We aimed to assess the possible presence of a seasonal pattern in three parameters of semen analysis: sperm concentration, morphology, and motility as a function of the time of ejaculation and sperm production (spermatogenesis) in normal and oligozoospermic men. This retrospective study included a consecutive series of 4,422 semen samples that were collected from patients as a part of the basic evaluation of the infertile couples attending the Reproductive Endocrine Outpatient Clinic of a tertiary women’s hospital in Ankara, Turkey, between January 1, 2012 and December 31, 2013. The samples were classified according to sperm concentration: ≥15 x10⁶/mL as normozoospermic samples and 4 -14.99 x10⁶/mL as oligozoospermic samples and seasonal analysis of the semen samples were carried out separately. When the data was analyzed according to the season of semen production, there was no seasonal effect on the sperm concentration. A gradual and consistent decrease in the rate of sperm with fast forward motility was observed from spring to fall with a recovery noticed during the winter. The percentage of sperms with normal morphology was found to be statistically significantly higher in the spring samples compared with the summer samples (p=0.001). Both normozoospermic and oligozoospermic semen samples appeared to have better sperm parameters in spring and winter. The circannual variation of semen parameters may be important in diagnosis and treatment desicions. Abbreviations: WHO: World Health Organization; mRNA:messenger ribonucleic acid

To investigate the correlation between sonographic, hysteroscopic, and pathological findings in postmenopausal asymptomatic patients with sonographically thickened endometrium. The records of postmenopausal patients who attended the Menopause Outpatient Clinic of a tertiary women's hospital in Ankara, Turkey between January 1, 2012 and December 15, 2013 were retrieved. A total of 266 postmenopausal women without vaginal bleeding underwent hysteroscopic evaluation and endometrial sampling. Patients whose pathological records indicated an endometrial thickness equal to or greater than 6 mm (double layer) on transvaginal ultrasonography without any symptoms were included in the study. The most frequently detected focal intrauterine lesions in asymptomatic women were endometrial polyps, which were diagnosed in 168 (63.1%) cases. Twenty-four (9%) patients were diagnosed as having simple hyperplasia, 4 (1%) atypical hyperplasia, and 8 (3%) endometrial adenocarcinoma. Two of the patients with adenocarcinoma were diagnosed based on endometrial polyps, and 6 cases showed endometrial hyperplasia on hysteroscopy, while histological examination showed endometrial carcinoma. We suggest 10.5 mm as the cutoff value for endometrial thickness and recommend hysteroscopy following dilatation and curettage to increase diagnostic efficacy and provide definitive treatment in asymptomatic postmenopausal women with thickened endometrium.

Objective: We aimed to analyze the risk factors for clavicle fractures in newborns with shoulder dystocia and brachial plexus injury and to determine whether their incidence is associated with local characteristics. Methods: This study was conducted as a retrospective trial between January 2017 and December 2018. Patients with clavicular fracture who were hospitalized in the neonatal intensive care unit of a community hospital were retrospectively analyzed. The clavicular fracture cohort was first divided into two groups and then two subgroups: patients with/without shoulder dystocia and patients with/without a brachial plexus injury. Peripartum and neonatal risk factors of these patients were reviewed using the patient information system. Any additional neurological or musculoskeletal trauma was noted. A multivariate logistic regression analysis was performed to determine independent predictors of shoulder dystocia and brachial plexus injury. Results: A total of 46 patients with shoulder dystocia in 25 (54%) and brachial plexus injury in 12 (26%) were included in the study. The birth weight of patients with shoulder dystocia was 4,164.2±412.7 g, and that of patients without was 3,535.8±865.2 g (p=0.003). In 11 of 14 patients (44%) in whom labor was induced and whose infant had a fractured clavicle, the infant also had shoulder dystocia (p=0.029). Brachial plexus injury was found in 8 (66.7%) of 14 infants who were born by induced labor and who had a clavicular fracture (p=0.002). The regression analysis revealed that age and induction of labor were independent risk factors for brachial plexus injury (odds ratio=1.599 and 81.862, respectively). Gestational weight gain (p=0.003) and neonatal birth weight (p=0.047) were also found as independent risk factors for shoulder dystocia. Conclusion: Evidence from this study has shown that not only birth age or birth weight but also excessive weight gain by mother and induction of labor may increase the risk of clavicula fracture with brachial plexus palsy. Advanced maternal age, multiparity, and deliveries after 39 weeks seem to be risk factors for a clavicular fracture with a brachial plexus injury. Level of Evidence: Level IV, Therapeutic study Cite this article as: Yenigül AE, Yenigül NN, Başer E, Özelçi R. A retrospective analysis of risk factors for clavicle fractures in newborns with shoulder dystocia and brachial plexus injury: A single-center experience. Acta Orthop Traumatol Turc 2020; 54(6): 609-13.

Diminished ovarian reserve (DOR) represents a major challenge in reproductive medicine, as it is often associated with poor ovarian stimulation response, high cycle cancellation rate, and low pregnancy rate. The aim of the present study is to compare the clinical pregnancy rates in intracytoplasmic sperm injection-embryo transfer (ICSI-ET) cycles in patients with different DOR etiologies. Patient data were recorded with a computer-based program called Success Estimation Using a Ranking Algorithm (SERA). Overall, 459 patients were divided into 3 groups according to their DOR etiologies (Group A: idiopathic, n = 81; Group B: age-related, n = 294; Group C: previous ovarian surgery, n = 84). Out of 459 stimulation cycles, 378 (82.4%) reached the oocyte retrieval stage, while 201 (43.8%) had embryo transfers. There was no significant difference between the patients with different DOR etiologies in terms of embryo transfer and cycle cancellation rate. The patients who had embryo transfer were 44 (52.4%) in Group A, 38 (46.9%) in Group B, and 119 (40.5%) in Group C. There were no significant differences between the three groups (P = 0.114). The percentages of women who had oocyte retrieval were 84.5% in Group A, 70% in Group B, and 80.3% in Group C (P = 0.104). While clinical pregnancy per transfer was 35.8% in Group A, 19.8% in Group B, and 29.5% in Group C, there was no statistically significant difference between the groups (P = 0.113) Although ovulation induction and ICSI-ET outcomes, including clinical pregnancy and live birth rates, were not significantly different with regards to the etiology of DOR, young women with DOR may benefit from assisted reproductive techniques.