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.

Adolescent dysmenorrhea and future endometriosis

Dysmenorrhoea is typically classified as primary, or secondary due to underlying pathologies like fibroids, endometriosis, adenomyosis or uterine anomalies. Generally, long-term dysmenorrhea is present in endometriotic patient's anamnesis, but until recently, the research to clarify this connection remained retrospective. Knox et al. from the Department of Paediatric and Adolescent Gynecology, The Royal Children's Hospital, Melbourne, Australia, conducted a longitudinal cohort study on adolescents who need multiple treatments in tertiary centers due to their severe dysmenorrhea, aiming to find the relation between…

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What happens to women with endometriosis after menopause?

Endometriosis affects women in their reproductive period of life, with expected regression of lesions in the postmenopausal period. Literature about postmenopausal endometriosis assessing the prevalence, pathogenesis, and treatment is limited. As 2-5 % of postmenopausal women are affected by this uncommon condition, developing stress push forward the necessity for future research on this topic. Ladanyi et al. from the Department of Obstetrics and Gynecology from the University of Tennessee, USA, reviewed the current literature and recently published their findings regarding postmenopausal endometriosis in the…

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How to Classify Endometriosis for a better and effective evaluation

Endometriosis affects 10% of women in their reproductive period and causes infertility around 40% of women who have the disease. Peritoneal fluid may be one of the factors to facilitate the spread of endometriosis to ovaries, peritoneum and other deep tissues. Small, but progressive lesions may progress more aggressively inside the pelvic space and be more harmful to patient fertility when compared to larger but calm masses of endometriomas. Joliniere et al., from the Department of Gynecology and Obstetrics in Fribourg…

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A position statement of diagnosing and treating endometriosis for gynecologists.

Endometriosis Treatment Italian Group recently declared 10 "valuable" conducts to evaluate endometriotic patients and published them in Hum. Reprod. Open. This society consists of 16 university departments and training center with expert clinicians on endometriosis from Italy. After arising the idea of defining medical interventions and achieving gold standards of diagnosing and treating endometriosis that can be adapted to various disease forms they performed first meeting in Oct.2016. In this meeting, the committee discussed and collectively selected the final ten remarks to…

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A study about adnexial torsion doubts in patients with endometriosis.

Endometrioma is the presence of endometriosis cysts in the ovary, and is one of the most common forms of endometriosis, with unknown pathophysiology. Adnexal torsion results in twisting ovarian tissues resulting in a decreased blood flow. The causes for adnexal torsion due endometrioma is not clear yet. Dr. Dafna and colleagues from the Department of Obstetrics and Gynecology of Tel Aviv University, Israel, recently published a retrospective cohort study in Israel Medical Association Journal, where they retrospectively examined the data of surgically…

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Analogous pathways of peritoneal tumor wound healing and endometriosis.

Endometriosis, diagnosed around 10-15% of women population in their reproductive period, is a chronically progressive inflammatory disease to cause peritoneal lesions while spreading into the abdominal cavity. The pathophysiology of the adhesions between the peritoneum and pelvic organs can be explained by the similar pathways of some other clinical conditions such as peritoneal metastasis and injuries, which cause hypoxia, cytokines discharge, fibrosis, and sclerosis of peritoneal tissues. Dr. Wilson, from the Upper Gastrointestinal Surgery Department of Liverpool Hospital, Australia, penned…

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Searching new biomarkers for endometriosis

This recent article published in Advances in Clinical Chemistry, is an overall summary of characteristics, physiopathological theories, diagnostic approaches and variety of biomarkers to diagnose endometriosis and penned by Coutinho et al. from Universidade Federal de Juiz de Fora, Belo Horizonte, Brazil. Endometriosis, a disorder with a broad spectrum of clinical presentation, varying from superficial implants in the peritoneum, to ovarian endometriomas, and deep infiltrating lesions and even outside the pelvis.  The absence of a currently available non-invasive diagnostic method and the nonspecific…

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The reason for lower BMI and less body fat in women with endometriosis.

Zolbin et al. from the Department of Obstetrics and Gynecology of Yale School of Medicine, New Haven, USA, recently published the results of their prospective controlled research on adipocyte alterations in endometriosis, in the journal "Reproductive Biology and Endocrinology". Endometriosis can be determined as a gynecologic disorder characterized deposition and proliferation of endometrial cells outside the uterus and caused pelvic pain as well as infertility in women. One of the unrelated gynecological symptoms about this disorder is lipid dysfunction as subcutaneous…

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A new hope for a "targeted" drug for endometriosis

Lin et al. from National Cheng Kung University, Taiwan, recently published in"Theranostics" the article entitled "Targeting Anthrax Toxin Receptor 2 Ameliorates Endometriosis Progression”,  report that ANTRX2 may be a novel therapeutic target for endometriosis. Thinking that the adhesion should be the first and the most critical step for retrogradely transferred endometrial tissues to develop endometriosis, authors tried to identify novel and druggable targets involved in the adhesion of endometriotic lesions. In this prospective study, they identified that ANTXR2, a membrane receptor, is overexpressed in ectopic…

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Proposed algorithm for a clinical diagnosis of endometriosis.

