Berna Şermin Kılıç, Hakan Seyisoğlu, Nil Atakul

In Vitro Fertilizasyon (IVF) Yapılan Polikistik Over Sendromlu Kadınların Gebelik Komplikasyonlarının Değerlendirilmesi

Amaç: Çalışmanın amacı polikistik over sendromlu (PKOS) kadınların gestasyonel diabetes mellitus (GDM) ve preeklampsi başta olmak üzere gebelik komplikasyonlarını normal gebe kadınlarda gelişen komplikasyonlar ile karşılaştırmaktır. Gereç ve Yöntem: PKOS’un gebelik komplikasyonları üzerine etkisini araştırmak için 2002 ile 2011 yılları arasında İstanbul Üniversitesi-Cerrahpaşa, Cerrahpaşa Tıp Fakültesi Tüp Bebek Merkezi’nde “intra cytoplasmic sperm injection” yöntemi kullanılarak gebe kalan, aynı yaş ve vücut kütle indeksine sahip PKOS tanısı olan gebe kadınlarla PKOS tanılı olmayan normal gebe kadınların gebelik komplikasyonları retrospektif olarak karşılaştırıldı. Bulgular: PKOS’lu hastalar ve kontrol grubu gebelik komplikasyonlarına göre karşılaştırıldığında erken gebelik kaybı ve GDM istatistiksel olarak anlamlı bulundu (sırasıyla p=0,005; p=0,013). Erken gebelik kaybı ve GDM ile yaş, vücut kütle indeksi, gebelik sırasındaki kilo alımı, açlık glukoz, açlık insülin ve Homeostasis Model Assessment (HOMA-IR) değeri etkileşimi Spearman korelasyon analizi ile incelendi. Erken gebelik kaybı için gebelik sırasındaki kilo alımı negatif korelasyon gösterirken, GDM için yaş, açlık glukoz, açlık insülin ve HOMA-IR’nin pozitif korelasyon gösterdiği bulundu (Erken gebelik kaybı için p=0,001: GDM için sırasıyla p=0,005, p=0,001, p=0,005, p=0,001). Sonuç: PKOS’da erken gebelik kaybı ve GDM sıklığı fazladır. PKOS’lu gebelerin erken gebelik kayıpları hastaların kan şeker regülasyon parametrelerinden bağımsız olarak yüksek bulunmuştur.

Evaluation of Pregnancy Complications in Women with Polycystic Ovarian Syndrome Who Have Undergone In Vitro Fertilization (IVF)

Objectives: The aim of the study is to compare the pregnancy complications including particularly gestational diabetes mellitus (GDM) and preeclampsia of women having polycystic ovarian syndrome (PCOS), with normal pregnancy complications. Materials and Methods: To investigate the impact of PCOS on pregnancy complications, we retrospectively compared the pregnant patients (diagnosed with PCOS) with normal pregnant patients who became pregnant using the intra cytoplasmic sperm injection method, having same age and body mass index, at İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Obstetrics and Gynecology, In Vitro Fertilization Unit between 2002 and 2011. Results: When the patients diagnosed with PCOS and control group were compared in terms of the pregnancy complications, early pregnancy loss and GDM were found to be statistically significant. (respectively p=0.005, p=0.013). The interaction between early pregnancy loss and gestational diabetes with age, body mass index, gestational weight gain, fasting glucose, fasting insulin and Homeostasis Model Assessment (HOMA-IR) values were investigated with the Spearman correlation analysis. While the gestational weight gain was negatively correlated with early pregnancy loss; age, fasting glucose, fasting insulin and HOMA-IR were positively correlated with gestational diabetes (p=0.001 for early pregnancy loss; p=0.005, p=0.001, p=0.005, p=0.001 respectively for GDM). Conclusion: Early pregnancy loss and GDM are seen more often in polycystic ovary syndrome. Early pregnancy loss of pregnant women with PCOS was found to be high independent of the blood sugar regulation parameters of the patients.

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