Search

R Muharam,1– 3 Anom Bowolaksono,1,4 Mila Maidarti,1– 3 Ririn Rahmala Febri,1 Kresna Mutia,1 Pritta Ameilia Iffanolida,1 Muhammad Ikhsan,1– 3 Kanadi Sumapraja,1– 3 Gita Pratama,1– 3 Achmad Kemal Harzif,1– 3 Andon Hestiantoro,1– 3 Budi Wiweko1– 3 1Human Reproduction, Infertility and Family Planning Research Center, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia Jakarta, Jakarta, 10430, Indonesia; 2Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia, DKI Jakarta, 10430, Indonesia; 3Yasmin IVF Clinic, Dr. Cipto Mangunkusumo General Hospital, Jakarta, 10430, Indonesia; 4Cellular and Molecular Mechanisms in Biological System (CEMBIOS) Research Group, Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Indonesia, Depok, 16424, IndonesiaCorrespondence: R Muharam, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology - Faculty of Medicine Universitas Indonesia, Jl. Diponegoro No. 71, Salemba, Jakarta Pusat, DKI Jakarta, 10430, Indonesia, Tel +62 3928720 / +62 816 1188027, Email rmuharam@yahoo.comPurpose: This study aimed to measure the correlation between miR-183 and gene expression that regulates apoptosis and adhesion mechanism that may be linked to the pathogenesis of endometriosis.Patients and Methods: Forty-four subjects, including 22 control subjects, participated in this study. We collected ectopic endometriosis and endometrial samples. For the control, the sample was taken from endometrial tissue through pipelle biopsy. RNA was extracted from all tissues using RNA mini kit, and the expression was assessed using quantitative-real time PCR. Relative mRNA and miRNA expression were presented using the formula of the Livak method. The data were statistically analyzed using GraphPad Prism 8.Results: The expression of Caspase-3, Survivin, Integrin β 1 (ITGB1), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) (adhesion- and apoptosis-related gene) were calculated using the relative expression method. We found significant differences in Caspase-3, Survivin, ITGB1, MMP-9, and TIMP-1 expression between ectopic endometriosis tissues of women with endometriosis compared to healthy endometrium. MMP-9, Survivin, and ITGB1 was significantly increased in the endometriosis group, while Caspase-3, TIMP-1, and miR-183 were significantly reduced in the endometriosis group. No correlation was found between the expression level of miR-183 and Caspase3, Survivin, ITGB1, and Cadherin in both tissue types.Conclusion: Despite the difference in expression levels of miR-183 and associated adhesion- and apoptosis-related genes, there was no significant association between miR-183 with specific adhesion and apoptosis genes in endometriosis tissue.Keywords: endometriosis, miR-183, MMP-9, TIMP1, apoptosis, antiapoptosis

Background: Chromosomal mosaicism, a phenomenon observed in a minority of embryos, showcases its prevalence and inherent unpredictability, leading to variations in embryo mosaic rates across different centers. This research endeavors to assess the prevalence of mosaicism and its characteristics within the scope of our preimplantation genetic testing-A (PGT-A) services in Indonesia. Specifically focusing on our center's experience since 2020, this study aims to elucidate mosaic rates among embryos in our care. Materials and Methods: In a retrospective approach, we collected secondary data sourced from our PGT-A outcomes dating back to 2020. A total of 196 embryos underwent analysis, their characteristics were documented and presented descriptively. Notably, the incidence of specific chromosome abnormalities was outlined. We assess a comparative analysis to investigate the relationship between mosaicism and its corresponding clinical characteristics. Results: In the analysis of 196 embryos, 106 (54.1%) displayed chromosomal anomalies spanning from low-level mosaicism to whole chromosome aneuploidy. Low mosaicism was observed in 25 (12.8%) of the embryos, while high mosaicism was identified in 8 (4.1%) embryos. Notably, low-level mosaicism predominated in chromosome 9 (n=10, 5.1%), whereas abnormality prevalence was highest in chromosome 21 (n=20, 10.2%). Statistical analysis revealed no significant disparity in mean maternal age among embryos with low-level mosaicism, high mosaicism, and normal chromosomes (33.88 vs. 35 vs. 33.26 years old, respectively). However, a statistically significant difference in mean maternal age (35.84 vs. 33.26 years) was observed between embryos with aneuploidy (monosomy or trisomy) and those with normal chromosomes. Furthermore, a significant difference in high mosaicism rates was detected in patients with unexplained infertility (P<0.05). Conclusion: In contrast to the study conducted elsewhere, our center had a higher mosaicism rate. Chromosomes 9, 8, and 6 were the most frequently affected. There was a significant difference in the high mosaicism rate for PGT-Arelated unexplained infertility causes. [ABSTRACT FROM AUTHOR]

