Person: ÇAKIR, CİHAN
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ÇAKIR
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CİHAN
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Publication Evaluation of endometrioma pathophysiology and related ovarian damage by PTEN / AKT apoptosis signaling pathway(Elsevier Science, 2020-09-01) Şen, Furkan; Aslan, Kiper; Kuşpınar, Göktan; Çakır, Cihan; Kasapoglu, Işıl; Avcı, Berrin; Uncu, Gürkan; ŞEN, HAMZA FURKAN; ASLAN, MÜNİR KİPER; KUŞPINAR, GÖKTAN; ÇAKIR, CİHAN; KASAPOĞLU, IŞIL; AVCI, BERRİN; UNCU, GÜRKAN; Tıp Fakültesi; Kadın Hastalıkları ve Doğum Ana Bilim Dalı; 0000-0002-9277-7735; 0000-0002-8332-7353; AAH-5119-2021; AAT-3479-2021; HTQ-5866-2023; AER-7173-2022; AAH-9694-2021; AAH-5249-2021; KEU-2073-2024; CXJ-7203-2022; ELU-2357-2022Publication Fertilisation and early embryonic development of immature and rescue in vitro-matured sibling oocytes(Taylor & Francis, 2020-01-16) Avcı, Berrin; Kasapoğlu, Işıl; Çakir, Cihan; Özbay, Aysun; Ata, Barış; Uncu, Gürkan; AVCI, BERRİN; KASAPOĞLU, IŞIL; ÇAKIR, CİHAN; Özbay, Aysun; UNCU, GÜRKAN; Tıp Fakültesi; Histoloji ve Embriyoloji Ana Bilim Dalı; 0000-0002-8332-7353; 0000-0001-8135-5468; AAT-3479-2021; GQR-0770-2022; AAH-5249-2021; CXJ-7203-2022 ; ABE-6685-2020The objective of this study was to assess the effect of rescue in vitro maturation and immediate intracytoplasmic sperm injection (ICSI) application on fertilisation success and early embryonic development of metaphase I (MI) oocytes. This was a retrospective cohort study including 2425 sibling oocytes in 259 ICSI cycles. ICSI was performed on 104 GV (germinal vesicle) oocytes which had reached the metaphase II (MII) stage (Group 1) and 231 MI oocytes which had reached the MII stage (Group 2) following IVM (in vitro maturation). Immediate ICSI was applied following oocyte aspiration on 292 MI stage (Group 3) and 1798 MII stage oocytes (Group 4). Normal fertilisation rates in Groups 1, 2, 3 and 4 were 51.9%, 39%, 30.1% and 59.5%, respectively. The rates of blastocyst development per oocyte and per zygote were calculated as 3.8%, 3.0%, 6.8%, 14.1% and 7.4%, 7.7%, 22.7%, 23.6% for Groups 1, 2, 3 and 4, respectively. The blastocyst development rate was significantly higher in the MI-ICSI group compared with other immature oocytes. Even though performing ICSI on the oocytes at the MI stage on the day of oocyte aspiration resulted in lower fertilisation rates, it was associated with significantly higher rates of blastocyst development.Publication The kisspeptin and kisspeptin receptor in follicular microenvironment: Is that really necessary for oocyte maturation and fertilisation?(Taylor & Francis Inc, 2022-08-19) Kuşpinar, Göktan; KUŞPINAR, GÖKTAN; Çakır, Cihan; ORAL, HALUK BARBAROS; ÇAKIR, CİHAN; KASAPOĞLU, IŞIL; Sarıbal, Seda; BUDAK, FERAH; Budak, Ferah; Avcı, Berrin; Uncu, Gürkan; UNCU, GÜRKAN; AVCI, BERRİN; Tıp Fakültesi; İmmunoloji Ana Bilim Dalı; 0000-0002-8332-7353; 0000-0001-7625-9148; IZP-9398-2023; AAH-5249-2021; F-4657-2014; HTQ-5866-2023The aim of this study was to determine whether Kisspeptin and Kisspeptin receptor in the follicular microenvironment is necessary for human oocyte maturation and fertilisation. The cumulus cell (CC) and follicle fluids (FF) obtained from the first aspirated follicles (n = 52) from 32 patients were divided into three groups considering nuclear maturation and fertilisation results of oocytes: (1) Metaphase I or germinal vesicle stage oocytes (incomplete nuclear maturation, n = 10), (2) unfertilised metaphase II oocytes (incomplete cytoplasmic maturation, n = 16), and (3) fertilised metaphase II oocytes (completed nuclear-cytoplasmic maturation, n = 26). The gene expression levels were assessed by RT-PCR. The