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"Sindrom ovarium polikistik (SOPK) merupakan suatu kondisi umum endokrinopati yang ditandai dengan adanya oligoovulasi atau anovulasi, produksi androgen berlebih, dan adanya kista ovarium kecil multipel yang diidentifikasi secara sonografis (kriteria Rotterdam, 2004). SOPK ditemukan pada 10% populasi wanita usia reproduksi dan berhubungan erat dengan disfungsi ovulasi sehingga menurunkan angka fertilitas. Tujuan penelitian ini adalah untuk mengetahui pengaruh terapi kombinasi elektroakupunktur dan medikamentosa terhadap SOPK. Uji klinis acak tersamar ganda dengan kontrol dilakukan terhadap 44 subjek dengan SOPK yang dialokasikan secara acak ke dalam kelompok elektroakupunktur sejati dan medikamentosa (n=22), serta kelompok elektroakupunktur sham dan medikamentosa (n=22). Penilaian menggunakan pencitraan USG transvaginal dan perhitungan panjang siklus menstruasi sebelum dan sesudah perlakuan. Hasil penelitian menunjukkan terdapat perbedaan bermakna rerata volume ovarium antara kedua kelompok sebelum dan sesudah perlakuan (p=0,002); penurunan jumlah folikel antral (p=0,005); angka kejadian menstruasi (p=0,001); dan pemendekan siklus menstruasi (p=0,003). Kesimpulan penelitian ini elektroakupunktur dan medikamentosa memberikan perbaikan terhadap keluhan dan gambaran ovarium pada pasien SOPK.

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Polycystic Ovarian Syndrome (PCOS) is a general endocrinopathy condition that signed with oligoovulation or anovulation cycle, excess androgen production, and an image of multiple small cysts identified by transvaginal ultrasound (Rotterdam criteria, 2004). PCOS found in 10% of reproductive women and highly corresponded with ovulation dysfunction and finally decrease the fertility rate. The goal of this study is to know the effect of electroacupuncture combined with medical treatment in PCOS. A double blind randomized controlled trial is performed in 44 subjects with PCOS and divided into true electroacupuncture combined with medical treatment group (n=22) and sham electroacupuncture combined with medical treatment group (n=22). Ovarian volume and antral follicle are evaluated with transvaginal ultrasound and the length of menstrual cycle is counted before and after the treatment. The results show there are significant mean differences between ovarian volume in two groups before and after treatment (p=0,002); antral follicle count (p=0,005); menstrual incidence during the treatment (p=0,001); and shortened menstrual cycle (p=0,003). The conclusion of this study is electroacupuncture combined with medical treatment could improve PCOS patients’ compaint and ovarian image."

"Sindrom ovarium polikistik (SOPK) adalah salah satu kelainan endokrin yang paling umum terjadi pada wanita usia reproduktif. Patogenenesis SOPK berhubungan langsung dengan resistensi insulin. Beberapa studi menyimpulkan bahwa akupunktur dapat meningkatkan sensitivitas insulin sehingga dapat memperbaiki gejala SOPK. Uji klinis acak tersamar ganda dilakukan pada 44 penderita SOPK yang dibagi secara acak ke dalam dua kelompok, yakni kelompok elektroakupunktur kombinasi medikamentosa (n=22) dan kelompok elektroakupunktur sham kombinasi medikamentosa (n=22). Elektroakupunktur dilakukan 3 kal seminggu, sebanyak 12 kali, selama 4 minggu, pada titik CV3 Zhongji, CV4 Guanyuan, CV6 Qihai, ST25 Tianshu, ST28 Shuidao, ST36 Zusanli, SP6 Sanyinjiao, dan BL57 Chengsan. Pemeriksaan gula darah puasa dan insulin puasa dilakukan untuk mengukur indeks HOMA-IR sebagai luaran primer. Hasil penelitian menunjukkan adanya perbedaan yang bermakna. Median indeks HOMA-IR pada kelompok elektroakupunktur kombinasi medikamentosa sebelum dan sesudah terapi menunjukkan perbedaan bermakna secara statistik (p=0,014). Sedangkan median indeks HOMA-IR pada kelompok elektroakupunktur sham kombinasi medikamentosa sebelum dan sesudah terapi tidak terdapat perbedaan bermakna (p=0,592). Kesimpulan penelitian ini elektroakupunktur kombinasi medikamentosa efektif untuk meningkatkan sensitivitas insulin.