R Muharam,1 Titi Amalia,1 Gita Pratama,1 Achmad Kemal Harzif,1 Feranindhya Agiananda,2 Mila Maidarti,1 Mazaya Azyati,1 Kanadi Sumapraja,1 Hariyono Winarto,1 Budi Wiweko,1 Andon Hestiantoro,1 Eva Suarthana,3 Togas Tulandi3 1Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia; 2Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia; 3Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, CanadaCorrespondence: R MuharamDepartment of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jl. Pangeran Diponegoro No.71, Kenari, Kec. Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota, Jakarta, 10430, Indonesia, Tel +62 812 85143491, Fax +1 205 975-6110, Email rmuharam@yahoo.comBackground: Endometriosis is a condition associated with pelvic pain, infertility, and possibly with decreased quality of life as well as psychiatric disorder. The purpose of our study was to evaluate the association between pain characteristic, psychiatric disorder, and quality of life in women with endometriosis.Methods: A cross-sectional study was done involving 160 women with medical diagnosis of endometriosis. Pain intensity was evaluated using Visual Analog Scale (VAS), Quality of Life with Endometriosis Health Profile (EHP-30), and psychologic condition with Mini International Neuropsychiatric Interview International Classification of Diseases (Mini-ICD).Results: VAS and psychiatric disorder were associated with higher EHP-30 score (β = 9.3 (95% CI: 7.15– 11.45; p < 0.001 and β = 28.51 (95% CI: 20.06– 36.05; p < 0.001), respectively) and hence, lower quality of life. The strongest correlation between VAS and EHP-30 was in pain (r=0.586; p< 0.001) and ‘control and powerlessness’ (r = 0.583; p < 0.001). VAS was also higher in subjects with depression (49.5 (25.4– 77.8) vs 34.4 (6.1– 74.6); p < 0.001).Conclusion: We conclude that severe endometriosis-related pain and the presence of psychiatric disorder were associated with lower quality of life. Comprehensive management of endometriosis is crucial to improve patients’ quality of life.Keywords: endometriosis, pain, depression, psychiatric disorder, quality of life

R Muharam, Kanadi Sumapraja, Gita Pratama, Mazaya Azyati, Kevin Ardito Prabowo Department of Obstetrics & Gynecology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, IndonesiaCorrespondence: R MuharamDepartment of Obstetrics & Gynecology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo National Hospital, Jl. Pangeran Diponegoro No. 71, Kenari, Kec. Senen, Kota Jakarta Pusat, Daerah Khusus Ibukota Jakarta, Jakarta, 10430, IndonesiaTel +62 812 85143491‬‬&#x202CEmail rmuharam@yahoo.comBackground: Age-related loss of female fertility is characterized by a decline in both the quantity and quality of ovarian follicles. Symptoms of ovarian stimulation, which is part of the process of in vitro fertilization (IVF), vary among women. This study was conducted to analyze the differences in menopausal timing and symptoms in women who had undergone IVF compared to those who had natural pregnancies.Methodology: In this cross-sectional study, menopausal women were categorized into two groups: those who had undergone IVF (n = 50) and those who had not (n = 50). Clinical data were obtained from the participants’ medical records, and patient interviews were conducted using the menopause rating scale (MRS) questionnaires.Results: The IVF had no significant impact on psychological or somatic symptoms in either group (p> 0.05). However, it affected urogenital symptoms (p< 0.05). Additionally, there was a significant difference in the age of onset of menopause between the groups (p< 0.05).Conclusion: There is a significant correlation between IVF treatment, urogenital symptoms in menopause, and the age of onset of menopause.Keywords: in vitro fertilization, menopause, infertility, psychological symptoms, urogenital

