ORİJİNAL ARAŞTIRMALAR
Yardımcı Üreme Teknikleri Kullanılarak Gebelik Elde Edilen Hastalarda Serum Kisspeptin Düzeyinin Erken Gebelik Sonuçlarını Öngörmedeki Rolü
The Role of Serum Kisspeptin Levels in Predicting Early Pregnancy Outcomes in Patients Who Achieved Pregnancy Using Assisted Reproductive Techniques
Received Date : 21 Aug 2023
Accepted Date : 12 Feb 2024
Available Online : 19 Feb 2024
Gökçe AYKANATa, Aslı AKDÖNERb, Onur YAVUZb, Erkan ÇAĞLIYANb,
Ali Rıza ŞİŞMANc, Recep Emre OKYAYb
aYerköy Devlet Hastanesi, Kadın Hastalıkları ve Doğum Kliniği, Yozgat, Türkiye
bDokuz Eylül Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum ABD, İzmir, Türkiye
cDokuz Eylül Üniversitesi Tıp Fakültesi, Tıbbi Biyokimya ABD, İzmir, Türkiye
Doi: 10.24074/tjrms.2023-99142 - Makale Dili: TR
Türk Üreme Tıbbı ve Cerrahisi Dergisi. 2024;8(1):12-20.
ÖZET
Amaç: Abortus, ilk trimester gebeliklerinin en sık görülen komplikasyonudur ve gelişen embriyonun sitogenetik anormalliği, bozulmuş implantasyon ve plasentasyon ile ilişkilidir.
Günümüzde abortus riskini doğru bir şekilde öngören güvenilir bir biyobelirteç bulunmamaktadır. Kisspeptinler, KISS1 geni tarafından kodlanan bir peptit ailesidir. Kisspeptin,
insanlarda gebelik boyunca plasentada yüksek oranda eksprese edilir. Çalışmamızda, yardımcı üreme teknikleri kullanılarak gebelik elde edilen 18-40 yaş arası olgularda,
kisspeptin düzeylerinin gebelik sonuçlarını öngörmedeki yerinin belirlenmesi ve abortusu öngörmede biyobelirteç olarak kullanılıp kullanılamayacağının belirlenmesi amaçlanmıştır.
Gereç ve Yöntemler: Çalışma, Dokuz Eylül Üniversitesi Tıp Fakültesi Hastanesi Tüp Bebek Merkezi’nde dahil olma kriterlerine uyan 28 gönüllü olgu ile gerçekleştirilmiştir.
Olgulardan, kontrollü ovaryen stimülasyona başlanmadan önce (KISS1), embriyo transfer günü (KISS2) ve embriyo transferinden 14 gün sonra (KISS3) olmak üzere
toplam 3 kez venöz kan örneği alınarak kisspeptin düzeyi belirlenmiş ve kisspeptin düzeyleri ile gebelik sonuçları karşılaştırılmıştır. Bulgular: Canlı doğum yapan olgularda, kisspeptin
ölçüm ortalamalarının anlamlı seviyede değiştiği (χ²=11,44, p=0,003), bu grupta ilk ölçümden ikinci ölçüme (p=0,043), ilk ölçümden üçüncü ölçüme (p=0,010) ve ikinci
ölçümden üçüncü ölçüme (p=0,006) kisspeptin değerlerinin anlamlı derecede arttığı saptanmıştır. Ayrıca canlı doğum yapan olguların β-hCG (p=0,049) ve KİSS3 (p=0,002) değerlerinin
ortalamalarının canlı doğum yapmayan olguların ortalamalarından daha yüksek olduğu bulunmuştur. Canlı doğum yapmayan olguların ilk ölçümden üçüncü ölçüme
kisspeptin değerlerinin anlamlı derecede azaldığı (p=0,017) saptanmıştır. Olguların β-hCG değerleri ile KİSS3 değerleri arasında anlamlı derecede pozitif yönde ilişki olduğu
(r=0,405, p=0,032), KİSS3 değerlerinin, canlı doğum yapma olasılığını anlamlı seviyede 1,05 kat artırdığı (p=0,009 OR=1,05 [%95 CI 1,01-1,09]) saptanmıştır. Sonuç: IVF tedavisi
sırasında bakılan kisspeptin düzey artışının ve KISS-3 değerinin canlı doğum ile sonuçlanan olgularla ilişkili olduğu gösterilmiştir.
Anahtar Kelimeler: Kisspeptin; abortus; yardımcı üreme teknikleri
ABSTRACT
Objective: Abortion is the most common complication of first trimester pregnancies and is associated with cytogenetic abnormality of the developing embryo, impaired implantation
and placentation. Currently, there is no reliable biomarker that accurately predicts the risk of abortion. Kisspeptins are a family of peptides encoded by the KISS1 gene.
Kisspeptin is highly expressed in the placenta throughout pregnancy in humans. In our study, it was aimed to determine the role of kisspeptin levels in predicting pregnancy outcomes
and to determine whether it can be used as a biomarker in predicting abortion in cases aged 18-40 years who achieved pregnancy using assisted reproductive techniques.
Materials and Methods: The study was carried out at Dokuz Eylul University Medical Faculty Hospital IVF Center with 28 volunteers who met the inclusion criteria. Before
starting controlled ovarian stimulation (KISS1), on the day of embryo transfer (KISS2) and 14 days after embryo transfer (KISS3), a total of 3 venous blood samples were taken
from the cases, and kisspeptin levels were determined. These kisspeptin levels were compared with pregnancy results. Results: It was observed that kisspeptin measurement averages
in live births changed significantly (χ²=11.44, p=0.003), from the first measurement to the second measurement (p=0.043), from the first measurement to the third measurement
(p=0.010), and from the second measurement to the third measurement (p=0.006) kisspeptin values were found to increase significantly. In addition, it was found that
the average β-hCG (p = 0.049) and KİSS3 (p=0.002) values of the cases who had a live birth were higher than the averages of the cases who did not have a live birth. It was determined
that kisspeptin values of the cases who did not give birth decreased significantly from the first measurement to the third measurement (p = 0.017).There was a significant
positive correlation between β-hCG values and KISS3 values of the cases (r=0.405, p=0.032), and KISS3 values significantly increased the probability of live birth 1.05 times
(p=0.009 OR=1.05 [%]. 95 CI 1.01-1.09]) was determined. Conclusion: As a result, it has been shown that the increase in kisspeptin levels during IVF treatment and the KISS-
3 value are associated with cases resulting in live birth.
Keywords: Kisspeptin; abortion; assisted reproductive techniques
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