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"Latar belakang: Fertilisasi in vitro (FIV) merupakan salah satu tata laksana utama dalam penanganan infertilitas. Penyuntikan human Chorionic Gonadotropin (hCG)eksogen merupakan salah satu tahapan penting dalam proses FIV untuk proses maturasi oosit. Walaupun sudah terdapat penelitian sebelumnya mengenai korelasi kedua hal tersebut, namun belum didapatkan suatu model prediksi maturitas oosit. Tujuan: Mengetahui korelasi kadar serum hCG 12 jam pascapenyuntikan terhadap tingkat maturitas oosit pada FIV dan model prediksi maturitas oosit. Metode: Penelitian ini merupakan sebuah penelitian potong lintang yang dilakukan pada peserta program FIV di Klinik Yasmin, RSUPN dr. Cipto Mangunkusumo, Jakarta, Indonesia sejak Januari 2020 hingga Desember 2020. Pasien dengan riwayat prosedur pembedahan ovarium, kemoterapi, radioterapi, dan peserta poor responder dieksklusi dari penelitian. Dilakukan penyuntikan r-hCG 250 µg secara subkutan pada semua subjek. Kadar serum hCG 12 jam pascapenyuntikan dan tingkat maturitas oosit setiap subjek dikumpulkan dan dianalisis. Hasil: Didapatkan sebanyak 28 subjek yang diikutsertakan dalam penelitian. Didapatkan korelasi yang tidak bermakna antara kadar hCG 12 jam pascapenyuntikan dan tingkat maturitas oosit (r = 0,052, p = 0,788). Namun, didapatkan kadar serum hCG 12 jam pascapenyuntikan yang lebih tinggi pada subjek dengan tingkat maturitas >75% (mean diff 34.78,p = 0.046). Didapatkan titik potong kadar serum hCG 12 jam pascapenyuntikan sebesar 90.15 mIU/mL untuk memprediksi tingkat maturitas yang baik. (sensitivitas 68.2%, spesifisitas 83.3%). Prediksi tingkat maturitas oosit dapat dilakukan dengan mengetahui kadar serum hCG 12 jam pascapenyuntikan dan indeks massa tubuh (IMT) subjek (sensitivitas 83.3%, spesifisitas 68.2%). Simpulan: Kadar serum hCG 12 jam pascapenyuntikan yang lebih tinggi berhubungan dengan tingkat maturitas oosit yang lebih baik pada peserta program FIV. Tingkat maturitas oosit dapat diprediksi melalui kadar serum hCG 12 jam pascapenyuntikan dan IMT.

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Background: In vitro fertilization (IVF) is one of the main treatments of infertility. Exogenous Human chorionic gonadotropin (hCG) injection is an important process of IVF and thought to be vital in determining oocyte maturation.

Purpose: This study aims to determine the relationship between 12 hours post-injection serum hCG and oocyte maturation rate on IVF participants.

Method: This is a cross-sectional study on IVF participants on Yasmin Clinic, dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, during the period of January 2020 to December 2020. Subjects with history of ovarian surgery, chemotherapy, radiotherapy, and poor responder subjects were excluded from the study. Subjects were injected with 250 µg of r-hCG subcutaneously. Twelve hours post-injection serum hCG level and oocyte maturation rate were collected and analyzed accordingly.

Result: A total of 28 subjects were included in the study. It was found that higher 12 hours post-injection serum hCG was related with subjects with >75% oocyte maturation rate (mean diff 23.78, p = 0.046). The cut-off point of 12 hours post-injection serum hCG in order to predict better oocyte maturation rate was found to be 90.15 mIU/mL (sensitivity 68.2%, specificity 83.3%). Oocyte maturation rate predicted may be calculated using body mass index and 12 hours post-injection serum hCG. (sensitivity 83,3%, specificity 68,2%).

Conclusion: Higher 12 hours post-injection serum hCG was associated with higher oocyte maturation rate on IVF subjects. Oocyte maturation rate may be predicted using body mass index and 12 hours post-injection serum hCG."