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Polycystic ovary syndrome (SOPK) is one of the most common endocrine disorders in women of reproductive age. The pathogenesis of SOPK is directly related to insulin resistance. Several studies have concluded that acupuncture can increase insulin sensitivity to improve symptoms of PCOS. Double-blind randomized clinical trials were performed on 44 patients with SOPK who were randomly divided into two groups, the electroacupuncture with medication group (n=22) and the electroacupuncture sham with medication group (n=22). Electroacupuncture was given 3 times a week, 12 times, for 4 weeks, at the point of CV3 Zhongji, CV4 Guanyuan, CV6 Qihai, ST25 Tianshu, ST28 Shuidao, ST36 Zusanli, SP6 Sanyinjiao, and BL57 Chengsan. Fasting blood glucose and fasting insulin were performed to measure the HOMA-IR index as the primary outcome. The results showed a significant difference. The median HOMA-IR index in the electroacupuncture with medication group before and after therapy showed statistically significant differences (p = 0.014). While median HOMA-IR index in electroacupuncture sham with medication group before and after therapy there was no significant difference (p = 0.592). The conclusion of this study electroacupuncture combination with medication is effective to improve insulin sensitivity. "

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Sindrom Ovarium Polikistik (SOPK) merupakan gangguan pada sistem reproduksi wanita yang menjadi penyebab umum terjadinya infertilitas pada usia reproduktif. Etiologi dari SOPK belum diketahui dengan pasti, namun lebih dari 50% wanita SOPK mengalami obesitas. Single Nucleotide Polymorphism (SNP) rs9939609 gen Fat Mass and Obesity Associated (FTO) merupakan kandidat genetik yang dapat memengaruhi perkembangan obesitas dan kerentanan terhadap SOPK. Tujuan dari penelitian ini untuk mengetahui asosiasi SNP rs9939609 gen FTO dengan SOPK. Penelitian ini menggunakan 120 sampel darah dengan masing-masing 30 sampel untuk setiap kelompok, yaitu kelompok wanita normal obesitas, normal non-obesitas, SOPK obesitas, dan SOPK non-obesitas. Metode yang digunakan yaitu amplifikasi sekuens target dengan Polymerase Chain Reaction (PCR), validasi dengan elektroforesis, dan sekuensing dengan menggunakan Automated Sanger. Hasil sekuensing dianalisis menggunakan perangkat lunak Bioedit dan FinchTV. Hasil penelitian ini menunjukkan adanya frekuensi minor alel A sebesar 29,6% serta frekuensi genotipe AA, AT, dan TT secara berurutan sebesar 10%, 39,20%, dan 50,80%. Studi ini juga menunjukkan hasil tidak adanya asosiasi (p>0,05) antara SNP rs9939609 gen FTO dengan sindrom ovarium polikistik.

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Polycystic Ovarian Syndrome (PCOS) is a female reproductive disorder which is a common cause of infertility at reproductive age. The etiology of PCOS is still unclear, however more than 50% of PCOS women are obese. Single Nucleotide Polymorphism (SNP) rs9939609 Fat Mass and Obesity Associated (FTO) gene is a genetic candidate that can affect the development of obesity and susceptibility to PCOS. This study aims to determine the association of FTO gene SNP rs9939609 with PCOS. Samples in this study was 120 blood samples divided into 30 samples for each group, normal with obesity, normal lean, PCOS with obesity, and PCOS lean. Amplification of target sequences using the PCR method, validation with electrophoresis, and sequencing was carried out using an Automated Sanger. Sequencing results were analyzed with Bioedit and FinchTV software. The results of this study showed that a minor allele A frequency was 29.6% and the genotype frequencies of AA, AT, and TT were 10%, 39.20%, and 50.80%, respectively. This study also showed no association (p>0.05) between SNP rs9939609 with polycystic ovarian syndrome.

