Browsing by Author "Yarkiner, Zalihe"

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A Comparative Analysis of Progestin-Primed Ovarian Stimulation Versus GnRH Antagonists Protocols Pertaining To Stimulation Parameters and Embryological Outcomes in Patients With Endometrioma
(Frontiers Media SA, 2025) Boynukalin, Fazilet Kübra; Tohma, Yusuf Aytaç; Gültomruk, Meral; Yarkiner, Zalihe; Akkaya, Ceren Melisa; Özkavukçu, Sinan; Bozdaǧ, Gürkan; 01. Atılım University
Research question: Do embryo parameters and live birth rates differ between patients with endometrioma undergoing a freeze-all strategy using either GnRH antagonists or progestin-primed ovarian stimulation (PPOS)? Design: This retrospective cohort study was conducted at Bahceci Health Group from January 2021 to January 2023. Inclusion criteria were females aged 20–40 with confirmed endometriosis, using either GnRH antagonists or PPOS ovarian stimulation, and opting for freezing all embryos without fresh embryo transfer (ET). A total of 543 patients were analyzed, with the primary outcome being usable embryos at cleavage stage and secondary outcomes including distribution of embryo quality, clinical pregnancy, and live birth rate. Results: For the GnRH antagonist arm, the median (25th-75th percentiles) total gonadotropin dose required during stimulation was significantly higher (2725 [2100–3587.5] vs. 2400 [2050–3075] IU, p = 0.001) and duration was longer (11 [10–12] vs. 10 [9–11] days, p = 0.01), although number of mature oocytes and maturation and fertilization rates were similar in both arms. However, the linear regression analysis revealed that the number of usable day-three embryos was higher with the PPOS protocol than with the GnRH antagonist protocol (OR: 0.890, CI 95%: 0.226 – 1.554, p= 0.009). Particularly in patients that had undergone FET, the respective live birth rates were 50.0% and 54.6% in GnRH antagonist and PPOS arms, respectively, without any statistical significance (p= 0.365). Conclusion: In patients with endometrioma, the PPOS protocol over GnRH antagonists might potentially enhance the quantity of usable cleavage-stage embryos while showing no significant impact on the number of collected oocytes. © 2025 Elsevier B.V., All rights reserved.
Citation - WoS: 1
Citation - Scopus: 1
Incidence of Medical Device-Related Pressure Injuries and Identification of Risk Factors in the Neonatal Unit
(Elsevier Sci Ltd, 2024) Yarkiner, Zalihe; Bahar, Arzu; Sonmez, Munevver; Kapan, Emine; Sahin, Simge; Kostekci, Ezgi; Erdeve, Omer; Department of Mechanical Engineering; Nursing; 15. Graduate School of Natural and Applied Sciences; 07. School of Health Sciences; 01. Atılım University
Aim: This study was conducted to investigate the incidence of medical device-related pressure injuries (MDRPIs) and the risk factors influencing their occurrence in the neonatal intensive care unit (NICU). Method: This study is a prospective, descriptive study. The research was conducted with 116 newborns between June 1, 2022, and June 1, 2023. Newborns who stayed in the neonatal intensive care unit for at least 24 h were observed daily for medical device-related pressure injuries under and around each medical device throughout their stay in the intensive care unit. The "Case Report Form," "MDRPIs Monitoring Form," "Braden Q scale for children," National Pressure Injury Advisory Panel (NPIAP) Pressure Grading, and Glasgow Coma Scale were used in the research. Results: The incidence of medical device-related pressure injuries is 35.3 % (41/116). It was found that 38.1 % (16/42) of medical device-related pressure injuries developed due to Near-Infrared Spectroscopy (NIRS) probes, and 33.5 % (14/42) developed due to medical devices related to the respiratory system. In terms of anatomical location, 38.1 % occurred on the forehead, and 23.8 % on the arm/leg. The difference between birth weight, gestational age, development of MDRPIs in newborns receiving sedation and inotropes was found to be statistically significant. Regression analysis identified gestational age (p = 0.040, OR = 0.795, 95%CI = [0.632-1.000]) as an independent risk factor for the occurrence of medical device-related pressure injuries. Conclusions: The incidence of medical device-related pressure injuries in newborns was relatively high in this study, with gestational age being the most significant risk factor for MDRPIs formation. It is crucial for neonatal intensive care nurses to consider associated risk factors while providing newborn care and implement appropriate preventive measures to reduce the incidence of MDRPIs.
Citation - WoS: 4
Citation - Scopus: 4
Individualized Luteal Phase Support in Frozen-Thawed Embryo Transfer After Intramuscular Progesterone Administration Might Rectify Live Birth Rate
(Frontiers Media Sa, 2024) Boynukalin, Fazilet Kubra; Tohma, Yusuf Aytac; Yarkiner, Zalihe; Gultomruk, Meral; Bozdag, Gurkan; Ozkavukcu, Sinan; Demir, Berfu; 01. Atılım University
Background: The serum P concentrations are suggested to have an impact on pregnancy outcome. However there is no consensus about the optimal progesterone cut-off during the luteal phase. Few studies evaluated the effectiveness of a "rescue protocol" for low serum P concentrations and most of these studies used vaginal progesterone administration. There is paucity of data on the effectiveness of rescue protocol using intramuscular progesterone (IM-P) in frozen-thawed embryo transfer (FET). Methods: This study is a retrospective cohort study included 637 single or double blastocyst FETs with artificially prepared endometrium receiving 100 mg IM progesterone (P) after incremental estrogen treatment. Serum P concentrations were evaluated using blood samples obtained 117-119 hours after the first IM-P administration and 21 +/- 2 hours after the last IM-P administration. Patients with serum P concentrations <20.6 ng/ml on the ET day were administrated 400 mg vaginal progesterone for rescue. Results: Demographic and cycle characteristics were similar between patients receiving rescue vaginal P (embryo transfer (ET)-day P concentration < 20.6 ng/ml) and patients who did not need rescue vaginal P (ET-day P concentration >= 20.6 ng/ml). Clinical pregnancy, miscarriage, and live birth rates were similar between two groups: 52.9%(45/85) vs 59.6%(326/552), p=0.287; 11.1%(5/45) vs 14.1%(46/326), p=0.583; and 47.1%(40/85) vs 50.7%(280/552), p=0.526, respectively. Logistic regression analysis revealed that the female age (p = 0.008, OR=0.942, 95% CI = 0.902-0.984) and embryo quality (ref: good quality for moderate: p=0.02, OR=0.469, 95% CI =0.269-0.760; for poor: p=0.013, OR= 0.269, 95% CI = 0.092-0.757) were independent variables for live birth. Following rescue protocol implementation, ET-day P concentration was not a significant predictor of live birth. Conclusions: Rescue vaginal P administration for low ET day serum P concentrations following IM-P yields comparable live birth rates.