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"Tujuan : Membandingkan dan menentukan perbedaan kadar homosistein dalam darah dan zalir folikel pada wanita infertil dengan dan tanpa endometriosis, kemudian menganalisis pengaruh kadar homosistein tersebut dengan mutu oosit.Metode : Penelitian ini merupakan penelitian potong lintang (cross sectional). Lima puluh sembilan subjek mengikuti program fertilisasi in-vitro yang masuk dalam kriteria penerimaan dibagi menjadi dua kelompok sama besar, yaknikelompok endometriosis dan tanpa endometriosis secara konsekutif (consecutive sampling). Masing-masing subjek diambil percontoh dari darah dan zalir folikel kemudian diukur kadar homosisteinnya dengan metode teraimun CMIA. Rerata masing-masing kelompok diuji statistik dengan uji t independen.Hasil : Rerata kadar homosistein dalam darah pada kelompok endometriosis lebih tinggi dibandingkan dengan tanpa endometriosis dan secara statisik berbeda bermakna (8,34 ±2,68 vs 6,71 ±1,56, p=0.007;95%CI: 0,02417-0,14657).Demikian pula dengan kadar homosistein dalam zalir folikel, kelompok endometriosis lebih tinggi dan secara statistik berbeda bermakna (6,19 ±1,67 vs 3,46 ±1,03; p= 0,000; 95% CI : 0,19310-0,32353). Semua mutu oosit baik padakedua kelompok, yakni derajat 3. Terdapat korelasi antara kadar homosistein di dalam darah dan zalir folikel pada kelompok endometriosis dan dinilai dengan uji Pearson didapatkan bermakna (p = 0,002) dan nilai korelasi 0,553 (kekuatan korelasi sedang) dan arah korelasi positif.Kesimpulan : Rerata kadar homosistein dalam darah dan zalir folikel pada wanita infertil dengan endometriosis lebih tinggi dibandingkan dengan tanpa endometriosis dan secara statistik berbeda bermakna. Kadar homosistein ini tidakberpengaruh terhadap mutu oosit. Terdapat korelasi positif antara kadar homosistein dalam darah dan zalir folikel pada kelompok endometriosis.

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Purpose : Compare and determine the differences in levels of homocysteine in

the blood and follicular fluid in infertile women with and without endometriosis, then analyze the effect of homocysteine levels with oocyte quality.

Method : This study was cross-sectional study. Fifty-nine subjects following the

in-vitro fertilization program are included in the admission criteria were divided into two equal groups, ie groups of endometriosis and without endometriosis consecutively (consecutive sampling). Each subject taken from the blood and follicular fluid then measured the levels of homocystein levels with immuoassay

method : The mean of each group was statistically tested with an independent t

test.

Results : The mean levels of homocysteine in the blood is higher in the endometriosis group than without endometriosis group and it was statisticaly significance (8,34 ±2,68 vs 6,71 ±1,56, p=0.007;95%CI: 0,02417-0,14657).

Similarly, the levels of homocysteine in follicular fluid , the endometriosis group

is higher and statisticaly significance (6,19 ±1,67 vs 3,46 ±1,03; p= 0,000; 95% CI : 0,19310-0,32353). All oocytes are in good quality in both groups, maturation grade 3. There is a correlation between the levels of homocysteine in the blood and follicular fluid in the endometriosis group and assessed with Pearson test, and it found significant (p = 0.002) and the correlation value 0.553 (moderate correlation strength) and direction of a positive correlation.

Conclusion : The mean levels of homocysteine in the blood and follicular fluid in infertile women with endometriosis is higher than without endometriosis and were statistically significantly different. These homocysteine levels does not affect the quality of oocytes. There is a positive correlation between the levels of homocysteine in the blood and follicular fluid in endometriosis group."

