Hasil Pencarian  ::  Simpan CSV :: Kembali

"Selama oogenesis, oosit tumbuh dalam ukuran dan memperoleh kompetensi pematangannya. Kompetensi pematangan oosit sangat diperlukan untuk mendukung terjadinya fertilisasi dan perkembangan embrio berkualitas baik. Ketidakmampuan untuk menentukan oosit yang berpotensi menghasilkan embrio yang viable masih menjadi kendala utama pada proses Fertilisasi In Vitro (FIV). Penelitian ini bertujuan mengetahui apakah ukuran diameter oosit bisa menjadi prediktor kualitas oosit dan embrio. Penelitian ini menggunakan desain penelitian prospektif cohort. Metode penelitian untuk pengukuran diameter oosit menggunakan aplikasi Image J, setiap oosit dan sel granulosa dikelompokkan sesuai ukuran diameter oosit, oosit dilakukan fertilisasi dengan teknik ICSI/IMSI kemudian diikuti perkembangan embrio sampai hari ke-5. Pemeriksaan ELISA dipakai untuk mengkonfirmasi kualitas oosit dengan melihat kadar protein Akt dan total Akt pada sel granulosa kumulus oosit, sedangkan untuk mengkonfirmasi kualitas embrio adalah dengan melihat parameter morfokinetik embrio, pencapaian blastokista dan frekuensi abnormalitas pembelahan. Hasil penelitian menunjukkan tidak ada perbedaan signifikan (P>0,05) pada kadar protein p-Akt dan total Akt sel granulosa kumulus antara ketiga kelompok. Selain itu pengamatan morfokinetik embrio menunjukkan tidak ada perbedaan signifikan (P>0.05) kecuali parameter S2, begitu pula dengan pencapaian blastokista serta frekuensi abnormalitas pembelahan kecuali parameter reverse cleavage (RC). Kesimpulan yang didapat dari penelitian ini adalah ukuran diameter oosit tidak mempengaruhi kualitas oosit dan embrio. Ukuran diameter oosit tidak bisa menjadi prediktor kualitas oosit dan embrio, karena tidak ada perbedaan signifikan pada kualitas oosit dan embrio ketiga kelompok. Oosit dengan ukuran diameter kecil memiliki potensi untuk menjadi embrio dengan kualitas baik.

---

During oogenesis, oocytes grow in size and acquire maturation competence. Oocyte maturation competence is necessary to support fertilization and the development of good quality embryos. The inability to determine which oocytes have the potential to produce viable embryos remains a major obstacle in the In Vitro Fertilization (IVF). This study aims to determine whether oocyte diameter can be a predictor of oocyte and embryo quality. This study used a prospective cohort research design. The method used for measuring oocyte diameter using Image J application. Each oocyte and cumulus granulosa cells is grouped according to the size of oocyte diameter, oocyte are fertilized with ICSI/IMSI techniques and then followed by embryo development until day 5. ELISA examination is used to confirm oocyte quality by looking at p-Akt and Akt total protein levels in oocyte cumulus granulosa cells, while to confirm embryo quality by looking at the morphokinetic embryo, blastocyst achievement and frequency of cleavage abnormalities. The results showed no significant difference (P>0.05) in p-Akt and Akt total protein levels in cumulus granulosa cells between the three groups. In addition, morphokinetic observation of embryos showed no significant difference (P>0.05) except S2 parameter, as well as the achievement of blastocyst and the frequency of cleavage abnormalities except the reverse cleavage (RC) parameter. The conclusion obtained from this study is that the size of the oocyte diameter does not affect the quality of oocytes and embryos. Oocytes diameter size can not be a predictor of oocyte and embryo quality, because there is no significant difference in the quality of oocytes and embryos of the three groups. Oocytes with a small diameter size have the potential to become embryos with good quality."

"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

---

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."

