Gender can be detected with great accuracy in gestations between 11 to 13 weeks and 6 days by using AGD. CRL and gestational week (GW) were determined as nonsignificant predictors of fetal gender by AGD measurement. In order to obtain more accurate results with AGD, consideration of further studies with larger series in different races is recommended.

IntroductionPolycystic ovary syndrome (PCOS) may have an increased risk for the development of systemic and metabolic pathogenesis such as cardiovascular diseases, insulin resistance (IR), diabetes mellitus (DM) and dyslipidemia. However, there is no reliable marker to show the relation. Fetuin-A is an adipokine whereas paraoxonase-1 (PON-1) is a high-density lipoprotein-linked enzyme to demonstrate oxidative stress. This study aimed to evaluate serum fetuin-A and PON-1 levels in infertile PCOS women based on body mass index (BMI). MethodsA prospective case-control study in a university setting was designed. A total of 88 patients admitted to the Giresun University Faculty of Medicine Gynecology Clinic between February and April 2021 were included in the study. The subjects were divided as follows: PCOS-low-BMI (BMI≤25) vs. Controls-low-BMI (BMI≤25) and PCOS-high-BMI (BMI>25) vs. Controls-high-BMI (BMI>25). Those who had at least two criteria of the 2003 Rotterdam Consensus were diagnosed with PCOS. Serum fetuin-A and PON-1 levels were compared. ResultsThe mean levels of fetuin-A were not significantly different in the groups (p=0.955). Serum PON-1 levels were lower in the PCOS group (109.1±61.4 vs. 140.1±80.0; p=0.040), but it lost significance with adjusted values for covariants as age and BMI. Although PON-1 was not significantly different in the PCOS group of BMI<25 kg/m 2 subgroup, it was significantly lower in the PCOS group of BMI≥25 kg/m 2 subgroup (p=0.820 vs. p=0.048). ConclusionSerum fetuin-A activity did not differ with PCOS. Serum PON-1 might be a promising and research-worthy marker, especially for obese PCOS patients.

Background Adnexal masses (AM) are a common gynecological problem. It is important to use a reliable imaging method in the differentiation of benign and malignant AMs. Purpose To assess the accuracy and validity of the O-RADS magnetic resonance imaging (MRI) score for characterizing AM using a simplified MRI protocol. Material and Methods The study population comprised 332 women who underwent MRI due to the detection of indeterminate AM on ultrasonography between January 2018 and June 2020. An experienced radiologist calculated the O-RADS MRI score into five categories, using an MRI protocol with a simplified dynamic study. Sensitivity, specificity, positive and negative predictive values, and area under the curve (AUC) were calculated (cutoff for malignancy, score ≥ 4). The reference standard was histopathologic diagnosis or imaging findings during >24 months of follow-up. Results Of 237 AMs, 28 (11.9%) were malignant. The malignancy rates of AMs with scores of 1, 2, 3, 4, and 5 were 0% (0/12), 0% (0/111), 1.2% (1/77), 50% (10/20), and 100% (17/17), respectively. The O-RADS MRI score showed 96.3% sensitivity, 95.2% specificity, and 95.3% accuracy in malignancy prediction. The AUC for the differentiation of benign and malignant masses were 0.983. False positivity rate was high in cases with an O-RADS MRI score of 4 (50%). Conclusion The O-RADS MRI score, based on a simplified MRI protocol, has high accuracy and validity in distinguishing benign from malignant sonographically indeterminate AMs. Its use in clinical practice can classify the malignancy risks of masses and prevent unnecessary surgery in benign lesions.

Objective: Determination of the clinical pregnancy rate in intrauterine insemination (IUI) cycles performed with microfluidic sperm sorting chips. Material and Methods: In Giresun University Obstetrics and Pediatrics Hospital Infertility Clinic, 133 patients who underwent IUI after ovarian stimulation with gonadotropins in unexplained infertility, mild to moderate male factor, ovulatory dysfunction, mild endometriosis were retrospectively analyzed between January 2016-January 2020. Microfluidic sperm sorting chip was used for sperm preparation. Results: The number of cycles was found to be 133. Mean female age was; 29.9±4.7 years, mean total motile sperm count was; 72.9±63.7 million, mean antral follicle count was; 18.1±10.1, the mean total gonadotropin dose used was 897.6±366 IU. Considering the causes of infertility; 54.1% unexplained, 8.3% mild male factor, 31.6% polycystic ovary syndrome (PCOS) and 6% endometriosis. The clinical pregnancy rate was found to be 19.5% (26/133). Conclusion: Microfluidic sperm sorting chips provide an increase in clinical pregnancy rates compared to conventional methods in IUI cycles and allow for a practical and rapid sperm preparation. Key Words: IUI, microfluidic sperm sorting chip, clinical pregnancy rate.