"Membandingkan dan menentukan rerata kadar AMH serum pada wanita infertil dengan tanpa endometriosis serta mengetahui rerata kadar AMH serum pada masing-masing derajat endometriosis. Metode: Penelitian ini merupakan penelitian potong lintang (cross sectional). Enam puluh delapan subjek yang menjalani laparoskopi, yang masuk dalam kriteria penerimaan dibagi menjadi dua kelompok sama besar, yakni kelompok endometriosis dan tanpa endometriosis secara konsekutif (consecutive sampling). Masing-masing subjek diambil percontoh dari darah sebelum dilakukan laparoskopi kemudian diukur kadar AMH serum. Rerata masing-masing kelompok diuji statistik dengan uji Mann-Whitney. Hasil: Rerata kadar AMH serum pada kelompok endometriosis lebih rendah dibandingkan dengan tanpa endometriosis dan secara statistik berbeda bermakna (2,30+1,8 ng/ml vs 3,75+2,13 ng/ml; p=0,005). Dengan uji Kruskal-Wallis, didapatkan perbedaan bermakna secara statistik pada subjek kelompok endometriosis berdasarkan derajat endometriosis (p=0,005). Bila dilakukan pengelompokkan kelompok endometriosis minimal-ringan dan kelompok endometriosis sedang-berat dibandingkan dengan kelompok tanpa endometriosis, maka hasilnya menunjukkan tidak adanya hubungan yang bermakna antara kadar AMH serum pada kelompok endometriosis minimal-ringan dengan kelompok tanpa endometriosis (p=0,34), sedangkan pada kelompok endometriosis sedang-berat dengan kelompok tanpa endometriosis terdapat hubungan yang bermakna (p<0,005).

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To compare and to determine the differences in levels of serum AMH in infertile women with and without endometriosis, and also to determine the mean levels of serum AMH in every grade of endometriosis.

Methods: This study is a cross-sectional study. Sixty-eight subjects who have undergone laparoscopy fulfilled the inclusion criteria are included and divided into two groups, i.e groups of endometriosis and without endometriosis consecutively (consecutive sampling). Blood samples are taken from each subject before laparoscopy which is then measured the levels of serum AMH. The mean levels of each group are tested with an Mann-Whitney test.

Results: The mean levels of serum AMH were lower in the endometriosis group than that group without endometriosis and it was statistically significance ( 2,30+1,8 ng/ml vs 3,75+2,13 ng/ml; p=0,005). With Kruskal-Wallis test, it was found that there was statistically significant difference among endometriosis group based on grading. There was no different at the mean levels of serum AMH between the minimal-mild endometriosis group and without endometriosis group (p=0,34), but the mean levels of serum AMH was lower in the moderate-severe endometriosis compare to the group without endometriosis and it was statistically significance (p<0,005).

Conclusions: The mean levels of serum AMH in infertile women with endometriosis were lower than that group without endometriosis and were statistically significantly different. There was no different between the mean levels of serum AMH in minimal-mild endometriosis group and that group without endometriosis, while in moderate-severe endometriosis group, it was lower than without endometriosis and it was statistically significance."

"ABSTRAKEndometriosis menjadi salah satu penyebab infertilitas terbanyak pada perempuan. Penelitian ini bertujuan untuk menilai hubungan antara beberapa faktor risiko terhadap terjadinya endometriosis pada perempuan infertil. Studi kasus kontrol dilakukan pada 960 perempuan infertil di klinik Morula IVF Jakarta antara Januari 2015 sampai Desember 2016. Dari jumlah tersebut, diantaranya 320 perempuan infertil dengan endometriosis (kasus) dan 640 perempun infertil tanpa endometriosis (kontrol). Uji chi square digunakan untuk membandingkan kedua kelompok. Regresi logistik digunakan untuk membangun model prediksi endometriosis. Model regresi logistik menunjukkan bahwa dismenore dan indeks massa tubuh berhubungan secara signifikan dengan endometriosis. Faktor yang paling berhubungan dengan endometriosis adalah dismenore. Perempuan yang mengalami dismenore akan berpeluang 2,4 kali untuk mengalami endometriosis dibandingkan perempuan tanpa mengalami dismenore.Endometriosis is one of the most causes of female infertil.