"

Latar belakang: Suplementasi mikronutrien untuk wanita pada masa prakonsepsi, khususnya zinc dan kalsium, terbukti penting untuk maturasi oosit dan ovulasi. Namun, peran zinc dalam mempromosikan kualitas oosit dan potensi perkembangannya belum diketahui secara jelas. GDF9, anggota superfamili TGF b yang disekresikan dari oosit selama proses folikulogenesis, terbukti dapat menjadi biomarker maturasi nuklear oosit dan kualitas embrio. Tujuan: Studi potong lintang ini bertujuan untuk mengetahui apakah ada hubungan antara kadar zinc dan kalsium dalam serum dan cairan folikel dengan ekspresi GDF9 terhadap maturasi oosit. Selain itu, penelitian ini juga bertujuan untuk mengetahui apakah kadar zinc dan kalsium dalam serum dapat mewakili kadar zinc dan kalsium dalam cairan folikel. Metode: Studi ini dilakukan pada 25 subjek penelitian yang menjalani program fertilisasi in vitro di Poliklinik Yasmin RSUPN Cipto Mangunkusumo (RSCM) Kencana. Darah vena sebanyak 6 cc diambil pada hari ovum pick up (OPU) dan kemudian dianalisis di laboratorium untuk mengetahui kadar zinc, kalsium, dan protein GDF9. Cairan intrafolikuler dan sel granulosa juga akan diambil dan diperiksa kadar zinc dan kalsium dari cairan intrafolikuler serta ekspresi mRNA GDF9 dari sel granulosa. Hasil:  Dari 25 subjek penelitian, 12 subjek (48%) di antaranya dikategorikan ke dalam kelompok angka maturasi oosit baik (berdasarkan indikator oosit matur dari konsensus Vienna) serta 13 (52%) sisanya dikategorikan ke dalam kelompok angka maturasi oosit buruk. Dari uji korelasi antara kadar zinc dan kalsium dalam serum dengan cairan folikel, kadar zinc folikel terbukti berkorelasi secara signifikan dengan kadar zinc serum (p = 0,019). Kadar GDF9 serum juga terbukti berkorelasi secara signifikan dengan ekspresi GDF9 (p = 0,047). Tidak didapatkan korelasi yang bermakna antara kadar zinc dan kalsium serum dengan kadar GDF9 serum serta ekspresi mRNA GDF9 dari sel granulosa terhadap angka maturasi oosit (p > 0,05). Kesimpulan: Kadar GDF9 serum dapat menjadi pengganti biomarker untuk kualitas oosit. Tidak didapatkan hubungan antara kadar zinc dan kalsium dalam serum atau cairan folikel terhadap kadar GDF9 serum atau ekspresi mRNA GDF9 dari sel granulosa terhadap angka maturasi oosit.

---

Background:  Micronutrient supplementation for women during preconception, especially zinc and calcium, is critical for oocyte maturation and ovulation. However, the role of Zinc in promoting quality of oocytes has not yet been elucidated. GDF9, one of oocyte sereting factor, has been proven to be a biomarker of maturation of nuclear oocyte and quality of embryo. Aim: to investigate any relationship between zinc and calcium levels in serum and follicular fluid and GDF9 expression towards maturation of oocytes. In addition, this study also aimed to determine whether zinc and calcium levels in serum could represent zinc and calcium levels in follicular fluid. Method: This cross-sectional study was conducted on 25 subjects who underwent IVF programs at the Yasmin Policlinic, RSCM Kencana. Six mililiters of venous blood was taken on the day of the ovum pick up (OPU) and then analyzed in the laboratory to determine the levels of zinc, calcium, and protein GDF9. In addition to venous blood, intrafollicular fluid and granulosa cells will also be taken and examined zinc and calcium levels from intrafollicular fluid and GDF9 mRNA expression from granulosa cells. Result: 12 (48%) out of 25 subjects were categorized into high oocyte maturation rate (based on Vienna consensus on oocyte maturation rate), and the other 13 (52%) were categorized into low oocyte maturation rate. Follicular zinc levels were significantly correlated with serum zinc levels (p = 0,019). Serum GDF9 levels were also significantly correlated with expressions of GDF9 mRNA (p = 0,047). No significant correlation was found between serum levels of zinc and calcium and serum GDF9 levels or GDF9 mRNA expression towards maturation of oocytes (p > 0,05). Conclusion: Serum GDF9 might substitute for follicular GDF9 as a biomarker of oocyte quality. There is no relationship between serum or follicular zinc/calcium levels and serum GDF9 levels or GDF9 mRNA expression from granulosa cells towards oocyte maturation rates.

