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    Current developments in assisted reproduction techniques
    (Maltepe Üniversitesi, 2019) Andaç, Tuğba; Demirci, Nurdan
    INTRODUCTION: Infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more unprotected sexual intercourse. According to the definition of the World Health Organization; Infertility, sexually active and do not do contraception in a couple of years cannot achieve pregnancy (Zegers-Hochschild et al., 2009). Infertility prevalence is 15% in Europe, 18- 27% in Africa, 17-26% in Asia and 14-20% in America (Petraglia, Serour, & Chapron, 2013). In developing countries, approximately 34 million women are living infertility, which causes longterm maternal morbidity. This is seen as the fifth highest global obstacle (Mascarenhas, Flaxman, Boerma, Vanderpoel, & Stevens, 2012). Infertility adversely affects couples’ quality of life (Dinçer, Şanlı, & Kızılkaya Beji, 2015). It can lead to personal and family problems which can cause significant stress, anxiety, and depression which can negatively affect marital relationships, sexual life, and economic situation; medical, emotional, psychological and social problems; cultural, religious and class aspects, is very difficult to deal with the crisis (Aşcı & Kızılkaya Beji, 2012; Benli, 2010). The nurse, a member of the health care team, is in a very suitable position for training and counseling because of the professional equipment of the couples in this important life experience (Coşkun, Yılmaz, & Yılmaz, 2009), (Yılmaz, 2012). On the first day of treatment, the couples interviewed with 60% nurses and 10% doctors. In the following stages; Vaginal USG performed for endometrial evaluation and follicle collection is administered by 33% nurse, 22% doctor, 44% other employees. 60% insemination is applied in the units for 7 days; 39% of the nurses, 22% of doctors, 39% of the nurses and doctors are doing together (Coşkun et al., 2009). Aim: To provide accurate counseling to individuals who face infertility problems, to discuss current developments in assisted reproductive techniques during diagnosis and treatment, to provide evidence-based, individualized care and treatment. METHOD: The study was performed in Turkish and English languages using the latest databases such as PUBMED-EBSCHO-SCİENCEDIRECT, using the keywords ‘infertility’, ‘evidence-based approaches in infertility’, ‘current treatment methods in infertility’. In the light of international guides and current news, recent developments in assisted reproductive techniques have been compiled. RESULTS: As a result of literature search assisted reproductive techniques; • Controlled Over Stimulation Protocols need to be individualized (Güngör, 2017), • Treatment with Corifollitropin Alpha (Youssef et al., 2012), • Developed in low molecular weight gonadotropins (oral) (Leão & Esteves, 2014) • There is a relationship between significant infection and inflammation and impaired reproductive function (Kalem, Kalem, & Gürgan, 2018) • Polarized microscopes (Machtinger & Racowsky, 2013), • Continuous Embryo Monitoring Systems (Time Lapse / Embryoscope) (Meseguer et al., 2012), • Computer-aided sperm analysis (Gungor, 2017), • Sperm Organelle Morphology Evaluation (MSOME) and Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) (Boitrelle et al., 2014), • Tests Evaluating Sperm DNA Integrity (Güngör, 2017), • Microfluidic Sperm Extracting Microchips (Bulgurcuoğlu Kuran & Altun, 2015), • Endometrial Co-Culture (Artificial Rahim) (Güngör, 2017), • Labeling of individual embryos with electronic p-chips (Mandecki & Drawbridge, 2016), • Gametes from stem cell sources (Yanar, Açıkgöz, Şahin, & Sarıkaya, 2017), • Transplantation of uterus (Turk, 04.10.2014), • Sperm swim sperm boots (Scutti, 2016), • Microscopic vasectomy reversal (Louis, 2007), • Ovarian tissue vitrification in patients with primary ovarian failure (Suzuki et al., 2015), • A new, single-dose treatment that can increase both male and female fertility (EurekAlert, 2018), • To be protected from OHSS, short protocols use new approaches such as GnRH analogs (Memorial, 2013) called ‘Analog trigger R instead of hCG in cycles. Conclusion: As a result, health professionals working in the field of infertility should follow all developments in this field and increase their competence; In the light of evidence-based practices, he/she should be able to perform his / her consultant role inappropriate treatment and care.