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ABSTRACTThis study aims to assess the association between some of risk factors of endometriosis on infertile women. The case-control study was implemented on 960 infertile women at In Vitro Fertilization (IVF) Morula IVF Jakarta between January 2015 and December 2016. Of these, there were 320 infertile women with endometriosis (cases) and 640 infertile women without endometriosis (comparison group). Chi square test was used to compare the two groups. Logistic regression was used to build prediction model for an endometriosis diagnosis. In the logistic regression model contraception and body mass index were significantly associated with endometriosis. The most factors associated with endometriosis is dysmenorrhea. The women with dysmenorrhea will be 2.4 times higher risk in endometriosis than the women without dysmenorrhea."

"Latar Belakang: Endometriosis dan infertilitas memiliki keterkaitan yang sangat erat. Namun etiopatogenesis terjadinya infertilitas pada kasus endometriosis sangat beragam. Teori yang berkembang akhir-akhir ini adalah buruknya reseptivitas endometrium. Gen HOXA 11 adalah salah satu gen yang berperan dalam reseptivitas endometrium karena berkorelasi dengan penanda lain seperti Leukemia Inhibitory Factor LIF, B3integrin, dan EMX2. Teori epigenetik yang berkembang adalah terjadi hipermetilasi pada gen HOXA 11 sehingga terjadi penurunan ekspresi gen tersebut.Metode: Penelitian potong lintang ini dilakukan di RS Cipto Mangunkusumo pada Juli 2015 - Juni 2016. Subjek penelitian adalah pasien endometriosis yang terbukti secara histopatologi dengan infertilitas dan kelompok kontrol merupakan pasien non-endometriosis yang fertil. Status metilasi gen HOXA 11 dari sampel endometrium eutopik pada kedua kelompok ini diperiksa dan dibandingkan.Hasil: Enam pasien endometriosis dan enam pasien kontrol diambil sebagai subjek. Perbedaan tingkat metilasi gen HOXA 11 pada kedua kelompok ini berbeda secara signifikan dengan nilai p 0.03 dengan perbedaan rerata peningkatan kadar metilasi pada kelompok pasien endometriosis sebesar 33.Kesimpulan: Gen HOXA 11 yang berperan dalam reseptivitas endometrium mengalami hipermetilasi pada pasien dengan endometriosis dan infertilitas.

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Introduction: Endometriosis compromises infertility in some patients. They have close relationship and many etiologies have been proposed. HOXA11 has important role in window implantation because it is related to other endometrial receptivity markers such as Leukemia Inhibitory Factor LIF , B3integrin, and EMX2. Recently, many researchers found poor endometrial receptivity in endometriosis due to hyper methylation of HOXA11 gene. Therefore, this study aims to find out the HOXA11 gene profile on endometriosis patients with infertility in Indonesia.

Methods: This cross sectional study was conducted in Dr. Cipto Mangunkusumo Hospital from July 2015 June 2016. The subjects were endometriosis patients with infertility who have been confirmed histopathological. The control group was taken from non endometriosis and fertile patients. Eutopic endometrium samples were taken and examined for the methylation of HOXA11 gene.

Results: Both groups consist of six patients. The difference of methylation of HOXA 11 gene between those two groups is statistically significant p 0.03 . There was hyper methylation in endometriosis group.

Conclusion: There is a hyper methylation of HOXA 11 gene in eutopic endometrium of endometriosis patients with infertility. Thus, possibly can explain the poor endometrial receptivity in endometriosis patient and give a broad research area in epigenetic therapy of endometriosis."