levels of Kisspeptin (KISS1) and Kisspeptin receptor (KISS1R) were measured by ELISA. There were no significant efficacy KISS1 and KISS1R gene expressions in cumulus cells in terms of oocyte nuclear maturation stage (Group 1, vs Group 2 + Group 3) (respectively p = .49; p = .45). In terms of the cytoplasmic maturation stage (Group 2, vs Group 3); KISS1 and KISS1R expressions in CCs were comparable (respectively p = .07; p = .08). In FFs, KISS1 and KISS1R concentrations were similar between all groups (respectively p = .86; p = .26). In conclusion, the relative KISS1 and KISS1R expressions in CC and also KISS1 and KISS1R level of FF were independent of oocytes nuclear and/or cytoplasmic maturation. Impact statement What is already known on this subject? It has been demonstrated that Kisspeptin is an essential regulator of reproductive function and plays a key role in the modulation of GnRH secretion and gonadotropin release. Still, no information is available about the link between gene expression or concentration in the follicular microenvironment and oocyte development. What do the results of this study add? The study has shown that the relative Kisspeptin (KISS1) and Kisspeptin receptor (KISS1R) and expressions in cumulus cell (CC) and also KISS1 and KISS1R levels of follicle fluids (FF) were independent of oocytes nuclear and/or cytoplasmic maturation. What are the implications of these findings for clinical practice and/or further research? Based on the findings, it is difficult to establish a concept that kisspeptin can directly induce oocyte maturation. Nevertheless, to confirm these findings, further studies with a larger sample size are needed.Publication Which is more predictive ovarian sensitivity marker if there is discordance between serum anti-Mullerian hormone levels and antral follicle count? A retrospective analysis(Taylor & Francis Inc, 2022-01-07) Aslan, Kiper; Kasapoğlu, Işıl; Çakır, Cihan; Koç, Meltem; Çelenk, Murat Deniz; Ata, Barış; Avcı, Berrin; Uncu, Gürkan; ASLAN, MÜNİR KİPER; KASAPOĞLU, IŞIL; ÇAKIR, CİHAN; KOÇ ÇAKAR, MELTEM; ÇELENK, MURAT DENİZ; AVCI, BERRİN; UNCU, GÜRKAN; Tıp Fakültesi; Kadın Hastalıkları ve Doğum Ana Bilim Dalı; 0000-0002-9277-7735; 0000-0002-8332-7353; 0000-0001-6456-8779; AAT-3479-2021; AAH-5249-2021; AER-7173-2022; CXJ-7203-2022; EPE-7010-2022; ELU-2357-2022This retrospective study aims to determine the more predictive ovarian reserve marker when there is discordance between anti-Mullerian hormone (AMH) and antral follicle count (AFC) in patients with diminished ovarian reserve (DOR). Patients who underwent ICSI because of DOR were divided into three groups. Group 1: patients with low AMH (<1.1 ng/ml) and AFC (n < 7), group 2: patients with low AMH (<1.1 ng/ml) and normal AFC (n >= 7) and group 3: patients with normal AMH (>= 1.1 ng/dl) and low AFC (n < 7). Demographic values, follicle output rate (FORT) score and follicle to oocyte index (FOI) score of the groups were compared. Totally, 662 cycles were enrolled in the study. There were 418 cycles in group 1, 167 cycles in group 2 and 77 cycles in group 3. As the primary result, FORT and FOI scores were higher in group 3 than the other two groups. Median FORT Score with quartiles: group 1: 100 (66-150), group 2: 71 (57-100), group 3: 136 (96-200), p<.01 - median FOI score with quartiles: group 1: 83 (50-140), group 2: 71 (40-100), group 3: 116 (66-216), p<.01. In conclusion, serum AMH level has more predictive value for stimulation success if there is discordance with AFC.Impact Statement What is already known on this subject? Female age, serum Anti-Mullerian Hormone (AMH) levels, and antral follicle count (AFC) are commonly used to assess ovarian reserve and predict response to ovarian stimulation. AMH