65 expression LOD improved physiological inflammation in women with PCOS.

Aims: To investigate whether there is a difference between serum tumor markers panel (CA 125, CA 19-9, CA 15-3, and carcinoembryonic antigen (CEA)) and tumor size and histopathology in well-staged patients with borderline ovarian tumors (BOTs). Methods: Over the past 20 years (January 2001 to January 2021), the results of four tumor markers (CA 125, CA 19-9, CA 15-3, and carcinoembryonic antigen (CEA)) have been clinically analyzed for for this retrospective cohort study of 156 patients who underwent surgery and were diagnosed with histopathology consistent with a borderline ovarian tumor. Results: The average age of patients with borderline ovarian tumors was determined to be 51.67 (4.726) years. Before the first surgery, high CA 125 levels (>35 U/l) were found in 53 patients (34%), high CEA levels (>4 ng/ml) were found in 24 patients (15.4%), high CA 19-9 levels (>37 U/ml) were found in 29 patients (18.6%), and high CA 15-3 (>30 ng/ml) levels were found in 12 patients (7.7%). The average CA 125 levels in tumors with serous histopathology [372.8 (1805.2)] were higher than those in tumors with mucinous histopathology (p=0.006). There was no statistically significant difference in tumor markers between tumors smaller than 8 cm and larger than 8 cm [(CA 125 p=0,257), (CEA p=0.9), (CA 19-9 p=0.295), (CA 15-3 p=0.404)]. Conclusion: Our primary outcome of the study is an increase in CA 125 levels, which indicates serous histopathology. Our secondary outcome is the higher levels of tumor markers, but it does not suggest larger tumors.