"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"

"Pendahuluan: Endometriosis berkaitan dengan adanya inflamasi  kronik,  gangguan  maturasi  oosit,  peningkatan stress  oksidatif  radikal,  dan  apoptosis  yang  kemudian  mendasari  terjadinya  infertilitas pada wanita usia subur.  Fertilisasi In Vitro (FIV)  merupakan  salah  satu  teknik  yang dapat menangani  infertilitas  dengan  tingkat  keberhasilannya  bergantung  dengan  kualitas  oosit  yang diambil  untuk  menjadi  embrio.  Kualitas oosit dipengaruhi  oleh  nutrisi. Profil  mikronutrien  seperti  vitamin  D  dan  zink  dianggap mempengaruhi  fungsi  reproduksi  melalui aktivitas  anti-inflamasi,  anti-apoptosis dan  anti-oksidan  yang dimiliki. Sayangnya, urgensi untuk menjaga adekuasi nutrisi  ini  sering diabaikan. Selain itu juga hingga saat ini  belum  ada  acuan  untuk  memprediksi  kadar  profil  vitamin  D  dan  zink  dalam serum  dan  cairan  folikular  yang  berhubungan  pada  pasien  endometriosis  itu  sendiri.Tujuan: Penelitian ini membandingkan kadar vitamin D dan zink di serum dan cairan folikular pada pasien endometriosis dan non-endometriosis.Metode: Studi ini merupakan studi potong lintang yang dilaksanakan pada pasien Fertilisasi In Vitro (FIV) di Klinik Yasmin, RSCM Kencana selama Juli –  Desember 2020. Data klinis diperoleh melalui rekam medis dan wawancara pasien. Data laboratorium diperoleh melalui sampel darah dan cairan folikuler yang diperoleh bersamaan dengan prosedur Ovum Pick Up (OPU). Sampel kemudian dikelompokkan menjadi kelompok endometriosis dan non-endometriosis. Setelah itu data disajikan dalam tabel dan dianalisis dengan uji parametrik, yaitu uji-t berpasangan bila sebaran data normal atau uji non parametrik, yaitu uji Mann-Whitney bila sebaran data tidak normal. Data dianalisis dengan SPSS 24.Hasil: Dari jumlah sampel 26 pasien pada studi ini, didapatkan tidak adanya perbedaan bermakna dari vitamin D serum pada pasien endometriosis (22,83 (5,00 – 40,00)) dan non endometriosis (30,11 (10,40-76,10)), namun secara rerata kadar vitamin D serum pada pasien endometriosis lebih rendah. Kadar vitamin D cairan folikular pada pasien endometriosis (15,33 (4,50-36,32)) dan non-endometriosis (23,64 (4,98-60,22)) tidak berbeda bermakna (P>0,05). Kadar zink serum pada pasien endometriosis (75,23 ± 11,58) dan non-endometriosis (79,46 ± 12,09) tidak berbeda bermakna (P>0,05). Konsentrasi zink paada cairan folikular tidak menunjukkan perbedaan bermakna antara pasien endometriosis (39,00 (22,00 – 49,00)) dan tanpa endometriosis (51,00 (19,00-95,00)) (P>0,05). Kesimpulan: Tidak ditemukan perbedaan bermakna antara kadar vitamin D serta zink serum dan cairan folikular pada pasien endometriosis dan non-endometriosis. 

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Background: Endometriosis associates with chronic inflammation, dysfunction of oocyte maturation, increase of oxidative stress, and apoptosis which underlie infertility problem in reproductive female. In-Vitro Fertilization (IVF) is a technique used to treat infertility with the success rate depending on the quality of the oocytes extracted to become embryos. Oocyte quality is influenced by nutrition. Micronutrient profiles such as vitamin D and zink are thought to influence reproductive function through their anti-inflammatory, anti-apoptotic and anti-oxidant activities. However, the urgency of maintaining nutritional adequacy is often overlooked. In addition, until now there is no reference for predicting levels of vitamin D and zink in serum and follicular fluid associated with endometriosis.