and AFC are both positively correlated with ovarian reserve. What do the results of this study add? If there is discordance between AFC and AMH in patients with diminished ovarian reserve (DOR), the ovarian response is better in patients with high AMH and low AFC than the patients with low AMH and high AFC. What are the implications of these findings for clinical practice and/or further research? It is important to assess both AFC and AMH before controlled ovarian hyperstimulation, to predict ovarian response in DOR patients, rather than assessing AFC or AMH alone.Publication Low molecular weight heparin-aspirin-prednisolone combination does not increase the live birth rate in recurrent implantation failure: A retrospective cohort study(Springer Heidelberg, 2023-05-30) Aslan, Kiper; Kasapoğlu, Işıl; Çınar, Ceren; Çakır, Cihan; Avcı, Berrin; Uncu, Gürkan; ASLAN, MÜNİR KİPER; KASAPOĞLU, IŞIL; ÇINAR, CEREN; ÇAKIR, CİHAN; AVCI, BERRİN; UNCU, GÜRKAN; Tıp Fakültesi; Kadın Hastalıkları ve Doğum Ana Bilim Dalı; 0000-0002-9277-7735; 0000-0002-8332-7353; AER-7173-2022; CXJ-7203-2022; IUD-1217-2023; AAH-5249-2021; ELU-2357-2022; AAT-3479-2021This study investigates the triple combination of adjuvants (low molecular weight heparin (LMWH)-aspirin-prednisolone) whether it improves the live birth rates of IVF&ICSI patients with previous implantation failure. This retrospective study included 1095 patients with >2 failed either fresh or frozen single embryo transfer cycles between 2014 Jan and 2021 Jan. Patients were divided into two subgroups. Group A consisted of patients with only vaginal progesterone for luteal phase support. Group B consisted of patients with triple (daily subcutaneous LMWH, daily 150 mg aspirin, and daily 16 mg prednisolone) luteal phase supplementation to vaginal progesterone. Demographic parameters, cycle characteristics, embryology, and pregnancy outcomes were compared, and the study's primary outcome was the live birth rate. Demographic parameters were similar between the groups. Positive b-hCG, miscarriage, and live birth rates were similar between groups as Group A vs. Group B, positive b-hCG 30.8% (190/617) vs. 35.4% (169/478), miscarriage rates 4.4% (27/617) vs. 6.7% (32/478), and live birth rates 20.4% (126/617) vs. 23.8% (114/478), respectively. When patients were stratified according to previous failures, live birth rates were still similar. Pregnancy outcomes were significantly improved in only patients with diminished ovarian reserve (Group A vs. Group B, positive b-hCG 24.2% vs. 34.3%, live birth rate 12.1% vs. 21.9%, p < 0.01). Whether the embryo transfer was fresh or frozen-thawed did not affect the results. A combined supplementation of LMWH, aspirin, and prednisolone in the luteal phase does not improve live birth rates of IVF&ICSI patients with previous implantation failure except potentially for patients with diminished ovarian reserve.Publication Luteal oestradiol for patients with serum oestradiol levels lower than expected per oocyte(Taylor, 2021-03-15) Kasapoğlu, Işıl; Düzok, Nergis; Şen, Esra; Çakır, Cihan; Avcı, Berrin; Uncu, Gürkan; KASAPOĞLU, IŞIL; DÜZOK, NERGİS; Şen, Esra; ÇAKIR, CİHAN; AVCI, BERRİN; UNCU, GÜRKAN; Tıp Fakültesi; Histoloji ve Embriyoloji Ana Bilim Dalı; 0000-0002-8332-7353; AAT-3479-2021; AAH-5249-2021; CXJ-7203-2022; JLC-5688-2023; FVL-9509-2022; ELU-2357-2022Although the efficiency of progesterone in providing luteal phase support has been established, the role of oestradiol supplementation during the luteal phase remains controversial. We evaluated pregnancy outcomes of patients who had a ratio of serum E2 levels on the hCG day to the number of oocytes retrieved (oestradiol/oocyte ratio - EOR) levels of <100 pg/ml by supporting them with