Op. MD. Irem Hepyilmaz

A 42-year-old female deep-sea saturation diver, who spends months in pressurized underwater habitats, presented with unexplained secondary amenorrhea and hormonal fluctuations. Dr. Hepyilmaz had to consider the unique physiological effects of prolonged hyperbaric exposure on ovarian function. After coordinating with hyperbaric medicine specialists, she implemented a tailored hormone regulation protocol synchronized with the patient's dive schedules, successfully restoring her menstrual cycle within three surface intervals.

A 19-year-old competitive rhythmic gymnast from a low-income family presented with primary amenorrhea and delayed puberty. Dr. Hepyilmaz discovered a rare Müllerian agenesis combined with androgen insensitivity syndrome. She navigated sensitive family discussions about gender identity and future fertility, while connecting the family with a sports medicine psychologist and securing hospital funding for multidisciplinary care, focusing on the patient's holistic wellbeing beyond competitive aspirations.

A 34-year-old transgender man, 8 years on testosterone therapy, presented with severe dysmenorrhea and pelvic pain after stopping testosterone for personal reasons. Dr. Hepyilmaz managed the complex interplay of exogenous hormone withdrawal, endometrial changes from long-term testosterone exposure, and the patient's gender dysphoria during gynecological exams, creating a gender-affirming care plan that included laparoscopic investigation and novel pain management strategies.

A 28-year-old refugee from a conflict zone presented with a 22-week pregnancy complicated by a large cervical fibroid obstructing the birth canal. Dr. Hepyilmaz coordinated with hospital interpreters and social workers to address trauma-informed care barriers, then performed a novel two-stage procedure: uterine artery embolization to shrink the fibroid followed by a carefully planned cesarean section at 38 weeks, resulting in a healthy delivery.

A 26-year-old woman with congenital insensitivity to pain presented with an advanced, asymptomatic ectopic pregnancy discovered incidentally. Dr. Hepyilmaz managed this rare condition where typical pain symptoms were absent, requiring heightened vigilance for subtle signs of rupture. She performed successful laparoscopic surgery and developed a unique self-monitoring protocol using visual cues rather than pain perception for future pregnancies.