 

 

"

"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.

---

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."

"Pendahuluan: Angka keberhasilan FIV di Indonesia sekitar 32-35%. Salah satu penyebab pencapaian yang rendah ini adalah mutu oosit yang dinilai secara mi­kros­kopik pada saat panen oosit. Dari sekian banyak faktor yang berperan dalam pembentukan oosit matang bermutu baik diduga yang paling menentukan per­olehan oosit ma­tang, jumlah fertilisasi, dan jumlah embrio yang dipindahkan ke ute­rus pada FIV adalah AMH, inhibin-B, IGF-2 dan nisbahnya. Bahan dan metoda: Kajian analitik potong-lintang pengukuran berulang dilaku­kan pada bu­lan September 2013-Agustus 2014 di Rumah Sakit Anak dan Bunda Harapan Kita, Jakarta. Sebanyak 38 pasien berumur 26-42 tahun yang mengikuti program FIV diukur kadar AMH, inhibin-B, IGF-2 saat basal, pencetus, panen oosit dalam serum dan dalam zalir folikel. Analisis regresi linear digunakan untuk memperoleh faktor penduga jumlah perolehan oosit matang, jumlah fertilisasi, dan jumlah embrio yang dipindahkan.Hasil: Parameter penduga perolehan oosit matang adalah inhibin-B serum panen oosit dan folikel antral basal (FAB) total. Parameter penduga jumlah fertilisasi adalah FAB to­tal, nisbah inhibin-B pencetus terhadap inhibin-B basal, dan nisbah IGF-2 pen­cetus terhadap inhibin-B pencetus. Parameter penduga jumlah embrio yang dipin­dahkan adalah FAB total, inhibin-B panen oosit, dan nisbah inhibin-B panen oosit terhadap inhi­bin-B pencetus.Pada analisis bivariat area under curve (AUC) terbesar (77,4%) ditemukan pada titik-potong in­hi­bin-B serum panen oosit. Kadar inhibin-B panen oosit yang lebih tinggi dari 131,16 ng/ mL adalah akurat untuk menetapkan kematangan oosit de­ngan ke­pe­­kaan (sensiti­vitas) 84% dan kekhasan (spesifisitas) 69,2%.Simpulan: Inhibin-B serum saat panen oosit berhubungan dengan pembentukan oo­sit matang dan normal sehingga dapat dijadikan parameter penduga perolehan oosit ma­tang dan jum­lah em­brio yang terbentuk. Ditemukan parameter-parameter baru, yaitu (1) nisbah inhibin-B pen­ce­tus terhadap inhibin-B basal serum, dan nisbah IGF-2 pen­cetus terhadap in­hibin-B pencetus serum untuk menduga jumlah fertili­sasi; (2) nisbah inhibin-B pa­nen terhadap inhibin-B pen­­cetus serum untuk menduga jumlah em­brio yang dipindahkan ke uterus pada FIV.

---

Background: The success rate of IVF in Indonesia was 30-35%. This low rate was caused by the microscopically evaluated oocyte quality that was obtained by ovum pick-up (OPU). The determinatively contributing factors for the formation of good quality mature oocytes, which are considered to be used as predictive parameter for mature oocytes recovery, number of fertilization, and number transferrable embryos in IVF, are AMH, inhibin-B, IGF-2, and their ratios. Therefore, the study to determine the correlation of those factors with the formation of ferti­li­zable mature oocyte in IVF program is necessary.

