Selma Oransay, MD
Dr. ORANSAY is 35 years experienced clinician in OB/ GYN. She worked in the main national maternity educational hospital of Turkey for 20 years than she moved to İstanbul and worked in private hospitals. Her published articles are mostly on topics of menopause and infertility. She is also experienced as a voluntary OB/GYN doctor in African healthcare program.
Women's willingness to donate menstrual blood for endometriosis research
The menstrual blood is 50-100 ml/per cycle, with 80% lost during the first three days. On the heaviest bleeding day, 2 to 8 ml may be collected from a cup worn for four hours. This fluid could be investigated by collecting viable immune and endometrial cells. The menstrual immune cells are similar to the circular immune cells in peripheral blood, with fewer T lymphocytes and more natural killer cells. The delay in diagnosing endometriosis is estimated to be 8 years.…
Key Points Lay Summary
Postoperative pain-related quality of life for patiens with different types of endometriosis surgery.
Endometriosis surgery usually improves chronic pelvic pain and the quality of life in women suffering from that disease. Response to surgery depends on several factors, however, in younger ages, recurrence of both pain and endometriosis lesions are reported. Most research on the outcomes of surgeries was conducted in retrospective studies. There is a lack of prospective study design to evaluate the surgical outcomes in the literature. Lee et al. from the Department of Obstetrics and Gynecology of British Columbia Women's…
Key Points Lay Summary
Current practice in robotic surgery for deep-infiltrating endometriosis
Today, surgical excision of endometriotic lesions is the only cytoreductive procedure for managing endometriosis. Hormonal treatment may partly relieve the symptoms, but it suppresses rather than cytoreduction of the disease. Minimally invasive surgery is usually the most preferred method due to reduced blood loss, postoperative pain, and hospitalization. Laparoscopic surgery is recommended in advanced and complex cases but sometimes may result in tissue alterations provoked by adhesions. Compared to 3D robotic surgery, laparoscopic surgery may have some technical limitations such…
Key Points Lay Summary
Early use of hormonal contraceptives and the probability of endometriosis diagnosis later in life
Hormonal contraceptives are the first-line medical treatment of endometriosis. If an adolescent has chronic pelvic pain and is an "unresponder" to hormonal therapy, the likelihood of having an "endometriosis diagnosis" is higher. This sign should warn clinicians about endometriosis diagnosis to refer the adolescent to a tertiary endometriosis clinic. Obern et al., from the Department of Children's Health, Uppsala University, Sweden, aimed to evaluate whether the early need for hormonal contraceptives could be a warning sign for endometriosis in adolescents.…
Key Points Lay Summary
Early diagnosis of deep infiltrating endometriosis in adolescence
Dysmenorrhea is widely observed in adolescence, and endometriosis is one of its causes. However, endometriosis diagnosis is usually made after 25 years of age. It is clear that early diagnosis and management of this progressive disease is essential and will have a good impact both on the quality of life and fertility. Moreover, patients who undergo surgery in advanced stages of the disease have more intra and postoperative complications. Martire et al. from the Gynecology Unit of the Department of…
Key Points Lay Summary
Cervical angle, retroflex uterus and abnormal placental position in women with endometriosis
Pregnancy complications such as miscarriage, preterm delivery, placenta previa, small for gestational age, and early abruption of the amniotic sac are more common in the pregnancies of endometriotic women. These complications could arise due to the inflammatory and adhesive characteristics of endometriosis disease resulting in retroflection. Dr. Higeta et al. from the Department of Obstetrics and Gynecology of Gunma University Graduate School of Medicine, Japan, aimed to evaluate the effect of endometriosis on perinatal complications by comparing pregnancies with and…
Key Points Lay Summary
Fertility outcomes after discoid excision for colorectal endometriosis.