 

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"TUJUAN: Mengetahui efek metformin atau DLBS3233 terhadap kadar AMH. LATAR BELAKANG: SOPK merupakan sindrom yang diketahui berkaitan dengan resistensi insulin dalam patofisiologi dan peranan AMH dalam patogenesis. Maka salah satu bagian dari tatalaksana SOPK adalah dengan pemberian insulin sensitizing agent ISA. ISA yang telah banyak digunakan yaitu metformin yang terbukti dalam memperbaiki siklus haid, namun obat ini juga menimbulkan efek samping seperti keluhan gastrointestinal yang cukup berat. Sehingga perkembangan obat herbal seperti fraksi bioaktif DLBS3233 memberikan harapan akan ISA yang efektif, namun memiliki efek samping minimal. Peranan ISA dalam efek perubahan AMH masih kontroversial, dan hanya ditemui penelitian yang meneliti metformin. DESAIN DAN METODE: Penelitian ini menggunakan desain uji klinis acak tersamar ganda yang berlangsung pada bulan Maret 2013 hingga Juni 2015 di klinik Yasmin, RSCM Kencana dan RS Hasan Sadikin, Bandung. Subjek penelitian akan mendapatkan metformin sebanyak 2x750mg atau DLBS3233 1x100mg per hari selama enam bulan. Evaluasi kadar AMH akan dilakukan sebanyak dua kali, sebelum dan sesudah pengobatan. HASIL: Sebanyak 20 subjek mendapati metformin dan 18 subjek mendapati DLBS3233. Rerata kadar AMH sebelum pengobatan didapati 9,30 5,06 ng/mL dan 11,27 6,47 ng/mL. Pasca pengobatan, didapati penurunan kadar AMH yang signifikan sebesar 1,52 0,07 p < 0,001. Penurunan kadar AMH didapati lebih tinggi pada grup metformin bila dibandingkan dengan DLBS3233 ? AMH = 1,83 ng/mL vs 1,15 ng/mL. Namun, metformin menimbulkan efek samping yang lebih signifikan dibandingkan DLBS3233 p=0,01. Sebanyak 7 pasien 18,42 hamil selama penelitian ini. Namun efek samping pengobatan jauh dirasakan oleh subjek yang mendapatkan metformin dibandingkan DLBS3233 p=0,01. KESIMPULAN: Baik metformin atau fraksi bioaktif DLBS3233 dapat menurunkan kadar AMH, dan DLBS3233 merupakan pilihan terapi SOPK dengan efek samping yang minimal.

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OBJECTIVE: To determine the effect of metformin and DLBS3233 on serum AMH level.

BACKGROUND: PCOS is known to be associated with insulin resistance in the pathophysiology and Anti Mullerian Hormone AMH in the pathogenesis. Thus, one of management of PCOS is to give insulin sensitizing agent ISA. Type of ISA which has been widely used is metformin which proven to improve menstrual cycle, but this medication cause major side effect such as gastrointestinal problems. So, the development of herbal medicine such as Bioactive Fraction DLBS3233, offer effective medicine, with minimal side effects. To date, the role of ISA to effects the changes in AMH still controversial, and studies only examine the effect of metformin to the level of AMH.

METHOD: Double blind randomized controlled trial was conducted in Yasmic Clinic, Cipto Mangunkusumo General Hospital, Kencana and Hasan Sadikin hospital, Bandung within March 2013 until June 2015. PCOS patient diagnosed using Rotterdam All participant get daily dose of metformin 2x750mg or DLBS3233 1x100mg for six months. Evaluation of serum AMH level was conducted twice prior therapy and after the completion of the therapy. Protocol analysis was carried out upon differences of AMH using SPSS 20.

RESULTS: 20 subjects received metformin, while 18 subject received DLBS3233. Level of AMH prior medication was known to be 9,30 5,06 ng mL and 11,27 6,47 ng mL. After six months of therapy, there is significant decrease of AMH level of 1,52 0,07 p 0,001. The decrease level of AMH was observed higher in metformin group compared to DLBS3233 AMH 1,83 ng mL vs 1,15 ng mL. However, metformin causing more side effects compared to DLBS3233 p 0,01. There are total of 7 subjects 18,42 pregnant during the studies.

CONCLUSION: There rsquo s a significant decrease of AMH level after administration of either metformin or DLBS3233. "