Aims and background: Currently, there is no consensus on the standardization of clinical phenotype data for endometriosis patients. The WERF-Endometriosis Phenome and Biobanking Harmonization Project initiated the development of standardization methods for collecting research samples of surgical phenotypes and clinical/biological data related to endometriosis research worldwide. Therefore, translation of the WERF-EPHect Clinical Questionnaire (Standard) (WERF EPQ-S) into Bahasa Indonesia and the validation of this questionnaire is required. To create a standard for taking clinical phenotype data for endometriosis patients by translating and validating WERF EPQ-S content. Materials and Methods: This research was conducted using the transcultural adaptation method. This validation test WERF EPQ-S questionnaire was carried out through a process of forward-backward translation, harmonization by experts, cognitive debriefing to questionnaire targets, and proofreading and finalization by experts. Results: Translation and validation of the Indonesian version of the WERF EPQ-S questionnaire had 10 stages. There are cultural differences from the country of origin of the questionnaire, including medicines available, medical terms that are common in the country of origin but unfamiliar in Indonesia, and the presentation of racial tribes that do not describe variants of Indonesian ethnic tribes. The duration of finishing the questionnaire population was 79.3 minutes, and out of 116 questions, there were 21 that required to be guided. Conclusion: The WERF EPQ-S Indonesian version was obtained with contents according to users' needs. Such a transcultural adaptation method is needed for this tool for the population. The WERF EPQ-S version in the Indonesian language is a valid questionnaire and is ready to be applied to endometriosis patients in Indonesia. Clinical significance: The translation and validation of the WERF-EPHect Clinical Questionnaire into Bahasa Indonesia represent a crucial step toward establishing a standardized and culturally relevant tool for collecting clinical phenotype data from endometriosis patients in Indonesia. [ABSTRACT FROM AUTHOR]

COVID-19 vaccination, especially vaccines that mimic the structure of the COVID-19 virus (mRNA vaccines), may be wrongly assumed to be disrupting factors affecting in vitro fertilization (IVF) outcome. This study aims to evaluate any significant impact of COVID-19 vaccination in women undergoing IVF to improve vaccine compliance and promote COVID-19 eradication. This was a systematic review study. We searched studies published between 2020 and 2022 using databases such as PubMed, Cochrane, PMC, and CINAHL. Selected studies were carefully analyzed to review the impact of the COVID-19 vaccine on IVF outcomes. Seven retrospective and prospective cohort studies, which involved 3232 female patients undergoing IVF, who also received full doses of COVID-19 vaccinations (mRNA), were included. All studies in the present review showed that despite presenting anti-SARS-CoV-2 antibodies after vaccination, there were no significant differences in IVF outcomes, implantation rates, and pregnancy rates. Contrary to the theory that presumed cross-reactivity between anti- SARS-CoV-2 antibodies and the human syncytin-1 protein could affect syncytiotrophoblast formation and embryo implantation. The present review concluded that COVID-19 vaccination does not result in any detrimental effects on IVF outcomes and is safe for women undergoing IVF treatment. The results of our study are important to tackle misinformation regarding COVID-19 vaccination and infertility that may cause vaccine hesitancy in women of reproductive age. [ABSTRACT FROM AUTHOR]

Background: A bioactive fraction of Cinnamomum burmanii and Lagerstroemia speciosa, DLBS3233, has recently been used for type-2-diabetes treatment due to its favorable effect on insulin sensitivity. The insulin resistance leading to metabolic syndrome is closely linked to hyperandrogenemia in polycystic ovary syndrome (PCOS). This study evaluated the metabolic and reproductive efficacy and safety of DLBS3233 in insulin-resistant PCOS women. Materials and Methods: This was a 2-arm, randomized, double-blind, controlled, noninferiority clinical study over a 6-month therapy with DLBS3233 100-mg daily in comparison to metformin-XR 750 mg twice daily, involving 124 PCOS women with insulin resistance. The primary efficacy endpoint was the improvement of Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). Secondary endpoints were improvements in other metabolic and reproductive parameters. Safety endpoints were based on blood pressure, heart rate, electrocardiogram findings, liver and renal function, and adverse events. Results: After 6 months, HOMA-IR improvement in DLBS3233-treated group (-1.03 ± 0.50) and metformin-XR (-1.19 ± 0.50) were comparable, with a between-group difference fell within the pre-set non-inferiority margin (0.16; 95% confidence interval (CI): -1.24, 1.56; P=0.3168). The HOMA-IR in both groups were significantly improved from baseline. On all secondary endpoints, both groups showed comparable effects. Markedly fewer adverse events occurred in the DLBS3233 treated group than in the Metformin-XR-treated group and most were mild clinically and had been resolved by the end of the study. Conclusion: Treatment with DLBS3233 100-mg daily in PCOS women demonstrated comparable efficacy to metformin-XR 750-mg twice daily in improving insulin resistance. However, the non-inferiority of DLBS3233 to metformin-XR remains inconclusive. DLBS3233 was more tolerable than metformin-XR (registration number: NCT01733459). [ABSTRACT FROM AUTHOR]