"Pengantar: Dalam siklus teknologi reproduksi berbantu TRB , sebanyak 30 oosit ditemukan dalam keadaan immatur, oosit immatur ini akan yang memiliki kapasitas maturasi dan fertilisasi yang rendah, dan jarang sampai ketahap embrio transfer, namun faktor-faktor yang menyebabkan terjadinya hal in belum diketahui secara luas. Tujuan: Untuk melihat hubungan antara maturitas oosit dengan kadar hCG serum 12 jam pasca penuntikan dan ekspresi mRNA LHR sel granulosa pada siklus TRB. Untuk menilai apakah kadar hCG serum dan ekspresi LHR ini bisa memprediksi laju maturasi oosit pada siklus TRB. Material dan Metode: total 30 sampel normoresponder yang mengikuti TRB dengan protocol antagonis dianalisa secra prospektif. Dua belas jam setelah penyuntikan hCG, kadar hCG serum diukur dan petik oosit melalui USG transvaginal dilakukan 35-36 jam kemudian. Sel granulosa oosit diperoleh saat denudasi oosit untuk proses intracytoplasmic sperm injection ICSI dan sel granulosa ini kemudian diproses RNA prufikasi, reverse transcription dan quantitative real-time polymerase chain reaction PCR . Oosit yang diperoleh saat itu langsung dinilai maturasinya. Test korelasi Pearson dilakukan untuk menilai korelasi laju maturasi oosit dengan kadar hCG dan ekspresi mRNA LHR. Analisa Receiver Operating Characteristic ROC dilakukan untuk menentukan nilai cut-off. Hasil: Kadar hCG seum memiliki korelasi positif dengan maturitas oosit r 0.467, p

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Introduction: During stimulated in vitro fertilization IVF cycle, up to 30 of the recovered oocytes are immatur ones which have lower maturation capacity, poor fertilization capacity and seldom yield transferable embryos however, the precise influencing factors are largely unknown.

Aim: To investigate the association of oocyte maturation with serum hCG levels measured 12 hours after trigger and LHr mRNA expression of granulosa cell in IVF cycles. To find out whether this serum hCG levels and expression of mRNA LHr granulosa cell can predict oocyte maturation rate in IVF cycles.

Material and Method A total of 30 normoresponder IVF cycles stimulated by antagonist protocol were analyzed prospectively. Twelve hours after triggering by exogenous hCG, level of hCG serum was measured and an ultrasound guided retrieval of oocytes was performed 35 36 hours later. Granulosa cells were obtained during oocyte denudation for intracytoplasmic sperm injection ICSI procedures and subjected to total RNA purification, reverse transcription and quantitative real time polymerase chain reaction PCR. Oocytes were stripped immediately after retrieval and maturation was assessed at this time. Pearson 39 s correlation test performed to analyze the correlation of oocyte maturation rate with serum hCG level and expression mRNA LHR. Receiver operating characteristic ROC analysis was performed to determine cut off value.

Result: Serum hCG have positive correlation with oocyte maturation r 0.467, p"

"ABSTRAK Latar Belakang: Gangguan kognitif merupakan salah satu masalah pada aging population berkaitan dengan perubahan neuroendokrin pascamenopause. Gangguan kognitif minimal (minimal cognitive impairment/MCI) merupakan kondisi peralihan fungsi kognitif antara penuaan normal dan demensia.Tujuan: Untuk mengetahui hubungan kadar kisspeptin dan kadar hCG hipofisis dengan gangguan kognitif minimal pada perempuan pascamenopause.Metodologi: MCI ditentukan dengan sistem skoring yang terdiri dari status diabetes melitus, toleransi glukosa terganggu, dislipidemia, Geriatric Depression Scale (GDS), uji Rey Osterrieth Complexion Figure (ROCF), uji digit span backward dan uji Trail Making Test B. Studi potong lintang terhadap 181 perempuan pascamenopause usia £ 65 tahun, terbagi 2 kelompok yaitu dengan MCI 90 orang dan tanpa MCI 91 orang.Hasil: Analisis terhadap usia, lama menopause, indeks massa tubuh, lama pendidikan, kadar kisspeptin dan kadar hCG hipofisis. Kadar kisspeptin menunjukkan perbedaan bermakna anatar kedua kelompok (p<0,001). Kadar kisspeptin dan lama menopause berkorelasi positif dengan skor MCI (r=0,607 dan r=0,542; berurutan). Namun, tidak ada perbedaan kadar hCG hipofisis antara kedua kelompok (p=0,664), dan skor MCI tidak berkorelasi dengan kadar hCG hipofisis (p=0,398; r=0,06).Kesimpulan: Kadar kisspeptin signifikan lebih tinggi pada perempuan pascamenopause dengan MCI, dan menunjukkan korelasi positif. Sementara kadar hCG hipofisis tidak berbeda di antara kedua kelompok dan tidak menunjukkan korelasi.

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ABSTRACT

Backgroud: Cognitive impairment is one of problems among elderly women due to neuroendocrine alteration after menopause. Minimal cognitive impairment (MCI) is a transition state of cognitive function between normal aging and dementia.

Aims: To investigate relationship between kisspeptin and pituitary hCG with MCI in postmenopausal women.

