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.

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

Quality of life analyses among women with endometriosis

Clinical factors that may affect the quality of life in women with endometriosis are mental health, sexual life, working capacity, and social relations. Symptom severity, especially dysmenorrhea, heavy periods, pelvic pain, and infertility complaints, are the most disturbing factors in their life. From the University of Uppsala, Sweden, a team led by Dr. Grundström, set up a prospective cross-sectional study in ten clinical centers in Sweden to analyze which clinical factors affect the quality of life of women with endometriosis.…

Key Points Lay Summary

Deep infiltrating endometriosis and postoperative pregnancy outcomes

Although the current ESHRE guidelines state that there is no strong evidence to support surgical intervention to improve the spontaneous pregnancy rate in women with deep infiltrating endometriosis and advise Assisted reproduction technology irrespective of the severity of endometriosis, several studies have reported that the excision of deep endometriosis lesions was associated with a higher pregnancy rate after surgery, reporting the negative influence of deep endometriosis on the artificial reproductive outcome in women with infertility. Fujii et al. from Kyoto Prefectural…

Key Points Lay Summary

Monitoring eating behavior is important

The relationship between dietary products and endometriosis gained interest after the recognition that a proper diet can improve pathological and physiological processes. There is also a belief that the benefits of some anti-oxidants may have a therapeutic effect on the chronic inflammatory process and reduce visceral pain perception.  Mazza et al. from Magna Grazia University, Italy, aimed to investigate the potential effect of endometriosis on dietary habits and daily activities in a cross-sectional study based on 4078 patient data collected…

Key Points Lay Summary

Sacral neuromodulation for endometriosis-related chronic pelvic pain

Sacral neuromodulation is a therapeutic technique that involves electrical stimulation of a sacral nerve route to modulate a neural pathway. The device is an implantable neurostimulator, and the procedure is a minimally invasive procedure with good long-term outcomes. This technique can cure fecal incontinence, urge urinary incontinence, and nonobstructive urinary retention. The latest application of sacral neuromodulation is chronic pelvic pain, which endometriotic patients frequently complain about. Zegrea et al., from Finland, intended to examine the effect of sacral neuromodulation…

Key Points Lay Summary

Hazardous substances in pollution and relationship with endometriosis.

Vallée and colleguages. from the Department of Epidemiology and Public Health of Foch Hospital, France, recently published a narrative review about environmental pollution and its association with endometriosis in BJOG. They used the existing English literature to discuss the association between hazardous materials and endometriosis and suggested public health policies related to the topic. Endocrine-disrupting chemicals are synthetic compounds that can mimic, block, or alter the actions of natural hormones in the body. These chemicals are found in everyday products…

Key Points Lay Summary

Live Birth Rate for ovarian stimulation protocols after laparoscopic endometrioma cystectomy.

The laparoscopic cystectomy of the ovaries is the first-line infertility treatment in patients with endometriomas. However, a possible diminished ovarian capacity after cystectomy with ovarian failure to respond to the gonadotropin stimuli seems an undesirable result of this procedure. Controlled ovarian hyperstimulation protocols may restore the cumulative pregnancy and life birth rate, and finding and applying the most appropriate protocol for these patients is of great interest. GnRH antagonist, microstimulation, and progestin-primed ovarian stimulation protocols are the commonly used three…

Key Points Lay Summary

Perioperative complications of outpatient surgery for endometriosis.

Surgical treatment of endometriosis plays an essential role in managing the disease. They are miscellaneous perioperative complications such as incomplete removal of the lesions, low quality of the first surgery, or incorrect approach to laparoscopic surgeries that result in increased recurrence risks. In this case, outpatient laparoscopic surgery approach to cases with endometriosis may even associated with a higher risk of complications. Bahrami et al. from the Reproductive, Mother, and Child Unit of the Department of Obstetrics and Gynecology of…

Key Points Lay Summary

Comparison of two different surgical approach to deep colorectal endometriosis in terms of postoperative outcomes.

Deep colorectal endometriosis affects one-fifth of women with endometriosis, which is commonly associated with more pelvic pain and severe gastrointestinal symptoms. Three surgical approaches for deep colorectal endometriosis are segmental colorectal resection, full-thickness discoid resection, and shaving operation. Choosing the surgical approach depends on various factors, which can differ from surgeon to surgeon. The generally preferred method is a segmental resection for multifocal and large nodules exceeding at least 3-4 cm., and a full-thickness discoid resection when small nodules less…

Key Points Lay Summary

Endometrioma surgery and the ovarian reserve

Traditionally, cystectomy is the gold standard for surgical approach owing to the reduced risk of recurrence. Still, it may lead to a reduction in postoperative ovarian volume and can be a cause of ovarian failure. The recent conservative surgical management of endometrioma consists of cystectomy by stripping, ablative approaches by laser, bipolar diathermy, sclerotherapy with ethanol, and their combination. Various measures such as Anti-Müllerian hormone (AMH), antral follicle count (AFC), FSH, and Inhibin B have been used to assess the follicular…

Key Points Lay Summary