"Latar belakang: Sindrom ovarium polikistik dapat memberi dampak yang besarterhadap kualitas hidup wanita. Adanya informasi yang cukup dapat mendukungperbaikan gaya hidup dan kemandirian pasien untuk menentukan tatalaksana terapiyang tepat .Akurasi dan presisi suatu informasi yang berasal dari internet masihsangat bervariasi. Diperlukan suatu data tentang kualitas informasi yang beredar diinternet berbahasa Indonesia.Tujuan: Untuk mengetahui gambaran kualitas informasi tatalaksana SOPKberbahasa Indonesia berbasis internet.Metode: Dilakukan pencarian situs internet berbahasa Indonesia dengan kata kuncisindrom ovarium polikistik menggunakan 2 mesin pencari (Google dan Bing).Situs teratas pada hasil pencarian dilakukan penilaian dengan daftar tilikanpenilaian yang sudah dibuat sebelumnya.Hasil: Terdapat 69 situs yang menjadi subjek penelitian. Dalam hal akurasi kontendan kredibilitas, sebagian besar situs memiliki kualitas yang baik. Tidak terdapatperbedaan kualitas situs antara kedua mesin pencari. Situs yang tampil pada 2halaman teratas memiliki kualitas yang lebih baik dibandingkan halaman-halamanberikutnya (p=0,02). Situs edukasi memiliki kualitas informasi yang lebih baik(p=0,05). Situs yang dibuat oleh organisasi yang bergerak di bidang kesehatanmemiliki kualitas informasi yang lebih baik (p=0,04). Situs non komersial memilikikualitas yang lebih baik dibandingkan situs komersial (p=0,01).Kesimpulan: Faktor yang mempengaruhi kualitas informasi kesehatan pada situsadalah ditampilkan pada 2 halaman pertama hasil pencarian, dibuat untuk tujuanedukasi, dibuat oleh organisasi kesehatan, dan bersifat non komersial.

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Background: Polycystic ovarian syndrome has pronounced quality of life effect onwomen. Sufficien information contribute significant role in lifestyle improvement,as well as patient empowerment. However, data on health information quality inthe internet is limited, especially in Bahasa Indonesia.Objectives: To investigate health information quality about PCOS on the internetin Bahasa Indonesia.Methods: Top website from two separate search engine (Google and Bing) wascollected using keyword of sindrom ovarium polikistik (polycistic ovariansyndrome). Analysis of health information quality on those website was performed.Results: Sixty-nine website were included for analysis. Majority of those websitehave good infromation quality in terms of content accuracy and website credibility.There was no difference in quality between two search engine. Website were foundat top two pages in each search engines have better quality than the latter pages(p=0.02). Educational website had better quality (p=0.05). Website made byhealthcare organization had better quality (p=0.04). Non-commercial website hadbetter information quality (p=0.01).Conclusion: Criteria affecting health information quality in the internet was asfollows: found at top two pages on search engine; educational website; made byhealthcare organization; and non-commercial purpose."

"Pendahuluan: Sindrom Ovarium Polikistik SOPK merupakan gangguan endokrin tersering penyebab infertifilitas pada wanita usia reproduktif. Wanita-wanita dengan SOPK diketahui memiliki tingkat apoptosis yang rendah dibandingkan dengan wanita tanpa SOPK dan memiliki kadar Anti-Muellerian Hormone AMH yang lebih tinggi dibandingkan dengan wanita tanpa SOPK. Akan tetapi, belum ada penelitian yang menghubungkan kadar AMH dengan apoptosis yaitu adanya atresia folikel pada ovarium wanita penderita SOPKTujuan: Untuk mengetahui hubungan antara kadar AMH yang tinggi dengan tingkat apoptosis sel granulosa yang terjadi pada pasien SOPK sehingga dapat diketahui salah satu patogenesis kelainan folikulogenesis pada pasien SOPKMetodologi: Studi cross sectional dengan mengambil sampel sel granulosa wanita SOPK dan tanpa SOPK atau kelainan ovarium yang mengikuti program Fertiisasi In Vitro FIV di Yasmin dan SMART-IVF, klinik dr. Sander B Jakarta. Jumlah sampel yaitu 40 sampel yang terdiri dari 20 wanita dengan SOPK dan 20 wanita tanpa SOPK. Tingkat apoptosis dievaluasi dengan mengukur ekspresi mRNA dari gen pengkode protein keluarga apoptotic Bcl2 Bax dan Bcl2 menggunakan metode kuantitatif absolut qPCR. Pengukuran kadar AMH di serum dilakukan dengan metode ELISA.Hasil: Terdapat perbedaan bermakna secara statistik antara kadar AMH wanita SOPK dan kontrol pABSTRACT Background Polycystic Ovary Syndrome PCOS is a common endocrine abnormality in causing infertility in reproductive aged women. Women with PCOS were reported have lower apoptosis rate compared to women without PCOS and have higher level Anti Muellerian Hormone compared to women without PCOS. However, there are no reported studies which directly study to know correlation between AMH level in serum and apoptosis result in follicle atresia in ovarium of PCOS patients.Objective To analysis correlation between serum AMH level and apoptosis in granulosa cell in PCOS pasien that may underlie the folliculogenesis abnormality in PCOS.Methods Cross sectional study of sample from granulose cells women with PCOS and without PCOS or with ovarian abnormalities that following Fertility In Vitro FIV program in Yasmine and SMART ndash IVF, dr. Sander B clinic, Jakarta. Sample number were 40 consisting 20 women with PCOS and 20 women without PCOS. Apoptosis level were evaluated with measuring mRNA expression from gene that of coding apoptotic Bcl2 family Bax and Bcl2 using quantitave absolute method qPCR. AMH level in serum were measured using ELISA method.Results There was a statistical significance difference AMH level between PCOS group and control group p"