Methods: MCI was determined by scoring; with diabetic status, glucose intolerant, dyslipidemia, Geriatric Depression Scale (GDS), Rey Osterrieth Complexion Figure (ROCF), digit span backward, and Trail Making Test (TMT) B. Using cross-sectional study, 181 postmenopausal women £ 65 years old, were grouped into with and without MCI; 90 and 91 women, respectively.

Results: Data was analysed to their ages, span of menopause, body mass index (BMI), education grade, kisspeptin and hCG level. Kisspeptin level had significantly different among the groups (p<0.001). There was a positive relationship between kisspeptin level and span of menopause to MCI score (R=0.607 and R= 0.542, respectively). Pituitary hCG level, however, showed no difference among the groups. Moreover, MCI score showed no relationship to hCG level (p=0.398; R=0.063).

Conclusions: Kisspeptin level was significantly higher among postmenopausal women with MCI, and showed a positive relationship. While pituitary hCG had no difference among the groups, and showed no relationship."

"Latar Belakang: Tumor sel germinal mediastinum merupakan kelompok neoplasma gonad yangsensitif terhadap kemoterapi, namun agresif dan memiliki prognosis buruk. Penegakkan diagnosisdini yang tepat adalah hal yang penting dan salah satunya adalah dengan penilaian penanda tumoralpha fetoprotein (AFP) dan beta human chorionic gonadotropin (ßHCG).Metode: penelitian ini dilakukan dengan desain uji diagnostik dengan pendekatan potong lintangterhadap pasien tumor sel germinal nonseminoma mediastinum di RSUP Persahabatan sejakJanuari 2015 hingga Desember 2022 dengan mengukur kadar Alfa Fetoprotein dan HumanChorionic Gonadotropin serum dan dilakukan pemeriksaan histopatologi. Analisis data dilakukanuntuk menguji sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif, akurasi diagnostik,dan analisis kurva receiver operating characteristic (ROC).Hasil: Dari total 362 subjek yang memenuhi kriteria inklusi, dari kedua penanda tumor AFP danßHCG didapatkansensitivitas 90,77% (IK 95% 80,98% - 96,54%), spesifisitas 97,98% (IK 95%95,65% - 99,26%), nilai duga positif 90,77% (IK 95% 81,61% - 95,61%), nilai duga negatif97,98% (IK 95% 95,77% - 99,05%), rasio kekerapan positif 45,4 (IK 95% 20,27 – 99,58), rasiokekerapan negatif 0,09 (IK 95% 0,04 – 0,2), serta nilai akurasi diagnostik sebesar 96,69% (IK95% 94,28% - 98,28%).Kesimpulan: Pemeriksaan kadar Alfa fetoprotein dan ßhuman chorionic gonadotropin memilikiakurasi 96,69%, sensitivitas 90,77% spesifisitas 97,98%, nilai duga positif 90,77%, nilai duganegatif = 97,98% dalam penegakkan diagnosis tumor sel germinal nonseminoma mediastinum

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Background: Mediastinal germ cell tumors are a group of gonadal neoplasms that are sensitive

to chemotherapy, but very aggressive and have poor prognosis. Early and correct diagnosis is

important, one of them is by measuring tumor markers in serum: alpha-fetoprotein (AFP) and

beta human chorionic gonadotropin (βHCG).

Method: This study was conducted with a diagnostic test with a cross sectional approach design

on patients with mediastinal germ cell tumors at RSUP Persahabatan from January 2015 to

December 2022, and also assessment of tumor markers alpha-fetoprotein (AFP) and beta human

chorionic gonadotropin (βHCG) serum and histopathology examination. Data analysis was

carried out to find the sensitivity, specificity, positive predictive value, negative predictive value,

diagnostic accuracy, and receiver operating characteristic (ROC)

Results: Of a total of 362 eligible subjects, the sensitivity was 90.77% (95% CI 80.98% -

96.54%), the specificity was 97.98% (95% CI 95.65% - 99.26%), the positive predictive value

was 90.77% (95% CI 81.61% - 95.61%), the negative predictive value was 97.98% (95% CI

95.77% - 99.05%), the positive likelihood ratio was 45.4 (95% CI 20.27 - 99.58), the negative

likelihood ratio was 0.09 (95% CI 0.04 - 0.2), and the diagnostic accuracy was 96.69% (95% CI

94.28% - 98.28%).

Conclusion: the sensitivity was 90.77%, the specificity was 97.98%, the positive predictive value

was 90.77%, the negative predictive value was 97.98%, and the diagnostic accuracy was 96.69%."

