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Amaç: Ovaryan hiperstimulasyon sendromu (OHSS) riski altındaki hastalarda, anjiotensin dönüştürücü enzim (ACE) gen insersiyon / delesyon (I/D) polimorfiziminin ovaryan hiperstimulasyon sendromu gelişiminde etkisinin olup olmadığının belirlenmesidir. Gereç ve yöntem: Yardımcı üreme teknikleri tedavisi için ovulasyon indüksiyon programına alınan, ve human koryonik gonadotropin yapıldığı gün estradiol seviyesi 3000 pg/ml’den fazla olan, OHSS gelişimi için yüksek risk altında bulunan 47 infertil hasta dahil edildi. Hastaların yaşı, infertilite süresi, kullanılan total gonadotropin dozu, indüksiyon süresi, elde edilen folikül sayısı, endometriyum kalınlığı ve infertilite nedeni kaydedildi. Kontrol (n:25) ve OHSS (n:22) grubu hastalarının ACE genine ait insersiyon/delesyon polimorfizmi, PCR yöntemiyle çalışılarak tesbit edildi. Bulgular: Yaş, infertilite süresi, gonadotropin dozu, indüksiyon süresi, endometriyum kalınlık ölçümleri iki grup arasında anlamlı farklılık göstermedi. Folikül sayısı kontrol grubunda 17,1 ± 4,2 OHSS grubunda 25,4 ± 6,8 olarak bulundu. Her iki grup arasında bulunan fark anlamlıdır (p<0,001). OHSS grubunda ACE geni D allel frekansı %56,8 kontrol grubunda %54,0 ve toplam 47 hastadaki D allel frekansı %55,3 olarak bulundu. OHSS ve kontrol grubu ACE genotipi için karşılaştırıldığında iki grup arasında II – ID – DD genotipleri bakımından anlamlı fark bulunmamıştır(p>0,05). OHSS grubunda genotipin DD olma olasılığı, kontrol grubuna gore 1,47 kat daha yüksektir (OR: 1,47 %95 Güven Sınırı, 0,44-4,86) fakat istatistiksel olarak anlamlı değildir. Sonuç: Çalışmada OHSS için yüksek riskli hastalarda ACE gen insersiyon/delesyon polimorfizmi çalışılmıştır. DD genotipinin oranı OHSS ve kontrol grubunda farklı değildir. ACE gen insersiyon/delesyon polimorfizminin, OHSS gelişiminde etken faktör olarak değerlendirilmemiştir.
Purpose: In patients at risk of ovarian hyperstimulation syndrome (OHSS), anjiotensin-transforming enzyme (ACE) gene insection/delition (I/D) polymorphism is to determine whether it has an effect on the development of ovarian hyperstimulation syndrome. Tools and methods: 47 infertile patients who were included in the ovulation induction program for the treatment of auxiliary reproductive techniques, with a level of estradiol above 3000 pg/ml on the day when human coronary gonadotropin was done, with a high risk of OHSS development. The patient’s age, infertility time, total dose of gonadotropin used, induction time, the number of follicles obtained, endometrium thickness and infertility cause were recorded. Control (n:25) and OHSS (n:22) groups of patients with ACE gene's insection/distribution polymorphism were tested by PCR method. Results: Age, infertility time, gonadotropin dose, induction time, endometrium thickness measurements showed no significant difference between the two groups. The number of follicles was found at 17.1 ± 4.2 OHSS in the control group at 25.4 ± 6.8. The difference between the two groups is meaningful (p<0,001). In the OHSS group, the ACE gene D allel frequency was 56.8% in the control group 54,0% and the D allel frequency was 55.3% in the total of 47 patients. When compared to the OHSS and the control group for the ACE genotype, there was no significant difference between the two groups in terms of II-ID-DD genotypes (p>0,05). The probability of having genotype DD in the OHSS group is 1.47 times higher than the control group (OR: 1.47% 95 confidence limit, 0.44-4.86) but is not statistically meaningful. Result: The study studied in patients with high risk for OHSS ACE gene insection/deposition polymorphism. The ratio of DD genotype is not different in OHSS and control group. ACE gen is not considered an active factor in the development of insection/dissection polymorphism, OHSS.
Purpose: Previous studies have shown that ovary contains all the components of renin-angiotensin system. Renin-angiotensin system may play a primary role in the pathogenesis of ovarian hyperstimulation syndrome (OHSS). In this study our purpose was to investigate the relationship between the angiotensin-converting enzyme (ACE) gene polymorphism and OHSS in high risk patients for the syndrome. Materials and methods: 47 patients who have undergone controlled ovarian hyperstimulation cycle (control n: 25; OHSS n: 22) were recruited in the study. Estradiol levels of all patients in both group were higher than 3000 pg/ml . Age, duration of infertility, total gonadotropin dose, induction time, total follicular number, endometrial thickness and cause of infertility were recorded. DNA was extracted, and the insertion/deletion polymorphism of ACE gene was detected by polymerase chain reaction (PCR). Results: There were no statistically difference in age, duration of infertility, total gonadotropin dose, induction time and endometrial thickness between control and OHSS group. Follicle number was higher in OHSS group (p<0,001). There were no difference in the ACE II – ID – DD genotypes between OHHS and control group patients (p>0,05). Homozygotes for the deletion polymorphism (DD genotype) were found 1,47 times higher in OHSS group (OR: 1,47 %95 confidence interval, 0,44 - 4,86) but this was statistically insignificant. Conclusion: These data indicate that ACE gene I/D polymorphism is not associated with OHSS. ACE gene polymorphism doesn’t play a major role in the pathogenesis of OHSS.
Field : Sağlık Bilimleri
Journal Type : Uluslararası
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