Method: This study is a cross-sectional study conducted on In Vitro Fertilization (FIV) patients at the Yasmin Clinic, RSCM Kencana during July – December 2020. Clinical data were obtained through medical records and patient interviews. Laboratory data were obtained through blood and follicular fluid samples obtained in conjunction with the Ovum Pick Up (OPU) procedure. The samples were then grouped into endometriosis and non-endometriosis groups. After that the data are presented in tables and analyzed by parametric test, namely paired t-test if the data distribution is normal or non-parametric test, namely the Mann-Whitney test if the data distribution is not normal. Data were analyzed by SPSS 24.

Result: From a total sample of 26 patients in this study, there was no significant difference in serum vitamin D in patients with endometriosis (22.83 (5.00 – 40.00)) and non-endometriosis (30.11 (10.40-76.10). )), but the mean serum vitamin D level in endometriosis patients was lower. Follicular fluid vitamin D levels in patients with endometriosis (15.33 (4.50-36.32)) and non-endometriosis (23.64 (4.98-60.22)) were not significantly different (P>0.05) . Serum zink levels in patients with endometriosis (75.23 ± 11.58) and non-endometriosis (79.46 ± 12.09) were not significantly different (P>0.05). Zink concentration in follicular fluid did not show a significant difference between endometriosis patients (39.00 (22.00 – 49.00)) and without endometriosis (51.00 (19.00-95.00)) (P>0.05) .

Conclusion: There was no significant difference between the levels of vitamin D and serum zink and follicular fluid in patients with endometriosis and non-endometriosis."

"Endometriosis merupakan jaringan yang ditemukan di luar uterus dan dapat menjadi faktor penyebab terjadinya infertilitas. Endometriosis dapat terjadi pada wanita umur reproduktif dengan probabilitas sebesar 10—15%. Selain itu, endometriosis dapat terjadi pada wanita yang memiliki nyeri kronis pada pelvis dengan besar probabilitas sebesar 70%. Pertumbuhan dan perkembangan jaringan endometriosis dipengaruhi oleh autofagi. Mekanisme autofagi yang terjadi pada tubuh manusia dapat dipicu dengan keberadaan HMGB1. Selain dengan HMGB1, autofagi dapat dipicu dengan adanya ekspresi gen LC3 dan BECN1. Adanya HMGB1 berpengaruh terhadap jumlah gen LC3 dan BECN1. Penelitian dilakukan dengan menganalisis sampel jaringan endometriosis pada fase proliferasi dan sekretori menggunakan metode RT-qPCR absolut dengan kurva standard. Kurva standard dibuat dengan fragmen gen HMGB1 didapatkan nilai efisiensi sebesar 88,38% dan nilai R2 sebesar 0,99618. Kedua nilai yang telah disebutkan masuk ke dalam kisaran yang dapat diterima yaitu dalam rentang 80—110% dan diatas 0,99. Sementara itu, Uji T menunjukkan perbedaan dengan hasil yang tidak signifikan (p<0,05) namun menunjukkan kecenderungan pada rata-rata kelompok. Penelitian ini juga melakukan uji Spearman’s Rank pada HMGB1 dan BECN1 dan menunjukkan korelasi positif baik itu pada kelompok sekretori maupun proliferasi dengan hasil masing-masing 0,721 dan 0,729. Sehingga dapat disimpulkan dari penelitian yang dilakukan bahwa jumlah salinan gen HMGB1 berperan dalam mekanisme autofagi dan memengaruhi tingkat autofagi pada jaringan endometriosis.