"Latar Belakang: Growth Differentiation Factor 9 (GDF9) adalah salah satu anggota dari superfamili TGF-β yang merupakan salah satu oocyte-secreted factor (OSF). GDF9 memainkan peran penting dalam folikulogenesis ovarium, kompetensi perkembangan oosit, serta sebagai molekul esensial yang mengontrol berbagai proses sel granulosa dan laju ovulasi. GDF9 merupakan OSF yang memainkan peran penting dalam menjaga fertilitas wanita. Penelitian ini bertujuan untuk mengetahui apakah ekspresi GDF9 berkorelasi dengan kualitas oosit dan laju fertilisasi pada pasien fertilisasi in vitro.Tujuan: Mengetahui korelasi ekspresi GDF-9 dengan kualitas oosit dan laju fertilisasi pada pasien Fertilisasi In VitroMetode: Penelitian ini adalah penelitian potong lintang yang dilaksanakan di Klinik Yasmin, Rumah Sakit dr. Cipto Mangunkusumo, Jakarta sejak bulan Juli 2019 sampai bulan Juli 2020. Terdapat 26 wanita berusia 25-40 tahun pasien Fertilisasi In Vitro tanpa penyakit endometriosis maupun Sindrom Ovarium Polikistik yang menjadi subjek penelitian ini. Cairan folikel pasien diambil, kemudian dilakukan pengukuran ekspresi gen GDF9. Setelah itu, dilakukan evaluasi pada data ekspresi gen GDF9 serta diuji korelasinya dengan kualitas oosit dan laju fertilisasi pasien menggunakan aplikasi SPSS.Hasil: Sebanyak 26 pasien IVF berpartisipasi dalam penelitian ini. Median jumlah ekspresi gen GDF9 adalah sebanyak 2.47 x 10-5 ng/μl dengan median kualitas oosit dan laju fertilisasi pasien IVF sebesar 3.00 dan 0.60. Berdasarkan hasil uji korelasi, terdapat korelasi negatif antara ekspresi GDF9 terhadap laju fertilisasi dengan kekuatan korelasi sedang (r = -0.443, p = 0.012). Sementara, ditemukan korelasi tidak bermakna antara ekspresi GDF9 terhadap kualitas oosit (r = -0.306, p = 0.064).Kesimpulan: Terdapat korelasi negatif dengan kekuatan korelasi sedang antara ekspresi GDF9 dengan laju fertilisasi, sementara hubungan ekspresi GDF-9 dengan kualitas oosit memiliki korelasi tidak bermakna.

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Background: Growth Differentiation Factor 9 (GDF9) is a member of the TGF-β superfamily which is one of the oocyte-secreted factor (OSF). GDF9 plays an important role in ovarian folliculogenesis, the competence of oocyte development, as well as an essential molecule that controls various granulosa cells process and the rate of ovulation. GDF9 is an OSF which plays an important role in maintaining female fertility. This study is conducted to see the correlation between the expression of GDF9 gene with the oocyte quality and the fertilization rate in the IVF patients.

Aim: To find out the correlation between the expression of GDF9 with the oocyte quality and the rate of fertilization of IVF Patients

Methods: This study is a cross-sectional study which was conducted at Klinik Yasmin dr. Cipto Mangunkusumo General Hospital, Jakarta since July 2019 to July 2020. 26 IVF patients aged 25-40 years without the conditions of endometriosis or Polycystic Ovary Syndrome (PCOS) participated in this study. Follicular fluids are taken from the patients and the GDF9 gene expression were measured. The data were then evaluated for its correlation with the oocyte quality and the fertilization rate using the SPSS application.

Results: Abour 26 IVF patients were participated in this study. The median amount of GDF9 gene expression was 2.47 x 10-5 ng/μl. The median of the oocyte quality and the fertilization rate was 3.00 and 0.60. According to the correlation test, there is a negative correlation between the expression of GDF9 gene and the fertilization rate with a moderate statistical correlation (r = -0.443, p = 0.012). Meanwhile, the expression of GDF9 gene has no significance correlation with the oocyte quality (r = -0.306, p = 0.064).

Conclusion: This study showed a negative correlation between the expression of GDF9 gene and the fertilizatio rate, while the relation between the GDF9 expression and the occyte quality has no significance correlation."