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    The effect of COVID-19 pandemic on the treatment and care process of gynecological cancers
    (Maltepe Üniversitesi, 2021) Öz, Tuğba; Ölmez Yalazı, Rüveyda; Demirci, Nurdan
    COVID-19 virus, which is included in the beta corona virus (beta-coronavirus) family, including SARS-CoV and MERS-CoV, emerged in Wuhan, China in December 2019 and rapidly affected the whole world in a short time. It was declared as a pandemic (global epidemic) in March 2020. According to the data of the American Cancer Association, 1,735,350 cancer cases and 110,070 gynecological cancer cases developed in 2018, and approximately 32,120 women died due to gynecological cancer. Gynecological cancers (cervix, endometrium, ovarian cancers), which are among the top 10 most common cancers among women in our country, constitute approximately 12.0% of all female cancers. Studies have reported that individuals diagnosed with cancer have a higher risk of getting COVID-19 than those without cancer. With this justification; It has been argued that personal protection measures should be applied in the strongest way in cancer patients who are undergoing cancer treatment or are under follow-up. During the pandemic process, it has been suggested that cancer surgery, even adjuvant chemotherapy, be delayed deliberately. according to some; Postponing surgery for 3-8 weeks is a reasonable approach in selected gynecological cancer cases. It should not be forgotten that; Postponement of oncologic surgery may result in disease progression, tumor non-resectable and poorer survival outcomes. With this justification; If surgery is delayed, it would be better to re-evaluate the cases every 2-4 weeks. During the pandemic, it was decided not to be operated on cases with no absolute surgical urgency, people with unknown COVID-19 status and those with flu-like symptoms and COVID-19 positive cases. It is thought that postponing surgery in cases with gynecological cancer is not psychologically acceptable for the patient and their relatives. Covid-19 virus outbreak stress has been added to the cancer treatment process, which is a physically and psychologically challenging process. For these reasons, this study aimed to examine the effect of the Covid-19 pandemic on gynecological cancers.
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    The effect of COVID-19 pandemic on women's health
    (Maltepe Üniversitesi, 2021) Gündüz, Ceyda Su; Arslan Tarus, Hamide; Demirci, Nurdan
    The Covid-19 virus, which emerged in Wuhan, China on December 31, 2019, affected the whole world in a short time. This disease, which causes many people to become ill and die, was declared a pandemic by the World Health Organization on March 12, 2020. The Covid-19 pandemic has brought many changes in people's lives. Pandemic process; It threatens the humanity of the whole world physically, spiritually and socially. One of the populations with the highest potential to be affected by the Covid-19 pandemic process can be considered as women. Because the Covid-19 pandemic has brought along some problems that may cause an increase in gender inequality and caused adverse effects on women's health due to existing gender roles. Pandemic period; women are more a ected by the fact that women constitute the majority of those working in the health sector, disruptions in their education and health service, increasing unemployment, prolonged stay at home, and increased domestic responsibilities and caregiver roles. Due to the gender roles of women, being close to the patient infected with the Covid-19 virus to care for the patient, being impoverished by working in unpaid jobs, not being able to benefit from health services sufficiently, being exposed to domestic violence negatively affected women's health. During the pandemic period, many routine health services provided to women, especially sexual and reproductive health services, were interrupted. Consequently, it is predicted that the demands for birth control methods will not be met, adolescent pregnancies, unsafe abortions, sexually transmitted diseases, maternal mortality and morbidity will increase. In addition, routine cancer screenings (breast cancer, colon cancer and cervical cancer) were postponed during this period. Accordingly, it is predicted that it will be seen in cancer incidence in the following years. However, women were exposed to more violence in the pandemic. In addition, women experienced more mental health problems such as anxiety, depression, posttraumatic stress disorder and stress than men. In this context, determining the effects of the Covid-19 pandemic on women's health is very important in terms of taking measures and making plans for the protection, development and improvement of women's health. With this review, it is aimed to evaluate the effect of Covid-19 pandemic on women's health
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    ÜRİNER İNKONTİNANSTA KANIT TEMELLİ TAMAMLAYICI VE ALTERNATİF TEDAVİLER
    (2020) Demirci, Nurdan; Gürkan, Özlem Can; Andaç, Tuğba
    Üriner inkontinans; medikal, psikososyal ve hijyenik sorunlara neden olan, bireylerin yaşam kalitesini olumsuz etkileyebilen, önemli ve yaygın birsağlık sorunudur. Dünyada ortalama 200 milyon insan üriner inkontinans şikâyeti yaşamaktadır. Yaşam kalitesi üzerinde önemli bir etkiye sahip olanüriner inkontinans semptomlarının tedavisinde sağlık profesyonelleri sürekli olarak daha iyi müdahaleler aramaktadırlar. Tamamlayıcı ve AlternatifTedavi yöntemlerinden olan davranış değişikliği, yaşam tarzı değişiklikleri, mesane eğitimi, Pelvik Taban Kas Egzersizleri, vajinal konlar,biofeedback, yoga, akupressure, akupunktur gibi uygulamalar mesane fonksiyon bozukluğunu önleyebilir veya azaltabilir. Derlememiz, ürinerinkontinansta kullanılan kanıt temelli tamamlayıcı ve alternatif tedavi uygulamalarını incelemek amacıyla hazırlanmıştır. Derlemenin hazırlanmasürecinde, Cochrane ve PubMed’de yayınlanmış konuyla ilgili makaleler taranmış ve elde edilen makalelerin kanıt düzeyi Joanna BriggsEnstitüsünün kabul ettiği kanıt düzeyi sınıflandırmasına göre incelenmiştir. Elde edilen veriler sonucunda, tamamlayıcı ve alternatif tedaviyöntemlerinin yararlı olup olmadığı konusunda güvenilir, yeterli kanıt bulunamamıştır ve araştırma önceliği olması gerekmektedir.