"Pendahuluan: Sindroma ovarium polikistik (SOPK) merupakan masalah reproduksi yang sering terjadi pada perempuan usia reproduksi, namun hingga saat ini etiopatogenesis SOPK masih belum jelas. Penelitian ini bertujuan menganalisis peran sel granulosa folikel ovarium dalam etiologi SOPK, keterkaitan genotip FSHR Asn680Ser dengan patogenesis SOPK dan peran gen CYP19A1(aromatase) dalam patogenesis SOPK. Metode: Penelitian ini menggunakan desain penelitian analitik observasional berbentuk studi seran lintang (cross sectional study) dan dilakukan di Departemen Biologi FKUI, Klinik Yasmin-RSCM Kencana dan Laboratorium terpadu FKUI pada tahun 2011-2014. Sebanyak 142 subyek penelitian (66 pasien SOPK dan 76 pasien bukan SOPK) terlibat dalam penelitian ini. Sampel penelitian berupa darah tepi dan cairan folikel ovarium yang diaspirasi ketika proses ovum pick up sebagai sumber sel granulosa. Dilakukan isolasi DNA untuk analisis RFLP polimorfisme FSHR Asn680Ser, dilakukan kultur sel granulosa untuk mengetahui kemampuan proliferasi sel granulosa dan analisis ekspresi mRNA aromatase sel granulosa dengan metode RT-qPCR. Hasil: Indeks proliferasi sel dan ekspresi mRNA aromatase sel granulosa pada kelompok SOPK lebih rendah secara bermakna dibandingkan bukan SOPK (p<0,05). Tidak ditemukan perbedaan bermakna distribusi genotip FSHR Asn680Ser antara kelompok SOPK dan bukan SOPK (p>0,05), tidak ditemukan perbedaan bermakna antara kadar hormon FSH basal berdasarkan variasi genotip FSHR Asn680Ser pada kelompok SOPK dan bukan SOPK (p>0,05). Tidak ditemukan perbedaan yang bermakna indeks proliferasi sel granulosa berdasarkan variasi genotip FSHR Asn680Ser baik pada kelompok SOPK maupun bukan SOPK (p>0,05). Tidak terdapat korelasi antara indeks proliferasi sel granulosa dengan ekspresi mRNA aromatase (p>0,05). Kesimpulan: Indeks proliferasi sel dan tingkat ekspresi mRNA aromatase sel granulosa kelompok SOPK menurun dibandingkan kelompok bukan SOPK. Genotip FSHR Asn680Ser tidak menentukan kerentanan individu untuk menderita SOPK. Kadar hormon FSH basal dan indeks proliferasi sel granulosa tidak berbeda antara kelompok SOPK dan bukan SOPK berdasarkan variasi genotip FSHR Asn680Ser. Tidak ada korelasi antara indeks proliferasi sel dengan ekspresi mRNA aromatase sel granulosa pada penelitian ini.

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Introduction: Polycystic ovary syndrome (PCOS) is a common reproductive problem in women at reproductive age, but until now aetiopathogenesis of PCOS has not been fully understood. The objective of this study was to analyse interrelationship between proliferation of ovarian follicular granulosa cells, CYP19A1 expression and polymorphism at codon 680 of FSHR towards the etiology of PCOS.