"Fertilisasi In Vitro (FIV) merupakan terapi pasutri ingin anak. Berbagai penelitian dilakukan untuk meningkatkan keberhasilan FIV seperti penelitian ini bertujuan untuk mengetahui hubungan dosis gonadotropin dengan ketebalan endometrium, serta menyelamatkan oosit imatur melalui suplementasi hCG. Analisis retrospektif dilakukan dari 2018 sampai 2021. Hasil yang diamati berupa jumlah oosit didapat, oosit matang, pembuahan, embrio berkualitas baik dan buruk, tingkat kehamilan. Analisis dilakukan terhadap penggunaan total dosis gonadotropin dan ketebalan endometrium serta penyelamatan oosit imatur dengan mengkultur oosit imatur dalam medium suplementasi hCG. Pembagian kelompok berdasarkan penggunaan gonadotropin, yaitu <2200 IU; 2200--3000 IU; dan >3000 IU. Penelitian ini menunjukkan tidak ada hubungan antara dosis gonadotropin dengan ketebalan endometrium (P>0,05). Dosis gonadotropin 2200--3000 IU menghasilkan kehamilan 48% meskipun tidak bermakna signifikan (P>0,05). Ketebalan endometrium 8--13 mm dan >13 mm memiliki keberhasilan hamil 44% dan 25 % (P>0,05). Gonadotropin tidak berpengaruh terhadap ketebalan endometrium dan kehamilan, namun gonadotropin berpeluang menghasilkan oosit imatur sehingga menurunkan kehamilan. Perlu dilakukan upaya penyelamatan oosit imatur dengan suplementasi 0,5 IU hCG. Suplementasi hCG 0,5 IU menunjukkan persamaan maturitas dengan media kultur (P>0,05). Suplementasi hCG 0,5 IU menunjukkan fertilisasi dengan hasil signifikan (P<0,05). Sehingga supplementasi hCG dapat dijadikan alternatif penyelamatan oosit imatur secara in vitro.

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In Vitro Fertilization (IVF) is couple treatment to have baby but its success rate is relatively low. Evaluating gonadotropin effect on endometrium thickness (EMT) and rescue immature oocyte was done to increase IVF success rate. An analytical retrospective study conducted in 2018 until 2021. The results observed were the oocytes obtained, maturation rates, fertilization rates, embryo quality, pregnancy rates. The measurement of EMT was taken on the day hCG administration. The immature oocytes were rescued in solely culture medium and suplemeted hCG. The gonadotropin doses divided into groups: low (<2200 IU); middle (2200--3000 IU); high (>3000 IU). The study showed there was no significant result between gonadotropin with EMT (P>0.05). 2200--3000 IU results 48% in pregnancy (P>0.05). Pregnancy rates in EMT 8--13mm and >13mm were 44% and 25%, respectively (P>0.05). Although gonadotropin doesn’t influence EMT and pregnancy, it produces immature oocytes that could decrease pregnancy rate. Therefore, rescue the immature oocyte by culturing in a suplemented 0.5 IU hCG is needed. There were same oocytes maturity in IVF medium and supplemented hCG. However suplemented hCG produced a higher fertilization rate (P<0.05). Medium with hCG supplemented can be used as an alternative to rescue immature oocyte in vitro."

"Latar belakang: Fertilisasi in vitro (FIV) merupakan salah satu metode tata laksana infertilitas yang paling banyak dilakukan di dunia. Kualitas embrio pada FIV sangat dipengaruhi oleh jumlah dan kualitas oosit. Kadar AMH merupakan marka yang rutin diperiksakan pada peserta program FIV. Namun, belum diketahui secara jelas hubungan AMH dengan kualitas dan jumlah oosit.Metode: Penelitian ini merupakan studi analitik observasional retrospektif dengan desain potong lintang pada seluruh peserta program FIV usia 18-45 tahun di Klinik Yasmin, RSCM Kencana, Jakarta, pada periode Januari 2013 hingga Desember 2019. Pengambilan sampel dilakukan secara total sampling. Subjek dengan data tidak lengkap, memiliki etiologi infertilitas berupa sindrom ovarium polikistik, endometriosis, dan faktor sperma dieksklusi dari penelitian. Data kadar AMH, jumlah oosit total, oosit matur, oosit terfertilisasi, dan laju fertilisasi didapatkan oleh pasien.Hasil: Didapatkan sebanyak 692 subjek yang memenuhi kriteria inklusi dan eksklusi. Pada analisis bivariat, didapatkan korelasi kuat antara kadar AMH dengan jumlah oosit total (r = 0,650, p < 0,001), jumlah oosit matur (r = 0,642, p < 0,001), dan jumlah oosit terfertilisasi (r = 0,607, p < 0,001), sedangkan tidak didapatkan korelasi antara kadar AMH dengan laju fertilisasi (r = 0,076, p = 0,049). Setelah dilakukan kontrol terhadap usia dan indeks massa tubuh, didapatkan korelasi antara kadar AMH dengan jumlah oosit total, jumlah oosit matur, jumlah oosit terfertilisasi, dan laju fertilisasi (p < 0,05). Berdasarkan analisis, nilai titik potong kadar AMH serum untuk memprediksi jumlah oosit optimal adalah 1.615 ng/mL (sensitifitas 77%, spesifisitas 77.3%).Simpulan: Kadar AMH serum berkorelasi dengan jumlah oosit total, jumlah oosit matur, jumlah oosit terfertilisasi, dan laju fertilisasi

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Background: In vitro fertilization (FIV) is one of the most widely practiced infertility treatment methods in the world. The quality of embryos in FIV is strongly influenced by the number and quality of oocytes. AMH level is a marker routinely checked on FIV program participants. However, it is not clear the relationship between AMH and the quality and quantity of oocytes.