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Endometriosis is human tissue found outside the uterus and can be a contributing factor to infertility. Endometriosis can occur in women of reproductive age with a percent probability of 10—15%. In addition, it can occur in women who have chronic pelvic pain with a 70%. The growth of endometriotic tissue can be influenced by autophagy. The mechanism of autophagy that occurs in the human body can be triggered by the presence of the HMGB1 protein. In addition to the HMGB1 protein, autophagy also regulated by the presence of LC3 and BECN1 genes. The presence of HMGB1 protein affects LC3 and BECN1. The study was conducted by analyzing tissue samples of endometriosis in the proliferative and secretory phase using the RT-qPCR absolute method with standard curve. The standard curve was made by HMGB1 gene fragment and obtained an efficiency value of 88.38% and R2 value of 0.99618. The two values ​​mentioned above fall into the acceptable range, namely in the range of 80-110% and above 0.99. Meanwhile, the results the T test showed there is no significant difference (p<0,05) but showed a tendency if it compared by the group means. Spearman's Rank test showed a positive correlation between HMGB1 and BECN1 expression in both the secretory and proliferative phase with results of 0.721 and 0.729, respectively. So, it can be concluded from the research that was conducted, it was found that the expression of HMGB1 gene mRNA in the secretory phase was higher in endometrial tissue while in the proliferative phase it was higher in endometrial tissue. In addition, it can be concluded that there is a tendency for the HMGB1 gene take parts to autophagy mechanism in endometriotic tissue.

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"Tesis ini bertujuan untuk mengetahui korelasi antara ekspresi reseptor leptin endometrium dengan ekspresi reseptor αvβ3 integrin endometrium pada fase luteal madya pasien infertilitas, untuk mencari tahu salah satu penyebab kegagalanimplantasi. Nilai leptin lokal endometrium dinilai melalui ekspresi leptin endometriumdan daya terima endometrium dinilai melalui ekspresi reseptor αvβ3 integrinendometrium. Penelitian ini dengan desain potong lintang di RSUPN Dr. CiptoMangunkusumo. Ekspresi reseptor dinilai dari H-score pada pewarnaanimunohistokimia yang diambil dengan cara biopsi endometrium sebagai baku emas. Dari 30 sampel didapatkan ekspresi reseptor leptin endometrium baik pada 23 sampel (76,7%), ekspresi reseptor leptin endometrium buruk pada 7 sampel (23,3%), sedangkan hasil daya terima endometrium baik pada 24 sampel (80%), dan dayaterima endometrium buruk pada 6 sampel (20%). Uji analisis membuktikkan kadarleptin serum berkorelasi kuat dengan ekspresi leptin endometrium (r=0,67;p<0,01)dengan ekspresi leptin endometrium, dan ekspresi leptin endometrium berkorelasidengan daya terima endometrium (r=0,72;p<0,01). Analisis multivariat menyebutkanfaktor-faktor yang berpengaruh terhadap daya terima endometrium secara berurutanadalah progesteron, ekspresi leptin endometrium, dan kadar leptin serum. ;The aim of this study is to correlate between endometrial leptin receptor expressionwith endometrial integrin αvβ3 expression on mid luteal phase of infertility patients toknow one of the cause of implantation failure. Leptin played important role in femaleneuroendocrine and endometrial implantation. Local leptin value were assessedthrough the expression of leptin endometrial receptor and endometrial receptivityassessed through the expression of integrin αvβ3 endometrial. This study was crosssectionaldesigninRSUPNDr.CiptoMangunkusumo.TheexpressionofthereceptorratedofH-scoreon immunohistochemical staining were taken by endometrial biopsyas the gold standard. From 30 samples obtained, good endometrial leptin receptor expression were found in 23 samples (76.7%), poor endometrial leptin receptorexpression in were found 7 samples (23.3% ), good endometrial receptivity werefound in 24 samples (80%) and poor endometrial receptivity in 6 samples (20%).Result of this study show leptin serum was strongly correlated (r=0,67;p<0,01) withleptin endometrial receptor expression and endometrial leptin receptor expression wasstrongly correlated with endometrial integrin αvβ3 expression (r=0,72;p<0,01).Multivariate analysis show factors that correlate to endometrial receptivitysequentially are progesterone, endometrial leptin receptor, and leptin serum. "