Methods: Observational analytic in the form of cross-sectional study was used in this research. The study was carried out between 2011-2014 at the Department of Biology, Integrated laboratory of Faculty of Medicine University of Indonesia and Yasmin clinic at the Cipto Mangunkusumo Hospital. A total of 142 subjects (66 patients with PCOS and 76 patients without PCOS) were involved in this study. Granulosa cells for culture were obtained from ovarian follicular fluid and total RNA was isolated from the cells. DNA samples were extracted from peripheral blood. Granulosa cell proliferation index was determined by counting under a phase-contrast microscope. CYP19A1 expression was measured by qRT-PCR, whereas polymorphism at Asn680Ser FSHR was performed by RFLP.

Result: Cell proliferation index and CYP19A1 mRNA expression levels in the granulosa cells of the PCOS group was significantly lower than non-PCOS (p < 0.05). There was no significant difference found in Asn680Ser FSHR genotype distribution between PCOS and non-PCOS group (p > 0.05). Based on Asn680Ser FSHR genotype variation, no significant difference was found between basal FSH hormone levels in the PCOS and non- PCOS group (p > 0.05) and FSHR genotype variation did not correlate with granulosa cell proliferation index between PCOS and non-PCOS group (p > 0.05). Moreover, there was no correlation between the granulosa cell proliferation index with aromatase mRNA expression levels (p > 0.05).

Conclusion: Cell proliferation index and CYPA1 expression of granulosa cells in PCOS group were lower compared to the non PCOS group although no correlation was found between the two parameters. Asn680Ser FSHR genotype did not correlate with individual susceptibility to PCOS. FSHR genotype variation did not correlate with basal FSH levels and granulosa cell proliferation index between PCOS and non-PCOS."

"Latar belakang: Hiperandrogen merupakan fenotip yang seingkali ditemukan pada SOPK memiliki peran terhadap perubahan tampilan fisik (hirsutisme dan obesitas) juga infertilitas. Kondisi ini dilaporkan dapat menyebabkan gangguan citra tubuh, kecemasan hingga depresi sehingga juga dapat berkontribusi terhadap kejadian disfungsi seksual. Gangguan fungsi seksual pada wanita seringkali tidak dilaporkan. Sebagai langkah awal, dengan mengetahui hubungan perubahan fisik akibat hiperandrogen dan obesitas terhadap disfungsi seksual, maka diharapkan penatalaksanaan infertilitas pada kasus SOPK dapat dilakukan lebih komprehensif.Tujuan: Mengetahui hubungan antara hiperandrogenisme, profil antropometri (IMT dan rasio pinggang-pinggul), dan disfungsi seksual pada wanita infertil Indonesia dengan SOPK.Metode: Penelitian menggunakan metode potong lintang (cross sectional). Subjek merupakan 71 wanita infertil dengan SOPK di Klinik Yasmin, Rumah Sakit Umum Dr. Cipto Mangunkusumo, Jakarta, Indonesia yang berobat pada Desember 2021 – Desember 2022. Hiperandrogenisme biokimiawi dinilai dengan kadar androgen bebas dan rasio LH/FSH sedangkan hiperandrogenisme klinis dinilai menggunakan skor Ferriman-Gallwey dimodifikasi. Profil antropometri dinilai menggunakan IMT dan rasio pinggang-pinggul. Kami menggunakan kuesioner FSFI untuk mengevaluasi disfungsi seksual dan kuesioner HAM-A untuk menilai kecemasan.Hasil: Sebanyak 53,3% subjek mengalami disfungsi seksual, namun tidak ditemukan hubungan yang signifikan secara statistik antara hirsutisme, profil antropometri, dan skor disfungsi seksual pada wanita infertil dengan SOPK (p >0,05). Analisis skor keseluruhan domain FSFI menunjukkan bahwa lubrikasi dan kepuasan lebih rendah pada pasien obesitas (p=0,02 dan p=0,03), tetapi ini tidak berkontribusi pada skor disfungsi seksual secara keseluruhan. Selain itu, subjek yang mengalami disfungsi seksual memiliki skor kecemasan yang lebih tinggi (p<0,005), dengan analisis korelasi menunjukkan bahwa skor FG memiliki korelasi positif yang signifikan terhadap kecemasan.Kesimpulan: Hirsutisme dan profil antropometri tidak terkait dengan disfungsi seksual pada wanita infertil Indonesia dengan SOPK. Namun, hirsutisme dapat berperan dalam menyebabkan kecemasan pada wanita Indonesia dengan SOPK. Penelitian kolaboratif dan kualitatif diperlukan selanjutnya karena fungsi seksual wanita adalah subjek yang kompleks.