Colorectal endometriosis is one of the most severe forms of deep endometriosis, composing 85% of all bowel lesions. Radical treatment is segmental resection of the bowels, which can cause postoperative severe complications such as rectovaginal fistula and voiding dysfunctions that negatively affect the quality of life. Surgeons are used to perform rectal shaving and discoid resection approaches besides this radical technique. Rectal shaving is usually indicated in serosal or superficial muscular involvement of endometriosis, with a higher risk of recurrence as…
Key Points Lay Summary
Management of uterine adenomyomas with percutaneous cryoablation.
Adenomyosis can negatively affect the quality of life by causing abnormal bleeding, pelvic pain, dysmenorrhea, and dyspareunia. It is often associated with endometriomas and/or leiomyomas. Treatment of the disease differs as conservative or radical, as well as pharmacological or surgical. For women with adenomyosis who want to preserve their uterus and fertility, adenomyomectomy is a challenging procedure due to excessive bleeding and a remaining uterine scar afterward. Ablation of adenomyomas using high-intensity focused US waves, microwaves, and radiofrequency has been performed…
Key Points Lay Summary
Spontaneous Conception After Deep Endometriosis Surgery
Deep endometriosis is a severe form of endometriosis where lesions invade deeper than 5 mm into subperitoneal space. Surgical management of the disease is a challenging task requiring a multi-disciplinary approach and significant expertise in the field. Anastomotic leaks, fistula, and pelvic abscesses are reported in around 5% of colorectal surgeries, even in expert clinics. Management of infertile women, particularly asymptomatic ones who are diagnosed with deep endometriosis, is open to debate between ART application or surgical approach. When the…
Key Points Lay Summary
Neonatal uterine bleeding at birth and endometriosis later in life
In the first few days after birth, some female newborns bleed from the vaginal route, and this is called newborn uterine bleeding. The overt and occult neonatal uterine bleeding prevalence rates are 3-5% and 25-60% retrospectively. The causative risk factors for this condition have been studied previously. The physiopathologic mechanism is similar to the adult endometrium, which is affected by circulating progesterone levels. Maternal progesterone levels caused decidual changes in developing fetal endometrium, and due to a rapid fall in progesterone…
Key Points Lay Summary
Bladder Function Alterations Following Endometriosis Surgery
Although endometriosis is a common gynecologic disorder, urinary tract involvement is present in only 1-5% of these patients. When endometriosis invades the urinary tract, clinical symptoms may vary from asymptomatic to frequency, urgency, bladder pain, hematuria, and recurrent urinary infections. These complaints lower the quality of life. Surgical management of endometriosis may cause short or long-term urinary dysfunctions as well. These urinary symptoms are not life-threatening but may affect the quality of life. To conduct a study for statistically comparing…
Key Points Lay Summary
Pregnancy outcomes of women with endometriosis/adenomyosis.
Endometriosis and adenomyosis are diseases presented by ectopic growth of endometrial-gland-like tissues, which we can find in ovaries, pelvic organs, and myometrium. These diseases are causes of hypermenorrhea, dysmenorrhea, chronic pelvic pain, and infertility. Although the number of reports about adenomyosis is less than endometriosis, increased perinatal mortality, small for gestational age, and stillbirths have been reported in those cases. Assisted reproductive technic applications and age are other factors that develop unwanted pregnancy outcomes. This study aimed to be the…
Key Points Lay Summary
Ovarian adhesion prevention with polytetrafluoroethylene during endometrioma surgery.