Background: In vitro fertilization (IVF) remains a main treatment for infertility cases. Post-injection human chorionic gonadotropin (hCG) level is an essential factor in determining oocyte maturation rate in IVF. This study aimed to determine the relationship between 12 hours post-injection serum hCG level and oocyte maturation rate among IVF participants. Materials and Methods: A cross-sectional study on IVF participants was done at a tertiary hospital in Indonesia from January 2020 to December 2021. Subjects were injected with 250 µg of recombinant-hCG (r-hCG) subcutaneously. Twelve hours post-injection serum hCG levels and oocyte maturation rate data were retrieved and analyzed accordingly. Results: Twenty-eight subjects were recruited into the study. Higher 12 hours post-injection serum hCG was related to oocyte maturation rate (P=0.046). The cut-off point of 12 hours post-injection serum hCG to predict better oocyte maturation rate was 90.15 mIU/mL (sensitivity 68.2%, specificity 83.3%). Oocyte maturation rate may be predicted using body mass index (BMI) and 12 hours post-injection serum hCG. Conclusion: Higher 12 hours post-injection serum hCG was associated with a higher oocyte maturation rate in IVF subjects. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is a chronic disorder and is one of the most common endocrine disorders in women of a reproductive age. The prevalence of PCOS is growing globally; 52% of women in Southeast Asia alone suffer from this disorder. This disorder is caused by chronic hyperandrogenism, which hinders folliculogenesis. There is also a close relationship between hyperandrogenism and hyperinsulinemia/insulin resistance (IR), and it is estimated that 40–80% of PCOS patients suffer from insulin resistance (IR). Mesenchymal stem cells (MSCs) and their secretomes have been shown to alleviate PCOS symptoms by decreasing IR and androgen secretion by reducing inflammation. This study aimed to systematically review the literature to study the reported potential of MSCs and their secretomes in decreasing inflammation markers in PCOS treatment. Methods: A systematic literature search was performed on EMBASE, PubMed (MEDLINE), and the Cochrane Library with the terms insulin-resistant PCOS, mesenchymal stem cells, and secretome or conditioned medium as the search keywords. A total of 317 articles were reviewed. Four articles were identified as relevant for this systematic review. Results: The results of this study supported the use of mesenchymal stem cells and their secretions in decreasing inflammatory markers in the treatment of polycystic ovary syndrome. Conclusions: This review provided evidence that treatment with mesenchymal stem cells and their secretomes has the potential to treat PCOS due to its ability to downregulate androgen levels and increase insulin sensitivity, which thereby lowers the level of proinflammatory factors. [ABSTRACT FROM AUTHOR]

Background: Hyperprolactin is one of the endocrine disorders that causes male infertility (11%). The mechanism is not widely known; it is thought to occur through disruption of LH receptor activity on germ cells. Objective: The aim of study to compare the level of prolactin secretion with receptor expression in non-azoospermic infertile men (NOA). Methods: During the period from July 2019 to July 2021, 40 samples of testicular tissue and serum were obtained from infertile NOA men, aged 25-50 years who were recruited from Ciptomangunkusumo Hospital (RSCM) Jakarta, Faculty of Medicine, Universitas Indonesia and Bunda Hospital Jakarta. Subjects were divided into 4 groups based on prolactin levels (20 ng/ml, 20-50 ng/ml, 50-100 ng/ml and 100ng/ml). This group was tested for significance between groups and continued with a correlation test with the level of LH receptor expression. Results: ANOVA test showed a significant decrease in LH receptor expression between prolactin levels < 20 ng/mL with levels of 50-100 ng/ml and prolactin levels > 100 ng/ml (P < 0.05). Furthermore, the results of the correlation test showed a significant decrease between prolactin levels and LH receptor expression (P < 0.05). Conclusion: The higher the level of prolactin secretion in this sample, there is a decrease in LH receptor expression, so that testosterone production decreases and the spermatogenesis process will be disrupted. [ABSTRACT FROM AUTHOR]