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Background: Hyperandrogenism, a phenotype often found in PCOS, plays a role in physical changes (hirsutism and obesity) as well as infertility. This condition is reported to contribute to body image disturbances, anxiety, and even depression, thereby potentially contributing to the occurrence of sexual dysfunction and impacting infertility conditions. Sexual dysfunction in women is often underreported, leading to a lack of in-depth evaluation by clinicians. As a preliminary step, by understanding the relationship between physical changes due to hyperandrogenism and obesity with sexual dysfunction, it is hoped that the management of infertility in PCOS cases in Indonesia can be more comprehensive.

Objective: To evaluate the relationship between hiperandrogenism, anthropometric profile (BMI and waist to hip ratio), and sexual dysfunction in infertile Indonesian women with PCOS.

Methods: A cross-sectional study was conducted from December 2021 to December 2022 on 71 infertile women with PCOS at Yasmin Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Biochemical hyperandrogenism was assessed through free androgen levels and the LH/FSH ratio, while clinical hyperandrogenism was evaluated using the modified Ferriman-Gallwey score. The anthropometric profile was assessed using BMI and waist-to-hip ratio. We utilized the FSFI questionnaire to evaluate sexual dysfunction and the HAM-A questionnaire to assess anxiety.

Results: In this study, it was discovered that 53.3% of subjects experienced sexual dysfunction. However, there was no statistically significant relationship between hirsutism, anthropometric profile, and sexual dysfunction score in infertile women with PCOS (p >0.05). Analysis of the overall FSFI domain score revealed that lubrication and satisfaction were lower in patients with obesity (p=0.02 and p=0.03), but this did not contribute to an overall sexual dysfunction score. Also, we found that subjects who experienced sexual dysfunction had a higher anxiety score (p<0.005), with correlation analysis showing that FG scores have a significant positive correlation with anxiety.

Conclusions: Hirsutism and anthropometric profile are not associated with sexual dysfunction in infertile Indonnesian women with PCOS. However, hirsutism could play a role in causing anxiety in Indonesian PCOS women. Additional qualitative and collaborative investigation is required as female sexual function is a intricate subject."

"ABSTRAK Latar Belakang: Sindrom Ovarium Polikistik (SOPK) merupakan penyebab 40%infertilitas pada wanita usia reproduksi. Resistensi insulin sebagai salah satupatofisiolofi yang mendasari SOPK, berkaitan erat dengan jaringan adiposaviseral dan ditemukan pada 30-50% pasien SOPK dengan indeks masa tubuhnormal serta lingkar pinggang kurang dari 80 cm. Retinol Binding Protein-4(RBP-4) yang disekresi oleh jaringan adiposa viseral diketahui sebagai salah satuadipokin yang menyebabkan resistensi insulin. Pengukuran IMT dan lingkarpinggang tidak dapat mewakili akumulasi jaringan adiposa viseral pada SOPKdengan IMT normal serta lingkar pinggang kurang dari 80 cm. Dengandiketahuinya titik potong optimal kadar serum RBP-4 sebagai penanda jaringanadiposa viseral, diharapkan dapat memprediksi risiko kejadian resistensi insulinyang bermanfaat dalam menentukan penatalaksanaan kasus SOPK dengan IMTnormal terkait strategi pengurangan akumulasi jaringan adiposa viseral. Tujuan: Diketahuinya titik potong optimal kadar serum RBP-4 sebagai penandajaringan adiposa viseral untuk memprediksi risiko kejadian resistensi insulin padapenderita SOPK dengan IMT normal. Metode: Studi observasional dengan desain potong lintang selama periode Juli2014 hingga Maret 2015 di Poliklinik Yasmin, RSCM, Jakarta. Hasil: Sejumlah 40 subjek SOPK dengan IMT normal yang memenuhi kriteriainklusi didapatkan 16 subjek (40%) yang mengalami resistensi insulin dan 24subjek (60%) nir resistensi insulin. Sejumlah 23 subjek (57.5%) memiliki lingkarpinggang kurang dari 80 cm, dimana 6 subjek (26%) diantaranya mengalami resistensi insulin. Kadar serum RBP-4 pada kelompok resistensi insulin bermakna lebih tinggi dibandingkan nir resistensi insulin (p 0.008). Dengan analisis ROCdidapatkan AUC kadar serum RBP-4 78.8% (IK 95% -8445.59 ? -1447.98)dengan nilai p 0.002. Titik potong optimal kadar serum RBP-4 adalah 24133ng/mL dengan sensitivitas sebesar 75% dan spesifisitas sebesar 75%. Dengananalisis regresi logistik biner didapatkan pemeriksaan serum RBP-4 menambahnilai diagnostik dari parameter demografis dan klinis AUC 85.7% menjadi 91.1%. Kesimpulan: Kadar serum RBP-4 sebagai penanda jaringan adiposa viseral dapat digunakan untuk memprediksi risiko kejadian resistensi insulin pada penderita SOPK dengan IMT normal. ABSTRACT Background: Polycystic ovarian syndrome (PCOS) contributes to fourty percent