The World Health Organization defined infertility as the inability to conceive after 12 months of regular unprotected intercourse or after six months of fertility-focused intercourse. Depending on the chronic inflammatory character and causing adhesion formations within the peritoneum, endometriosis is one of the diseases that cause infertility. Adhesion prevention strategies with liquids and solid barrier agents have been studied recently. Multiple commercial barrier products are available to prevent adhesions, including oxidized-generated cellulose, hyaluronate carboxymethyl cellulose, icodextrin, andexpanded polytetrafluoroethylene (ePTFE). However,…
Key Points Lay Summary
Peritoneal fluid in young women with endometriosis
Many blood substances are present in peritoneal fluid due to their derivation from the transudation of blood through the peritoneal surface. Ectopic endometriotic lesions can also change the medium to contribute to the definition of the local environment of the peritoneal cavity. There is miscellaneous research about peritoneal fluid biomarkers to understand the pathology of endometriosis in the literature. However, only a few are about the gross characteristics of the peritoneal fluid. Yousif et al. from the Department of Obstetrics…
Key Points Lay Summary
Endometriosis and the risk of breast cancer
An increased risk of cancer with endometriosis has been in the attention field of endometriosis researchers since 1925, starting with Sampson. Several large meta-analyses supported the increased risk of clear cell and endometrioid ovarian cancer in women with deep infiltrating endometriosis. Breast cancer also attracted the attention of many authors, and a potential association was explored. Endometriosis and breast cancer share many risk factors due to prolonged estrogen exposure to tissues from early menarche to late menopause. However, conflict results have been…
Key Points Lay Summary
Family history of endometriosis and its characteristics
Depression and migraine are two familial disorders affected by menstrual cycle and endometriosis patients have an increased likelihood of suffering from these comorbidities. A correlation of endometriosis, migraine and depression has been already reporteed in the literature, however a link for their familial history is not clear. Metzler et al. from the Department of Gynecology of University Hospital Zurich, Switzerland, planned a observational case-control study with the aim to investigate if a positive family history for endometriosis, migraine, depression or early menapause might…
Key Points Lay Summary
"Ovarian Reserve Markers" in Peritoneal Endometriosis
Endometriosis-related subfertility is attributed to multiple factors, including mechanical obstructions, adhesions, pelvic inflammation, and diminished ovarian reserve. Serum anti-Mullerian hormone (AMH) levels and ovarian antral follicle counts (AFC) currently serve as fertility markers to diagnose decreased ovarian reserve and failure. Recent literature reported a significant decrease in serum AMH levels and lower AFC in women with endometrioma and DIE. The status of ovarian reserve in patients with the most common endometriosis type, namely "peritoneal endometriosis" is not well-known. "Peritoneal endometriosis"…
Key Points Lay Summary
Embryo Morphokinetics of Endometriotic Patients by Time Lapse Monitoring
Many studies showed adverse effects of endometriosis on oocyte quality due to increased apoptosis and dysregulation of molecular pathways related to the development and growth of granulosa cells resulting on developmental arrest in embryos of women with endometriosis. Time-lapse monitoring is a new technology that continuously analyze embryo development by serial image acquisition hence enables embryologists to select the highest-quality embryo during an IVF procedure. A group of researchers from Austria, Germany and the Philipinnes decided to make a systematic literature…
Key Points Lay Summary
Perception of quality of professional healthcare in Italian patients with endometriosis
According to the Italian Ministry of Health, the prevalence rate of endometriosis among women in their reproductive age is 10-15%. Many of them suffer from intense pain and a poor quality of life due to diagnostic delay. The average delay was reported as seven years in 2021 and 10 years in 2022 annual statistics. Starting in 2017, "endometriosis" was accepted as an "Essential level of Assistance" in Italy. The disease's most advanced stages were included in the list of chronic and…
Key Points Lay Summary
Diagnosis and the Treatment of Postmenopausal Endometriosis
About 190 million women around the world are diagnosed with endometriosis. The majority of the cases are between 30 and 40 years of age. After menopause, the incidence of endometriosis declines to 2-5%, and it is more common in women who continue hormonal treatment. The risk increases if the hormonal therapy is estrogen alone or tamoxifen. The symptoms of endometriosis, such as pelvic pain, dysmenorrhea, and non-menstrual pain, largely depend on estrogen. Naturally, these symptoms due to decreasing estrogen levels…
Key Points Lay Summary