Materials and methods: An analytic cross-sectional repeated measurements study was conducted from September 2013 until August 2014 at Harapan Kita Mother and Chil­d Hospital, Jakarta. There were 38 patients aged between 26-42 years who par­ticipated in the IVF program; all of them underwent measurement for serum AMH, inhibin-B, and IGF-2 levels at basal, trigger, and OPU times. Predictive parameters for the number of mature oocytes, fertilizable oocytes, number of embryos transferred were analysed using linear regression.

Results: Predictive parameter for the number of mature oocytes are inhibin-B at OPU and total basal antral follicle (BAF) count. Predictive factors for the number of fertili­za­tion are total BAF count, the ratio of inhibin-B at triggering to inhibin-B at basal ti­mes. Predic­ti­ve factors for the number of embryos transferred are total BAF, inhibin-B at OPU, and the ratio of inhibin-B at OPU to inhibin-B at triggering time.

Using bivariate analysis, at the largest area under the curve (AUC) which was as high as 77.4%, the cut-off point of serum inhibin-B at OPU was found. The serum inhibin-B level at OPU higher than 131.16 ng/mL is accurate for determining the oocyte ma­turity (84% sensitivity and 69.2% spe­cificity).

Conclusions: Serum inhibin-B at OPU correlates with the formation of both mature and normal oocytes, thus it can be used as a predictor for the number of mature oo­cytes recovered and the number of embryos transferred. New parameters are found, those are: (1) the ratio of inhibin-B at triggering to inhi­bin-B in serum at basal times; and the ratio of IGF-2 at triggering to inhibin-B in serum at triggering times to pre­dict the number of fer­tilization; (2) the ratio of inhibin-B at OPU to inhibin-B in se­rum at triggering times to pre­dict the number of embryos transferred."

"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.

---

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."

"Penilaian morfokinetik embrio dipakai untuk seleksi embrio. Penelitian cohort ini bertujuan untuk evaluasi hubungan antara jumlah salinan mtDNA di cumulus granulosa cells (CGCs) dengan parameter morfokinetik embrio dan status kromosom. Perhitungan jumlah salinan mtDNA menggunakan real-time PCR pada 129 sample CGCs dari 30 pasien yang mengikuti program IVF-IMSI di Morula IVF Jakarta antara Juli-Oktober 2020. Hubungan antara jumlah salinan mtDNA di CGCs dengan semua parameter menggunakan analisa bivariate dan multiple. Terdapat hubungan signifikan antara jumlah salinan mtDNA di CGCs dengan pencapaian blastokista setelah dikontrol variabel usia maternal dan morfologi sperma (coefficient 0.832, p-value = 0.032, RR value 2.299). Hubungan signifikan pada jumlah salinan mtDNA di CGCs dengan fase awal perkembangan embrio M1 (t2-t8), dengan persamaan M1 adalah 5.702-0.271 jumlah salinan mtDNA di CGCs + 0.017 usia maternal + 0.013 motilitas sperma – 0.115 morfologi sperma (p-value = 0.032). Ditemukan hubungan tidak signifikan antara jumlah salinan mtDNA di CGCs dengan parameter morfokinetik lainnya (M2: tC-tEB, M3: t2-tEB, DC, RC, MN dengan P> 0.05), serta dengan status kromosom embrio (euploid: 139.44 ± 133.12, aneuploid: 142.40 ± 111.30, p= 0.806). Penelitian ini menunjukkan bahwa jumlah salinan mtDNA di CGCs merupakan biomarker untuk memprediksi pencapaian blastokista dan fase awal perkembangan embrio, tetapi tidak status kromosom.