"Latar Belakang: Salah satu hipotesis yang menjelaskan hubungan endometriosis dengan infertilitas adalah endometriosis diyakini menyebabkan gangguan fisiologi ovarium, salah satunya dengan mempengaruhi folikulogenesis yang menyebabkan penurunan kualitas oosit. Oosit memainkan peran penting dalam mengatur dan mendukung pertumbuhan folikel, melalui produksi faktor pertumbuhan oosit. Beberapa faktor pertumbuhan telah diidentifikasi pada oosit manusia, termasuk growth differentiation factor-9 GDF-9 . Namun, sampai saat ini penelitian mengenai ekspresi GDF-9 pada sel granulosa pada wanita infertil dengan endometriosis masih belum banyak dilakukan. Tujuan: Untuk mengetahui ekspresi mRNA GDF-9 pada sel granulosa pasien endometriosis yang menjalani FIV dan untuk mencari adanya korelasi antara ekspresi GDF-9 dengan kualitas oosit. Metode: Penelitian potong lintang ini dilakukan di Klinik IVF Yasmin RSCM dan Klinik Sander B di Jakarta pada bulan Juli 2014 - Juli 2017. Sebanyak 50 sampel terdiri atas 25 wanita dengan endometriosis dan 25 kontrol. Sampel sel granulosa dikumpulkan pada saat petik oosit. Ekspresi mRNA GDF-9 dinilai menggunakan real time PCR. Hasil: Terdapat penurunan jumlah ambilan oosit, jumlah oosit matur dan skor morfologi oosit pada kelompok pasien dengan endometriosis dan bermakna secara statistik. Ekspresi GDF-9 secara kuantitatif lebih rendah pada kelompok endometriosis dibandingkan dengan kontrol 5.05 0.00002 ndash; 3523 ng/ l vs 81.93 1,47 ndash; 32450 ng/ l; p=0,01 . Pada penelitian ini tidak didapatkan korelasi antara ekspresi GDF-9 dan kualitas oosit dari skor morfologi oosit dan laju fertilisasi. Kesimpulan: Ekspresi GDF9 lebih rendah pada kelompok endometriosis dibandingkan kelompok kontrol. Namun, kami tidak menemukan korelasi antara ekspresi GDF-9 dengan kualitas oosit. Dibutuhkan studi dengan besar sampel yang lebih besar untuk mengkonfirmasi apakah perubahan ekspresi GDF-9 memiliki korelasi dengan kualitas oosit serta untuk membuktikan apakah GDF-9 dapat digunakan sebagai penanda molekuler baru untuk memprediksi kompetensi perkembangan oosit.

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Background: One of the hypothesis that explains the association between endometriosis and infertility is that endometriosis is believed to cause ovarian physiology disturbances, one of them by affecting folliculogenesis that cause decreased oocyte quality. The oocyte plays an important role in regulating and promoting follicle growth, by the production of oocyte growth factors. Several growth factors have been identified in human oocytes, including growth differentiation factor-9 GDF-9. However the studies on GDF-9 expression in granulosa cells of infertile women with endometriosis are sparse.

Objective: To investigate the expression of GDF-9 mRNA in granulosa cells of endometriosis patients undergoing IVF and to find the correlation between GDF-9 expression and oocyte quality.

Method: This cross sectional study was done at Yasmin IVF Clinic and dr. Sander B Clinic Jakarta in July 2014 - July 2017. A total fifty samples of 25 womens with endometriosis and 25 controls were included. We collect the granulosa cells sample at the time of oocyte retrieval. GDF-9 mRNA expression were investigated by Real-Time PCR.