of infertility?s issues on reproductive women. Insulin resistance as one of

important pathophysiology in PCOS, correlates with visceral adipose tissue and is

found on 30-50% PCOS patients with normal body mass index and waist

circumference less than 80 cm. Retinol Binding Protein-4 (RBP-4), which is

secreted by visceral adipose tissue, known as one of adipokines that cause insulin

resistance. The measurement of body mass index and waist circumference could

not represent visceral adiposity on PCOS with normal body mass index and waist

circumference less than 80 cm. Determination of serum RBP-4 cut off level as

visceral adipose tissue marker hopefully could predict the risk of insulin

resistance on polycystic ovarian syndrome with normal body mass index,

therefore it will be useful on its management related to reduction of visceral

adiposity.

Objective: To obtain serum RBP-4 cut off level as visceral adipose tissue marker

to predict the risk of insulin resistance on PCOS with normal body mass index.

Method: This was an observational study with cross sectional design conducted at

Yasmin Clinic, RSCM, Jakarta during a period of July 2014 until March 2015.

Result: Fourty PCOS patients with normal body mass index were participated on

this study. There were 16 subjects (40%) who were insulin resistance and 24

subjects (60%) who were not insulin resistance. There were 23 subjects (57.5%)

who had waist circumference less than 80 cm, where 6 of them (26%) were

insulim resistance. Serum RBP-4 level was significantly higher on insulin

resistance group (p 0.008). After ROC analysis was performed, AUC of serum

RBP-4 was 78.8% (CI 95% -8445.59 ? -1447.98, p 0.002). The cut off level of

serum RBP-4 was 24133 ng/mL with sensitivity 75% and specificity 75%. After

logistic regression analysis was performed, it was found that serum RBP-4 increase diagnostic value of demographic and clinical parameter with AUC 85.7% to 91.1%. ;Background: Polycystic ovarian syndrome (PCOS) contributes to fourty percent

of infertility?s issues on reproductive women. Insulin resistance as one of

important pathophysiology in PCOS, correlates with visceral adipose tissue and is

found on 30-50% PCOS patients with normal body mass index and waist

circumference less than 80 cm. Retinol Binding Protein-4 (RBP-4), which is

secreted by visceral adipose tissue, known as one of adipokines that cause insulin

resistance. The measurement of body mass index and waist circumference could

not represent visceral adiposity on PCOS with normal body mass index and waist

circumference less than 80 cm. Determination of serum RBP-4 cut off level as

visceral adipose tissue marker hopefully could predict the risk of insulin

resistance on polycystic ovarian syndrome with normal body mass index,

therefore it will be useful on its management related to reduction of visceral

adiposity.

Objective: To obtain serum RBP-4 cut off level as visceral adipose tissue marker

to predict the risk of insulin resistance on PCOS with normal body mass index.

Method: This was an observational study with cross sectional design conducted at

Yasmin Clinic, RSCM, Jakarta during a period of July 2014 until March 2015.

Result: Fourty PCOS patients with normal body mass index were participated on

this study. There were 16 subjects (40%) who were insulin resistance and 24

subjects (60%) who were not insulin resistance. There were 23 subjects (57.5%)

who had waist circumference less than 80 cm, where 6 of them (26%) were

insulim resistance. Serum RBP-4 level was significantly higher on insulin

resistance group (p 0.008). After ROC analysis was performed, AUC of serum

RBP-4 was 78.8% (CI 95% -8445.59 ? -1447.98, p 0.002). The cut off level of

serum RBP-4 was 24133 ng/mL with sensitivity 75% and specificity 75%. After

logistic regression analysis was performed, it was found that serum RBP-4 increase diagnostic value of demographic and clinical parameter with AUC 85.7% to 91.1%. "