Method: This study is a retrospective observational analytic study with a cross-sectional design on all FIV program participants aged 18-45 years at the Yasmin Clinic, RSCM Kencana, Jakarta, from January 2013 to December 2019. Sampling was carried out by total sampling. Subjects with incomplete data, having infertility etiology in the form of polycystic ovary syndrome, endometriosis, and sperm factors were excluded from the study. Data on AMH levels, total oocyte count, mature oocytes, fertilized oocytes, and fertilization rate were obtained by the patient.

Result: There were 692 subjects who met the inclusion and exclusion criteria. In the bivariate analysis, there was a strong correlation between AMH levels and the total number of oocytes (r = 0.650, p <0.001), the number of mature oocytes (r = 0.642, p <0.001), and the number of fertilized oocytes (r = 0.607, p <0.001), whereas there was no correlation between AMH levels and fertilization rate (r = 0.076, p = 0.049). After controlling age and body mass index, a correlation was found between AMH levels with total oocyte count, mature oocyte count, fertilized oocyte count, and fertilization rate (p <0.05). Based on the analysis, cut-off of AMH level to predict optimal total oocyte is 1.615 ng/mL (sensitivity 77%, specificity 77.3%).

Conclusion: Serum AMH levels correlate with the total number of oocytes, the number of mature oocytes, the number of fertilized oocytes, and fertilization rate."

"Pendahuluan : Infertilitas merupakan salah satu gejala pada endometriosis dengan prevalensi mencapai 40-50%. Endometriosis memiliki dampak merugikan terhadap kualitas oosit, sementara sampai saat ini belum ada biomarker baik dari serum ataupun cairan folikel yang dapat dijadikan acuan penilaian kualitas oosit untuk dapat digunakan pada pasien endometriosis yang menjalani fertilisasi in vitro (FIV). Telah ditemukan bahwa pada serum pasien endometriosis terjadi perubahan ekspresi microRNA dimana miRNA-125b memiliki peningkatan yang paling signifikan dengan sensitifitas dan spesifisitas yang paling tinggi. Pada cairan folikel, miRNA-125b berperan saat transisi fase folikular-luteal dengan mempengaruhi ekspresi leukemia inhibitory factor (LIF). LIF diketahui dapat menginduksi sel kumulus yang kemudian mempengaruhi maturasi oosit.Tujuan: Tujuan penelitian ini adalah untuk mencari apakah terdapat hubungan antara miRNA-125b serta LIF dengan kualitas oosit pada pasien infertil dengan endometriosis.Desain: Studi Analitik korelatif dengan desain potong lintang.Material dan Metode: Sampel penelitian didapatkan dari 31 pasien infertil dengan endometriosis yang menjalankan program FIV di Klinik Yasmin RSCM Kencana, dan Klinik Melati RSAB Harapan Kita. Sesaat sebelum petik ovum, sebanyak 5cc sampel darah dari setiap pasien akan diambil untuk penilaian ekspresi miRNA-125b. Pada saat petik ovum, sebanyak 10cc dari total cairan dari folikel yang didapat akan diambil untuk penilaian ekspresi miRNA-125b dan kadar LIF. Oosit yang didapat dinilai oleh embriolog. Pemeriksaan ekspresi miRNA dilakukan dengan RT-PCR, dan kadar LIF menggunakan metode sandwich ELISA.Hasil:Terdapat korelasi negatif antara miRNA-125b serum dengan LIF cairan folikel (p=0,042; r=-0,34). Tidak terdapat korelasi antara miRNA-125b serum dengan miRNA-125b cairan folikel. Tidak terdapat korelasi antara miRNA-125b cairan folikel dengan LIF cairan folikel. Tidak terdapat korelasi antara miRNA-125b serum, miRNA-125b cairan folikel, dan LIF cairan folikel dengan kualitas oosit. Terdapat hubungan yang bermakna antara kadar ekspresi miRNA-125b cairan folikel dengan angka kehamilan biokimia.Kesimpulan: Terdapat ekspresi miRNA-125b pada serum dan cairan folikel pada pasien endometriosis, namun miRNA-125b belum dapat dijadikan sebagai parameter yang kuat untuk pemeriksaan kualitas oosit pada pasien endometriosis yang menjalani FIV.