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Objectives:The success of ovulation induction-intrauterine insemination (OI-IUI) procedures may be limited by the absence of ovulation detection. The aim of this study was to evaluate the empirical use of ultrasonography and luteal phase progesterone (P4) as ovulation indicators and determine its effect on pregnancy outcome in OI-IUI cycles.Material and methods: This prospective observational study, which was performed in a university setting, included 107 women with unexplained infertility. Following OI, IUI was performed 36 hours after human chorionic gonadotropin (hCG). P4 was measured 72-96 hours after hCG. At the same time, the appearance of ovaries and signs indicative of ovulation, which are decreased follicle dimensions, irregularity of follicular walls, and the presence of free fluid in the Douglas pouch, were noted. Results:In 58 patients (54.2%), ovulation was detected at the P4 level of > 10 ng/mL. Eighty-nine patients had ultrasound images suggestive of ovulation. However, only 50 of these were confirmed ovulation as indicated using P4. Implantation was observed in a total of 13 patients (12.1%). All patients were in the ovulation detected group with P4 > 10 ng/mL (AUC: 0.750; p = 0.004). P4 of > 21.5 ng/mL detected successful ovulation and was strongly associated with implantation with 77% sensitivity and 61% specificity (OR: 9.9; 95% CI: 2.4-41.2). Body mass index (BMI) > 23.9 kg/m 2 was a reliable anovulation indicator as a secondary outcome (AUC: 0.696; p = 0.02). Conclusions:In 45.8% of the patients, ovulation did not occur even with OI treatment. The association of progesterone measurement and ovarian ultrasound scanning between 72 and 96 hours after hCG treatment can be used to detect ovulation. In doing so, we can find the optimal treatment for patients with infertility in their next cycle.

Aim: Omentin-1, an adipokine primarily secreted from visceral adipose tissue, regulates metabolic homeostasis, whereas carotid intima-media thickness (CIMT) is a valid marker for early diagnosis of atherosclerosis. We aimed to investigate whether polycystic ovary syndrome (PCOS) is related to levels of omentin-1 and CIMT and demonstrate the association with cardiovascular risk. Methods: A prospective case-control study was performed on 47 PCOS patients and 35 healthy subjects. Hormonal and metabolic parameters, levels of serum omentin-1, and CIMT were evaluated in the two groups. Results: The right, left, total CIMT, and levels of serum omentin-1 were significantly higher in the PCOS group than in the healthy controls (p = 0.015, p = 0.009, p = 0.021, and p = 0.002, respectively). Using multiple linear and backward elimination regression analyses, serum omentin-1 was found to be independently associated with age and Ln-transformed homeostasis model assessment of insulin resistance, and cardiovascular parameters were independently associated with body mass index (BMI). In the PCOS group, the means of right, left, and total CIMT were significantly higher in the subgroup with BMI levels ≥25 kg/m 2 compared to the subgroup with BMI levels <25 kg/m 2 (p < 0.001 for all comparisons). Conclusion: A significant increase in CIMT is associated with cardiovascular risk in patients with PCOS. Levels of serum omentin-1 were found to be significantly higher in early PCOS cases at a younger age, acting as a protective acute-phase reactant.

Objective: The primary target of birth preparation program is guiding women to realistic expectations for the birth experience. The aim of the present study is to evaluate the influence of a systematic multidisciplinary birth preparation program on delivery expectation, childbirth fear, mode of delivery and neonatal outcomes.Methods: 159 nulliparous pregnant women in their 3rd trimester were enrolled in this cross-sectional cohort study between January 2018 and March 2020. Women who participated to the systematic birth preparation program were grouped as Group A (n = 80) and those who refused to participate were considered Group B (n = 79). Fear of childbirth was scanned by Wijma Delivery Expectancy Questionnaire Version-A; socio-demographic and obstetric features were assessed through a self-developed survey by face-to-face interview. The mode of delivery, labor induction needs, cesarean indications, birth weights, APGAR scores, newborns hospitalization requirements if any were noted.Results: The Wijma-A mean score was 44.60 ± 19.63 in those who attended the systematic birth preparation program and 72.05 ± 24.82 in those who did not (p&lt;0.001). Childbirth fear was significantly lower in attended group when pregnant women were evaluated according to the four different level childbirth fear categories (p&lt;0.001). The birth weights were significantly higher in attended group (p=0.017). There was no significant difference between the two groups in terms of mode of delivery, APGAR scores, neonatal hospitalization and labor induction requirements (p&gt;0.05).Conclusion: The present study shows that systematic and multidisciplinary birth preparation program may positively influence the childbirth fear and increase the birth weights of neonates.