This recently published article in the American Journal of Obstetrics and Gynecology is about the challenge of diagnosing endometriosis, its impact on women's daily life and authored by Agarwal et al. from The University of California, San Diego, CA, USA. Authors called attention to the nature of endometriosis, including uncertain clinical symptoms such as pelvic pain and infertility that caused 4 to 11 years of well-established delay for diagnosis. In the USA last population-based data shows there are more than 4 million of endometriosis diagnosed…

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A new trial to reduce the failure of IVF/ICS protocols in severe endometriosis

Kong et al., from the first affiliated hospital of Zhengzhou University, China, recently published this single-blinded, a multicentered and randomized controlled study in the Journal of Reproductive Health, with the aim to find a safer and more effective ovulation induction regimen for patients with endometriosis.  In the long-term GnRH agonist (GnRH-a) regimen of patients with endometriosis, to create a low estrogen status which serves to depress the ectopic endometrial tissues, 2 to 3 doses of long-acting Triptorelin is given prior to ovulation induction, and, after…

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Antimullerian Hormone, endometrioma and ovarian reserve

Younis et al. from Baruch-Padeh Medical Center, Poriya, Israel, designed a review study on ovarian reserve alterations before and after endometrioma surgery that recently documented in "Human Reproduction Update". The authors examined the electronic databases of articles published between January 2000 and October 2018  by focusing on the papers measuring anti-Müllerian hormone (AMH) and antral follicle count (AFC) as markers of ovarian reserve, and compare unilateral or bilateral ovarian endometrioma resection operations to prove it. Out of 28 prospective full-text articles assessed for eligibility,…

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Ovarian stimulation regimes: Concerns on progression or recurrence of endometriosis

Somigliana et al., from the University of Milan, Italy, performed a literature review to predict the endometriosis-enhancing effect of ART regimes on infertile women and reported their results in Reproductive Biomedicine Online. Their points of interest were increasing dysmenorrhea, dyspareunia, non-menstrual pain and growing of endometriotic lesions during the application of ART. The quality of case-control and cohort studies were evaluated by Newcastle-Ottowa scale (NOS) to grade the literature as low, moderate or high quality. Meta-analysis cannot be made because of the variability of study…

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Menstrual blood-derived stem cells

Chen et al.  from the Center of Diagnosis and Treatment of İnfectious Disease, Zhejiang University, China penned this recent review in the Journal of Stem Cell Research Therapy which is presenting the clinical potential of MenSCs (Menstrual blood-derived stem cells).  The authors touched on multi-functional roles of MenSCs which derived from decidual endometrial cells and have high proliferation rate, pluripotency, low immunogenicity beside their easy collectibility with non-invasive methods. MenSCs also have the ability to differentiate into cardiomyocytic, neurotic, cartilaginous, myocytic, respiratory,…

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Estrogen Receptor Signaling and Endometriosis-Associated Ovarian Cancer

Andersen et al. published a prospective cohort study in the Journal of Hormones and Cancer to enlighten the estrogen signaling pathway during the transition from endometriosis to endometriosis-associated ovarian cancer. Given the shared pathway of endometriosis and ovarian cancer as estrogen-responsive disease entities, estrogen signaling has been implicated in endometriosis-associated ovarian cancer. To examine the relation and the progression, and to be able to observe its association with estrogen signaling, eighty-three samples collected from the patients with endometriosis, including 11 atypical endometriosis, 9…

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A link between endometrioid ovarian carcinoma and endometriosis.

Ciavattini et al.from Polytechnic University Ancona, Italy create a pilot study which recently published in Oncology Letters to clarify the link between endometriosis and endometrioid ovarian cancer. The unfolded protein response (UPR) activity as a promoter of neoplastic progression of malignancies is well known. In hypoxic conditions, normally pro-apoptotic signals, cellular metabolic changes, and stimulation of neoangiogenesis occur within the cell, if it could not be restored, terminally ends with apoptosis-mediated cellular death. In a malignant cell, UPR activation via Endoplasmic Reticulum (ER) transmembrane receptors such…

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Building an ultrasonographic database for superficial endometriosis.

Chowdary et al. from University of Auckland, Australia, recently published a retrospective, small group study in Australian New Zeland Journal of Obstetrics and Gynecology, to demonstrate ultrasonographic findings of mild endometriosis patients with pelvic pain are associated with their laparoscopic diagnosis. The study was performed on fifty-three patients with pelvic pain and diagnosed as superficial endometriosis after the ultrasonography performed by a single expert sonologist between 2012 and 2015.  The laparoscopic findings of seventy-nine percent of the patients were consistent when compared…

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Can we prevent the progression of endometriosis?

Torres-Reveron et al. from the University of Texas, USA, planned this prospective laboratory research on female rats to assay the reduce on the progression of endometriosis and recently published the results in PloS One. At first,  endometriosis was induced in female rats surgically, while one half have undergone a sham operation.  The authors did not find any significant effect of surgeries on cyclicity or on the behavioral parameters. After seven days of surgery for generating endometriosis, CHRH1 levels were elevated twice in endometriosis,…

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Somatic mutations in iatrogenic endometriosis.

Lac and al., from the Department of Molecular Oncology in BC Cancer Research Center, Vancouver, Canada, planned a retrospective and multinational research to investigate the prevalence of somatic cancer-driver mutations in incisional endometriosis and recently published in the "Journal of Human Reproduction". Their aim was to investigate if incisional endometriosis harbor somatic cancer-driver mutations like deeply infiltrated endometriosis (DIE), as was previously reported. Endometriosis specimens of 40 women with incisional endometriosis and 36 women with DIE without a known history of malignancy were collected from clinics of Canada,…

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Is the mystery for progression of endometriosis hiding out in abnormally located endometrial cells?

This prospective study was conducted by Hapangama et al. in Research İnstute of the University of Liverpool, UK, and the results have recently published in the Journal of Human Reproduction. The authors hypothesized that abnormally located endometrial basalis-like (SSEA1/nSOX9+)cells could be contributing to ectopic endometriotic lesion formation, based on the previous findings of a higher number of  "basalis-like cells"  in eutopic endometrium of women with endometriosis, these cells have a [SSE1(+)/SOX9(+)] signature showed progenitor activity in-vitro, are also present in the ectopic endometrium. All these findings support…

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