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Introduction : Infertility is one of the symptoms in endometriosis with prevalence reaching 40-50%. Endometriosis is known to have detrimental effect on oocyte quality, yet until now there is no biomarker derived from either serum, or even follicular fluid, which can be used as reference for oocyte quality assessment in endometriosis patients going through in vitro fertilization (IVF) procedures. Changes of some microRNAs expression has been found in serum of endometriosis patients, with miRNA-125b showing the most significant increase with the highest sensitivy and specificity. In follicular fluid, miRNA-125b play role during follicular-lutheal phase transition by targeting the expression of Leukemia Inhibitory Factor (LIF). LIF has been studied to have the ability to induce cumulus cell expansion which in turn will affect the oocytes maturation.

Purpose: The purpose of this study is to observe the correlation between miRNA-125b, LIF, and oocyte quality in infertile patient with endometriosis.

Design: this is a cross-sectional study with correlation analysis method.

Materials and Methods: in this study, samples were collected from 31 infertile women with endometriosis undergoing in vitro fertilization procedure at Yasmin Clinic of Dr. Cipto Mangunkusumo Hospital, and Melati Clinic of Harapan Kita Mother and Child Hospital. Shortly prior to ovum pick up (OPU) procedure, 5cc of blood sample from each patients was collected, and 10 cc of total follicular fluid was obtained during OPU. Harvested oocytes during the procedure were assessed and scored by embryologist. MiRNA-125b expressions from serum and follicular fluid samples were analyzed using RT-PCR, and LIF levels were analized using ELISA sandwich method.

Result: negative correlation was found between the expression of miRNA-125b serum and LIF follicular fluid (p=0,042; r=-0,34). No correlation was found between the expression of miRNA-125b in serum and in follicular fluid, as well as the expression of miRNA-125b in follicular fluid and LIF in follicular fluid. No correlation was found between the expression of miRNA-125b in serum, follicular fluid, also LIF in follicular fluid, with oocyte quality. Significant result was found between the expression of miRNA-125b in follicular fluid and biochemical pregnancy rate.

Conclusion: This study found miRNA-125 expression represented in serum and follicular fluid in endometriosis patient, but it still cannot be used as a strong parameter for assessing the oocyte quality in infertile women with endometriosis"

"Prevalensi infertilitas di Indonesia yang meningkat tiap tahunnya juga memperbesar kebutuhan pasangan infertil terhadap program fertilisasi in vitro (FIV). Diketahui oosit mempunyai peranan penting dalam keberhasilan FIV. Namun pada pelaksanaannya, oosit yang didapat saat tindakan petik oosit mempunyai maturitas yang tidak sama. Dari beberapa penelitian didapatkan stimulasi ovarium terkendali (SOT) dapat meningkatkan apoptosis sel granulosa dan reactive oxygen species (ROS) yang dapat memberikan efek negatif pada maturasi oosit. Penelitian ini bertujuan untuk mengetahui pengaruh elektroakupunktur terhadap maturasi oosit, laju fertilisasi, kadar GDF9 dan BMP15 pada program FIV. Uji klinis acak tersamar ganda dengan kontrol dilakukan terhadap 24 subjek yang menjalani program FIV. Subjek dialokasikan secara acak ke dalam kelompok elektroakupunktur (n=12), dan kelompok elektroakupunktur sham (n=12). Penilaian maturasi oosit dan laju fertilisasi dilakukan secara mikroskopis oleh embriolog, sedangkan pemeriksaan kadar ekspresi mRNA GDF9 dan BMP15 oleh analis lab. Hasil penelitian menunjukkan terdapat perbedaan bermakna maturasi oosit antara kelompok elektroakupunktur dengan elektroakupunktur sham (p=0,02); laju fertilisasi (p=0,03). Tidak didapatkan perbedaan bermakna kadar GDF9 (p=0,34) dan BMP15 (p=0,47) antara kelompok elektroakupunktur dengan elektroakupunktur sham. Kesimpulan penelitian ini adalah elektroakupunktur dapat meningatkan maturasi oosit dan laju fertilisasi pada program FIV.