---

This cohort study evaluates the association between the mtDNA copy number in cumulus granulosa cells (CGCs) with embryo morphokinetic parameters and chromosomal status. mtDNA copy number of 129 CGCs from 30 patients undergoing the IVF-IMSI program at Morula IVF Jakarta between July-October 2020 were analyzed using real-time PCR. Bivariate and multiple analyses were conducted to see its relationship with all parameters. There was a significant correlation between the mtDNA copy number and the blastocyst after adjusting the maternal age and sperm morphology (coefficient 0.832, p-value = 0.032, RR value 2.299). A significant link was observed between mtDNA copy number in CGCs and early embryo developmental phase M1 (t2-t8), with the equation of M1 is 5.702 - 0.271 mtDNA copy number of CGCs + 0.017 maternal age + 0.013 sperm motility -0.115 sperm morphology (p-value = 0.032). No correlation was found between the mtDNA copy number in CGCs with the other morphokinetic parameters (M2: tC-tEB, M3: t2-tEB, DC, RC, MN with p> 0.05), and the chromosomal status (euploid: 139.44 ± 133.12, aneuploid: 142.40 ± 111.30, p= 0.806). mtDNA copy number in CGCs can serve as a useful biomarker for blastocyst status and early embryo developmental phase but not for chromosomal status."

"Pengawetan fungsi reproduksi dengan simpan beku oosit matur tidak dapat dilakukan pada pasien kanker, sehingga simpan beku oosit imatur menjadi pilihan. Simpan beku oosit imatur masih terkendala angka maturasi dan fertilisasi yang rendah. Penelitian ini bertujuan untuk mengidentifikasi pengaruh vitrifikasi sel kumulus granulosa sebagai representasi maturitas dan kualitas oosit matur dan imatur. Penanda maturitas adalah GDF-9, BMP-15, FSHR, LHR, dan koneksin-37, sedangkan kaspase-3 dan survivin sebagai penanda kualitas. Kadar protein total dan protein spesifik penanda maturitas (FSHR, LHR) dan kualitas (kaspase-3) oosit juga diteliti untuk memperoleh gambaran komprehensif pascavitrifikasi.Disain penelitian adalah true eksperimental in-vitro, dilakukan dari bulan Juli 2020 sampai Februari 2022. Subjek penelitian adalah pasien yang menjalani program fertilisasi in-vitro di klinik bayi tabung Morula IVF, RSIA Bunda Jakarta. Sampel sel kumulus-granulosa dari 38 pasien dengan diagnosis sindrom ovarium polikistik (SOPK) dianalisis. Prosedur vitrifikasi dilakukan dengan memajan sel kumulus-granulosa pada medium ekuilibrasi (VS1, 15% etilen glikol) selama 5 menit dan medium vitrifikasi (VS2, 15% etilen glikol, 15% dimethyl sulfoxide dan 0,5 M sukrosa) selama 30 detik. Sel kumulus-granulosa dimasukkan secara cepat ke nitrogen cair (suhu -196 oC). Setelah 5 menit, sampel dihangatkan dengan memajankan larutan sukrosa bertingkat 0,5 M, 0,25 M, 0.125 M. Metode real-time quantitative polimerase chain reaction (rt-qPCR) digunakan untuk mengukur ekspresi relatif dan sandwich Enzyme-linked Immunosorbent Assay (ELISA) untuk mengukur kadar protein. Analisis data menggunakan T-independent atau Mann-Whitney. Analisis ekspresi relatif gen target level mRNA menggunakan rumus Pfaffl.Didapatkan kadar protein total yang tidak berbeda bermakna antara sel kumulus-granulosa oosit matur dan imatur (30 µg/mL dan 12,5 µg/mL, nilai p > 0,05). Kadar protein spesifik FSHR, LHR dan Kaspase-3 juga tidak berbeda bermakna antara kelompok oosit matur dan imatur (masing-masing adalah 0,47 µg/mL dan 0,48 µg/mL, 0,1 µg/mL dan 0,09 µg/mL, 0.51 µg/mL dan 0.58 µg/mL, nilai p > 0,05). Tidak terdapat perbedaan bermakna ekspresi relatif BMP-15, LHR dan koneksin-37 pascavitrifikasi pada kelompok sel kumulus-granulosa oosit matur dan imatur (masing-masing 1,6 dan 1,4 kali untuk BMP-15, 2,3 dan 2,3 kali untuk LHR, 0,9 dan 0,9 kali untuk koneksin-37, nilai p < 0,01). Didapatkan penurunan bermakna ekspresi relatif GDF-9 dan FSHR pada kelompok sel kumulus-granulosa oosit matur dan imatur (masing-masing 0,2 dan 0,1 kali untuk GDF-9, 0,3 dan 0,02 kali untuk FSHR, nilai p < 0,01). Ekspresi relatif gen penanda kualitas oosit matur dan imatur yaitu survivin dan kasapase-3 tidak berubah pascavitrifikasi (1,3 dan 1,2 kali untuk survivin, 0,7 dan 0,8 kali untuk kaspase-3, nilai p > 0,05). Analisis kadar protein FSHR, LHR, dan kaspase-3 pascavitrifikasi menunjukkan bahwa vitrifikasi tidak mengubah ekspresi gen sel kumulus granulosa oosit matur dan imatur (masing-masing adalah 0,4;0,4 µg/mL dan 0;4;0,5 µg/mL untuk FSHR, 0,1;0,1 µg/mL dan 0,1;0,1 µg/mL untuk LHR, 1,9;1,5 µg/mL dan 1,7;1,6 µg/mL untuk kaspase-3, nilai p > 0,05).Disimpulkan simpan beku sel kumulus-granulosa dengan metode vitrifikasi tidak mengubah ekspresi gen penanda maturitas dan kualitas oosit kecuali GDF-9 dan FSHR. Vitrifikasi terbukti aman untuk mempertahankan viabilitas sel kumulus-granulosa sebagai representasi kesintasan oosit matur dan imatur.