Result: The number of oocytes retrieved, mature oocytes and the oocyte morphology score were lower in the group of patients with endometriosis and this was statistically significant. GDF-9 mRNA expression levels was quantitatively lower in endometriosis groups compared to control 5.05 0.00002 ndash; 3523 ng/ l vs 81.93 1,47 ndash; 32450 ng/ l; p=0,01. However, we did not find any correlation between GDF-9 expression levels and oocyte quality from oocyte morphology score and fertilization rate.

Conclusion: GDF9 mRNA level was lower in endometriosis group compared to control group. However, we did not find correlation between individual GDF-9 level and oocyte quality. Large-sample studies were needed to confirm whether the expression of GDF-9 had a correlation with oocyte quality as well as to prove whether GDF-9 could be used as a new molecular marker to predict the oocyte developmental competence."

"Latar Belakang: Kejadian infertilitas di Indonesia 10-15 dari 39,8 juta wanita usia subur. Infertilitas dapat memberi masalah fisik, mental, sosial hingga perceraian. Sekitar 25 -50 perempuan infertil disertai endometriosis dan laparoskopi telah menjadi salah satu pilihan tatalaksananya. Dalam menjalani suatu metode, ahli bedah dan pasangan selalu ingin mengetahui peluang keberhasilan mereka baik dari data praoperasi ataupun intraoperasi. Lee dkk menyatakan keberhasilan kehamilan alamiah pasca laparoskopi secara keseluruhan adalah 41,9 dan tidak berhubungan dengan derajat endometriosis atau temuan laparoskopi atau jenis operasi. Di Indonesia, belum ada studi yang membahas faktor yang paling mempengaruhi keberhasilan kehamilan alamiah pada perempuan yang menjalani metode laparoskopi operatif.Tujuan: Penelitian ini bertujuan untuk mengetahui faktor-faktor apa saja yang mempengaruhi keberhasilan kehamilan alamiah pasca laparoskopi operatif.Metode: Penelitian ini menggunakan desain kohort retrospektif. Dengan total sampling, data diambil dari catatan pasien yang menjalani operasi laparoskopi karena infertilitas dengan endometriosis di RS Cipto Mangunkusumo dan RS Yayasan Pemeliharaan Kesehatan YPK di Jakarta, Indonesia. Analisis data dilakukan dengan perangkat lunak SPSS 20 untuk mengetahui hubungan antara usia, durasi infertilitas, jenis infertilitas, kadar CA-125, ukuran dan bilateralitas endometrioma, perlekatan organ genitalia interna, nodul endometriosis dan patologi tuba dengan keberhasilan kehamilan alamiah dalam 1 tahun pasca laparoskopi operatif.Hasil: Terdapat 70 subjek yang dianalisis. Sebanyak 32 subjek 45,7 hamil dalam satu tahun pasca laparoskopi. Lama infertilitas menggunakan titik potong

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Background and aims The incidence of infertility in Indonesia is 10 15 of the 39.8 million women of childbearing age. It can give physical, mental, social and divorce problems. Approximately 25 50 of infertile women cause by endometriosis. Laparoscopy operative LO has become one of its treatments. In choosing a method, surgeon and couples always want to know the chances of their success either from preoperative or intraoperative data. In Indonesia, there are no studies that address the factors influence the success of natural pregnancy in women undergoing LO methods. This study aims to determine what factors affect the success of natural pregnancy postoperative laparoscopy.Methods This study used a retrospective cohort design. With total sampling, the data were taken from the patient records who underwent laparoscopic operative due to infertility with endometriosis at RS Cipto Mangunkusumo and the Health Care Foundation Foundation YPK in Jakarta, Indonesia. Data analysis was performed with SPSS 20 software to determine the relationship between age, duration of infertility, type of infertility, ca 125 levels, size and bilaterality of endometrioma, internal genital adhesion, endometriosis nodules and tubal pathology with successful natural pregnancy in 1 year after laparoscopic operative.Result There were 70 subjects analyzed. A total of 32 subjects 45.7 were pregnant within one year after laparoscopy. The length of infertility using a "