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Increasing prevalence of infertility in Indonesia every year also increases the need for infertile couples in the in vitro fertilization program (FIV). It is known that oocytes have an important role in the success of FIV. But in its implementation, oocytes obtained during oocyte retrieval have unequal maturity. From several studies it was found that controlled ovarian stimulation (COS) can increase the apoptosis of granulosa cells and reactive oxygen species (ROS) which can have a negative effect on oocyte maturation. This study aims to determine the effect of electroacupuncture on oocyte maturation, fertilization rate, levels of GDF9 and BMP15 in the FIV program. A double blind randomized clinical trial with controls was conducted on 24 subjects who underwent the FIV program. Subjects were randomly allocated to the electroacupuncture group (n = 12), and the electroacupuncture sham group (n = 12). The assessment of oocyte maturation and the rate of fertilization were carried out microscopically by the embryologist, while the examination of the levels of GDF9 and BMP15 mRNA by lab analysts. The results showed that there were significant differences in oocyte maturation between the electroacupuncture group and electroacupuncture sham (p = 0.02); fertilization rate (p = 0.03). There were no significant difference in GDF9 levels (p = 0.34) and BMP15 levels (p = 0.47) between the electroacupuncture group and sham electroacupuncture. The conclusion of this study is electroacupuncture can enhance oocyte maturation and fertilization rate in the FIV program."

"Tujuan : Untuk mengetahui hubungan antara GDF-9 dan BMP-15 Serum dan cairan folikel, untuk memprediksi kualitas oosit pada wanita yang menjalani siklus fertilisasi in vitro (FIV). Metode : Studi  Potong Lintang dengan jumlah sampel penelitian sebanyak 30 darah sérum dan 30 sampel cairan folikel yang diambil saat petik telur (OPU), dilakukan pemeriksaan GDF-9 dan BMP-15 menggunakan kit ELISA. Dilakukan analisa dengan uji korelasi Pearson dan Spearman  untuk melakukan analisa hubungan antara GDF-9 dan BMP-15 serum dan cairan folikel dengan parameter-parameter kualitas oosit seperti laju maturasi dan laju fertilisasi. Hasil : rerata usia subyek penelitiann adalah 35,0(26,0-39,0) tahun. Kadar GDF-9 cairan folikel adalah 163,0 pg/ml (48,0-537) dan kadar GDF-9 serum 260,33 pg.ml ± 121,82) sedangkan kadar rerata BMP-15 cairan folikel adalah 58,30 pg/ml ± 31,54 dan kadar BMP-15 serum 74,20 pg/ml (1,0-610). Tidak terdapat hubungan yang bermakna antara kadar GDF-9 serum dan GDF-9 cairan folikel (p =0,245) sedangkan antara BMP 15 serum dan BMP-15 cairan folikel  terdapat hubungan bermakna (p =0,001). Simpulan : Terdapat sebaran yang tidak normal kadar GDF-9 serum dan cairan folikel, keduanya tidak berkorelasi. Terdapat korelasi positif kadar BMP-15 serum dan BMP-15 cairan folikel. Terdapat  korelasi yang kuat. antara BMP-15 serum dengan laju maturasi. Tidak terdapat korelasi antara kadar GDF-9 serum, GDF-9 cairan folikel dan BMP-15 cairan folikel dengan laju maturasi dan laju fertilisasi. GDF-9 serum-cairan folikel dan BMP-15 serum-cairan folikel tidak dapat memprediksi kualitas oosit.

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Aim : To determine the relationship between GDF-9 and BMP-15 serum within follicular fluid in order to predict the quality of oocytes in women undergoing In Vitro Fertilisation (IVF). Method : We collected 30 samples of blood serum and 30 samples of follicular fluid on the day of ovum pickup (OPU), and we examined GDF-9 and BMP-15 using ELISA kits. Analysis by Pearson and a partial-correlation was conducted to analyse the correlation between the concentration of GDF-9 and BMP-15 in serum and follicular fluid with general physiological parameters, such as maturation rates and fertilisation rates.Results : The mean age of the subjects was 35,0 (26,0-39,0) years. The level of GDF-9 in the follicular fluid was 163,0 pg/ml (48,0-537), and the level in the serum was 260.33 pg/ml±121,82. The level of BMP-15 in the follicular fluid was 58,30 pg/ml ± 31,54, and the level in the serum was 74,20 pg/ml (1,0-610). There was no correlation between GDF-9 serum and follicular fluid (P = 0.245) but any correlation  between BMP-15 and follicular fluid (p = 0.001). Conclusion : There was an abnormal distribution of GDF-9 serum and follicular fluid levels, both of them not correlate. There was a positive correlation between BMP-15 serum and BMP-15 follicular fluid. There was strong correlation between BMP-15 serum and maturation rates. No correlation between levels of GDF-9 serum-follicular fluid, and BMP-9 follicular fluid with maturation and fertilization rates. GDF-9 serum-follicular fluid, BMP-15 serum-follicular fluid are not able to predict the quality of oocytes."