Purpose. We aimed to determine the predictive value of several hematological markers of inflammation on the presence/absence of cervical cancer and also to determine their ability in discriminating precancerous cervical pathologies from cervical cancer. Materials and Methods. In this study, patients who presented to Acıbadem Kayseri Hospital between May 2010 and June 2018 were evaluated. Forty patients with low-grade squamous intraepithelial lesions (LSIL), 40 patients with high-grade squamous intraepithelial lesions (HSIL), and 30 patients with cervical cancer (CC) were retrospectively included in this study. A control group of 70 healthy volunteers with normal cervical cytology was also included in the study. Results. The neutrophil-to-lymphocyte ratio (NLR) was significantly higher in patients with CC than in controls. The platelet-to-lymphocyte ratio (PLR) was significantly higher in patients with CC compared to those with LSIL and HSIL diagnoses and also controls (p<0.001). Logistic regression analysis revealed that age (OR: 1.075, 95% CI: 1.020–1.132, p=0.007), NLR (OR: 1.643, 95% CI: 1.009–3.142, p=0.047), and PLR (OR: 1.032, 95% CI: 1.003–1.062, p=0.029) were predictors for the presence of CC. ROC curve analysis revealed that both NLR and PLR were predictive of CC with a cutoff value of 2.02 for NLR (71% sensitivity and 60% specificity, AUC: 0.682, p=0.004) and 126.7 for PLR (83% sensitivity and 69% specificity, AUC: 0.752, p<0.001). Conclusion. In addition to patients’ age, determination of NLR and PLR values, which are simple, inexpensive, and readily available markers of systemic inflammation, may help in decision making precancerous pathologies of the cervix.

Introduction: The aim of this prospective trial was to evaluate the ovarian reserve with anti-Müllerian hormone (AMH), which is the best predictor of ovarian reserve, and perform histological analysis after exposure to cisplatin with a GnRH agonist or antagonist.Material and methods: Twenty-four Wistar albino rats were randomly divided into three groups, each consisting of eight rats. In the GnRH agonist group (group 1), rats received a single dose of 50 mg/m2 cisplatin with 1 mg/kg triptorelin. In the GnRH antagonist group (group 2), rats received a single dose of 50 mg/m2 cisplatin with 1 mg/kg cetrorelix. In the control group (group 3), rats received 50 mg/m2 cisplatin. Ovarian reserve was assessed by AMH and histology.Results: Primary follicle counts were higher in group 2 (4.50 ±1.47 vs. 3.50 ±1.70 vs. 3.00 ±3.54) and secondary follicle counts were higher in group 1 (2.96 ±1.11 vs. 1.74 ±1.03 vs. 1.37 ±3.11). Numbers of tertiary follicles were higher both in groups 1 and 2 than the control group (1.36 ±0.83 vs. 0.84 ±0.99 vs. 0.50 ±0.75). The total follicle count of the study groups were significantly higher compared with the control group (14.32 ±5.96 vs. 12.48 ±4.12 vs. 10.63 ±6.80). AMH was significantly higher in groups 1 and 2 compared with the control group (18.56 ±25.33 vs. 16.48 ±24.66 vs. 9.37 ±26.54).Conclusions: This is the first prospective randomized controlled study showing the protective effects of GnRH agonist and antagonist on ovarian reserve after cisplatin exposure in an animal model.

This study aims to compare the pregnancy outcomes of vaginal micronized progesterone capsules with oral dydrogesterone in subjects with unexplained subfertility who are undergoing IUI in conjunction with ovarian stimulation by using rFSH. A total of 432 patients with unexplained subfertility who underwent IUI in conjunction with ovarian stimulation were enrolled in this retrospective study. Patients were randomized into two groups: (1) dydrogesterone or (2) vaginal micronized progesterone capsules, for luteal phase support. Clinical pregnancy and live birth were the primary outcome measures of the present study. Dydrogesterone was used in 233 participants (54%) and 337 cycles, while 199 participants (46%) and 233 cycles received vaginal micronized progesterone capsule treatment. The proportion of clinical pregnancies (7.4% vs. 10.2%, p = .213), live births (68% vs. 73%, p = .286) were similar in the two groups. Oral dydrogesterone and vaginal micronized progesterone provide similar pregnancy outcomes in terms of clinical pregnancy and live birth rates in women undergoing IUI in conjunction with ovarian stimulation with rFSH. Given the simple and easy administration, lack of safety concerns and better patient tolerability, we suggest that oral dydrogesterone might be preferred for luteal phase support in IUI.

Aim: Recent evidence has shown that Myoinositol (MI), a nutrient belonging to vitamin B family, may improve hormone profile, and the metabolic disorders accompanying polycystic ovary syndrome (PCOS), probably through the amelioration of preexisting insulin resistance. This study aimed to compare the ovulation and pregnancy outcomes of clomiphene citrate (CC) and its combination with MI in obese PCOS women with infertility. Methods: Data concerning 80 obese, PCOS women with infertility who had undergone ovarian induction were retrieved from the institutional digital database. Controlled ovarian stimulation (OS) was performed using CC 100 mg or CC (100mg) + MI (4 g). The primary outcome measure of this study was the difference in the ovulation and the pregnancy rates of the women receiving CC (CC group) or CC+MI (combination group) for ovarian stimulation. There were 40 patients in each group. Results: Endometrial thickness was significantly higher in the combination group than in the CC group (8.4 (1.1) mm vs. 7.7 (1.2) mm, P=0.006) and the number of the follicles>17 mm following OS was significantly higher in the combination group compared to that of the CC group (1.6 (0.5) vs. 1.4 (0.5), P=0.036). However, the rate of ovulation following OS [37 (92%) vs. 37 (92%), P=1.000] and the rate of the pregnancy were similar in CC and combination groups [6 (15%) vs. 11 (27.5%), P=0.172, respectively]. Conclusions: Compared to ovarian stimulation with CC alone, the combination provides a beneficial effect on endometrial thickness and the number of mature follicles. However, ovulation rates are similar with the two regimens. Although not statistically significant, there was a trend towards higher rates of pregnancy on CC+MI combination compared to CC alone. Further prospective and randomized trials are required to clearly address the role of the MI in management of the PCOS women with infertility.

Objectives: To determine the effect of short-term metformin administration on follicular fluid (FF) total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI) and nuclear factor kappa B (NF-kB) in women with clomiphene citrate-resistant polycystic ovary syndrome (PCOS). Methods: Fifty-eight patients aged 23–34 who were planned to have intracytoplasmic sperm injection due to clomiphene citrate-resistant PCOS were included in the study. Participants were divided into two groups according to whether they used metformin or not. While 30 of 58 PCOS patients were using short-term metformin in combination with controlled ovarian stimulation, 28 PCOS patients were not using metformin. Metformin was started in the mid-luteal period and continued until the day before oocyte retrieval at 850 mg twice daily. To determine FF-NF-kB, TAS, TOS and OSI values, a dominant follicle ≥17–18 mm in diameter was selected for aspiration. Results: The number of mature follicles and fertilization rates of the metformin group were significantly higher than those not taking metformin. FF-TOS and OSI of the metformin group were significantly lower than those of the group not receiving metformin. Patients receiving metformin had higher FF-TAS than the group not receiving metformin. FF-NF-kB levels of the metformin group were significantly lower than the group not receiving metformin. Insulin resistance, FF-NF-kB and FF-TOS were negatively correlated with the number of mature oocytes. FF-TAS was positively correlated with the number of oocytes. Conclusions: Short-term metformin treatment in clomiphene-resistant PCOS improves the number of mature follicles and fertilization rates by regulating the intra-follicle redox balance.