---

Fertility preservation through mature oocytes cannot be recommended for cancer patients and immature oocytes is preferable. However, immature oocyte vitrification remains unfavorable due to low number of mature oocytes as well as low fertilizability post-warming. This study aimed to investigate the effect of cumulus-granulosa cells' vitrification on maturity and quality-associated markers of mature and immature oocytes as an indirect assessment. Expression of GDF-9, BMP-15, FSHR, LHR, and Connexin-37 genes which represent oocyte maturity and oocyte quality (caspase-3 and survivin) were analyzed post-warming. Protein total and specific proteins including FSHR, LHR, and Caspase-3 were also measured to comprehend the effect of vitrification.

This was an in-vitro experimental study conducted from Juli 2020–February 2022 in Morula IVF Jakarta Clinic. A total of 38 cumulus-granulosa cell samples from infertile women diagnosed with polycystic ovary syndrome (PCOS) were analyzed. Vitrification was commenced by exposing the cells sample to the equilibration medium containing 15% EG for 5 minutes followed by exposing the cells to vitrification medium (15% EG and 15% DMSO) for 30 seconds. Cell samples were subsequently immersed in liquid nitrogen (-196 0C) for 5 minutes. Warming procedure using sucrose solution (0.5 M, 0.25 M, 0.125 M) was performed consecutively. Real-time quantitative polymerase chain reaction (rt-qPCR) dan sandwich ELISA was utilized to measure relative expression and concentration of both total and specific protein. Data analysis was performed using T-independent or Mann-Whitney and Pfaffl formulation for fold-changes measurement.