additional oestradiol during the luteal phase. In total, 150 patients with an EOR < 100 pg/ml of oestradiol undergoing antagonist intracytoplasmic sperm injection (ICSI) cycles were randomly assigned into two groups to receive either oral oestradiol (4 mg/d) plus vaginal progesterone (90 mg, 2 x 1/day) (group 1) or vaginal progesterone (90 mg, 2 x 1/d) alone (group 2). Implantation rate following transfer of a single embryo did not differ between the two groups (group 1 = 33.3%; group 2 = 34.9%; p = 0.85). Similarly, both groups gave comparable clinical pregnancy rates per embryo transfer with 31.7% in group 1 compared with 28.6% in group 2 (p = 0.69). In conclusion the study suggests that the addition of 4 mg oral E2 to progesterone does not increase the probability of pregnancy.Publication The effect of premature elevated progesterone level in late follicular phase on oocyte quality.(Elsevier, 2019-09-01) Çakır, Cihan; Kuşpınar, Göktan; Kasapoğlu, Işıl; Ata, Mustafa Barış; Uncu, Gürkan; Avcı, Berrin; ÇAKIR, CİHAN; KUŞPINAR, GÖKTAN; KASAPOĞLU, IŞIL; UNCU, GÜRKAN; AVCI, BERRİN; Tıp Fakültesi; Kadın Hastalıkları ve Doğum; 0000-0002-8332-7353; AAT-3479-2021; HTQ-5866-2023; ABE-6685-2020; AAH-5119-2021; AAH-5249-2021; CXJ-7203-2022Publication Glutamate receptor antagonist suppresses the activation of nesfatin-1 neurons following refeeding or glucose administration(Via Medica, 2022-01-01) Koçoğlu, S. Serter; Oy, C.; Halk, Z.; Çakır, C.; Minbay, Z.; Eyigör, O.; OY, CEREN; Halk, Z.; ÇAKIR, CİHAN; MİNBAY, FATMA ZEHRA; EYİGÖR, ÖZHAN; Tıp Fakültesi; Histoloji ve Embriyoloji Ana Bilim Dalı; 0000-0002-8332-7353; 0000-0003-3463-7483; ABQ-8779-2022; ABE-5128-2020; AAH-5249-2021; ABC-1475-2020Background: Nesfatin-1 is a newly identified satiety peptide that has regulatory effects on food intake and glucose metabolism, and is located in the hypothalamic nuclei, including the supraoptic nucleus (SON). In this study, we have investigated the hypothesis that nesfatin-1 neurons are activated by refeeding and intraperito-neal glucose injection and that the glutamatergic system has regulatory influences on nesfatin-1 neurons in the SON. Materials and methods: The first set of experiments analysed activation of nesfatin-1 neurons after refeeding as a physiological stimulus and the effective-ness of the glutamatergic system on this physiological stimulation. The subjects were randomly divided into three groups: fasting group, refeeding group and antagonist (CNQX + refeeding) group. The second set of experiments analysed activation of nesfatin-1 neurons by glucose injection as a metabolic stimulus and the effectiveness of the glutamatergic system on this metabolic stimulation. The subjects were randomly divided into three groups: saline group, glucose group and antagonist (CNQX + glucose) group. Results: Refeeding significantly increased the number of activated nesfatin-1 neurons by approximately 66%, and intraperitoneal glucose injection activated these neurons by about 55%, compared to the fasting and saline controls. The injections of glutamate antagonist (CNQX) greatly decreased the number of ac-tivated nesfatin-1 neurons. Conclusions: This study suggested that nesfatin-1 neurons were activated by peripheral and/or metabolic signals and that this effect was mediated through the glutamatergic system. (Folia Morphol 2022; 81, 2: 379-386)Publication Expression of the ionotropic glutamate receptors on neuronostatin neurons in the periventricular nucleus of the hypothalamus(Via Medica, 2022-01-01) Kocoğlu, S. Serter; Çakir, Cihan; ÇAKIR, CİHAN; Eyigör, Özhan; MİNBAY, FATMA ZEHRA; EYİGÖR, ÖZHAN; Tıp Fakültesi; Histoloji ve Embriyoloji Ana Bilim Dalı; 0000-0002-8332-7353; 0000-0003-3463-7483; ABC-1475-2020; ABE-5128-2020; AAH-5249-2021; ABQ-8779-2022Background: Neuronostatin, a newly identified peptide, is accepted as an anorex- igenic peptide since it suppresses food intake when given intracerebroventricularly. Although the effect mechanisms of neuronostatin have been shown in different studies, there are no reports in the literature describing the mechanisms controlling neuronostatin neurons. In this study, we aimed to determine the presence of the ionotropic glutamate receptor subunits (iGluRs) in neuronostatin neurons in the periventricular nucleus of the hypothalamus. Materials and methods: The presence of glutamate receptors in neuronostatin neurons was investigated by dual immunohistochemistry. Immunohistochemistry was performed on 40 mu m thick coronal brain sections with antibodies against AMPA (GluA1-4), kainate (GluK1/2/3, and GluK5), and NMDA (GluN1 and GluN2A) receptor subunits. Results: The results showed that the neuronostatin neurons expressed most of the NMDA and non-NMDA receptor subunits. The neuronostatin neurons in the anterior hypothalamic periventricular nucleus were particularly immunopositive for GluA1, GluA4, GluK1/2/3, GluK5 and GluN1 antibodies. No expression was observed for GluA2, GluA3 and GluN2A antibodies. Conclusions: For the first time in the literature, our study demonstrated that the neuronostatin neurons express glutamate receptor subunits which may form homomeric or heteromeric functional receptor complexes. Taken together, these results suggest that multiple subunits of iGluRs are responsible for glutamate transmission on neuronostatin neurons in the anterior hypothalamic periventricular nucleus.Publication The effect of the gonadotropin dose increment during controlled ovarian hyperstimulation on live birth rates of POSEIDON group 3-4 patients(Bursa Uludağ Üniversitesi, 2024-06-12) Aslan, Kiper; Kasapoğlu, Işıl; Mesut, Çağatay; Gürbüz, Tansu Bahar; Çakır, Cihan; Avcı, Berrin; Uncu, Gürkan; ASLAN, MÜNİR KİPER; KASAPOĞLU, IŞIL; MESUT, ÖMER ÇAĞATAY; GÜRBÜZ, TANSU BAHAR; ÇAKIR, CİHAN; AVCI, BERRİN; UNCU, GÜRKANThis retrospective study seeks to explore whether modifying the gonadotropin dose in cases of poor ovarian response during controlled ovarian hyperstimulation contributes to improved live birth rates in Poseidon Group 3-4 patients. The study took place at a tertiary level university. The electronic database spanning 2012-2021 was scrutinized to identify patients with diminished ovarian reserve (DOR) who underwent intra-cytoplasmic sperm injection – embryo transfer (ICSI-ET). Diminished ovarian reserve was determined using the POSEIDON criteria. Patients were categorized into two groups based on whether dose adjustment was implemented during the initial ultrasound assessment in controlled ovarian hyperstimulation (COH). There were 188 patients in the dose adjustment (DA) group and 310 patients in the fixed-dose (FD) group. The demographic parameters were similar between the groups. The started gonadotropin dose was similar in both groups (300 IU). The median dose adjustment on the first control was +75 IU in the DA group. The follicle output rates, follicle to oocyte indexes, and the embryology parameters were comparable between the groups. The positive pregnancy rate was 19.7% (36/188) in the DA group vs. 19.1% (61/310) in the FD Group (p=0.4). The primary outcome of the study; live birth rates were 12% in the DA group vs. 9% in the FD group, and the results were statistically similar (p=0.3). Our research revealed that adjusting the gonadotropin dose in cases of inadequate ovarian response during COH results in comparable live birth rates to those observed in the fixed-dose group. For patients exhibiting an inadequate response, dose adjustment may be deemed necessary.