This study found that concentration of both total (30 µg/mL vs. 12.5 µg/mL, p > 0.05) and specific proteins was similar between cumulus-granulosa cells of mature and immature oocytes (FSHR: 0.47 µg/mL vs. 0.48 µg/mL , LHR: 0.1 µg/mL vs. 0.09 µg/mL, and caspase-3: 0.51 µg/mL and 0.58 µg/mL, respectively, p > 0.05). Relative expression of maturity-associated genes such as BMP-15, LHR and connexin-37 post-warming did not significantly different in either cumulus-granulosa cells obtained from mature or immature oocytes (BMP-15: 1.6 vs. 1.4 fold, LHR: 2.3 vs. 2.3 fold, connexin-37: 0.9 vs. 0.9 fold, p > 0.05). However, we observed decreased relative expression of GDF-9 and FSHR post-warming in either cumulus-granulosa cells obtained from mature or immature oocytes (GDF-9: 0.2 vs 0.1 fold, and FSHR: 0.3 vs. 0.02 fold, p < 0.01, respectively). In protein level, concentration of FSHR, LHR, and caspase-3 as well as protein total post-warming did not significantly different than that of fresh condition (FSHR: 0.4 vs. 0.4 µg/mL and 0.4 vs. 0.5 µg/mL, LHR: 0.1 vs. 0.1 µg/mL dan 0.1 vs. 0.1 µg/mL, and caspase-3: 1.9 vs. 1.5 µg/mL and 1.7 vs. 1.6 µg/mL, repectively, p > 0,05).

This study concluded that vitrification is a safe procedure for fertility preservation which is able to preserve cumulus-granulosa cells viability as a representative of mature and immature oocytes survival post-warming."

"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

---

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"

"Pengantar: Endometriosis merupakan salah satu penyebab infertilitas dan menjadi indikasi fertilisasi in vitro (FIV). Laju apoptosis dan stress oksidatif yang tinggi pada pasien endometriosis diyakini menimbulkan efek negatif terhadap peluang keberhasilan FIV. Namun, pengaruh endometriosis terhadap keberhasilan FIV menunjukkan bukti yang inkonsisten dan belum banyak studi yang menilai langsung efek endometriosis terhadap kualitas oosit sebagai parameter keberhasilan FIV.Tujuan: Untuk menilai laju apoptosis pada sel granulosa pasien endometriosis dibanding pasien non-endometriosis melalui rasio ekspresi mRNA BAX/BCL-2 dan menilai korelasinya dengan kualitas oosit yang didapatkan saat petik ovum.Hasil: Sampel didapatkan dari 15 subjek dengan endometriosis dan 15 subjek kontrol. Dosis rekombinan FSH total yang diterima pada kelompok endometriosis untuk stimulasi ovarium lebih tinggi dibandingkan kelompok kontrol (p=0.005). Terdapat perbedaan bermakna kadar ekspresi BAX (p=0.029) dan BCL-2 (p<0.001) pada kedua kelompok, tetapi perbedaan rasio keduanya tidak signifikan (p=0.787). Korelasi antara rasio BAX/BCL-2 dengan parameter kualitas oosit tidak menunjukkan hubungan bermakna di kedua kelompok.Kesimpulan: Tidak terdapat perbedaan signifikan pada rasio kadar BAX/BCL-2 di kedua kelompok dan tidak ditemukan hubungan bermakna antara rasio tersebut dengan kualitas oosit. 

---

Introduction: Endometriosis is one of common conditions causing infertility and an indication to undergo in vitro fertilization (IVF). High apoptosis rate and oxidative stress in patient with endometriosis is believed to cause negative effect on IVF success rate. However, there has been conflicting results on endometriosis effect to IVF success and there have been limited studies that directly assess endometriosis and its effect on oocyte quality.

Aim: To assess apoptosis rate on granulosa cells in patients with endometriosis compared to non-endometriosis patients through mRNA BAX/BCL-2 ratio and how it correlates with oocyte quality collected during ovum pick up.

Results: Samples were collected from 15 subjects with endometriosis and 15 control subjects. Total dose of recombinant FSH received by endometriosis group is significantly higher compared to control (p=0.005). There is difference in BAX level (p=0.029) and BCL-2 level (p<0.001) in both groups. However, the ratio does not differ significantly (p=0.787). No significant correlation is found in BAX/BCL-2 ratio and any of the oocyte quality parameters.

Conclusion: We found no significant difference in BAX/BCL-2 ratio between endometriosis and control group as well as significant correlation between the ratio and oocyte quality."