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All Journal Majalah Obstetri dan Ginekologi Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) JKM (Jurnal Kebidanan Malahayati) Journal of Health, Education, And Literacy (J-Healt) Biomolecular and Health Science Journal Pediomaternal Nursing Journal Majalah Biomorfologi (Biomorphology Journal) JIK (Jurnal Ilmu Kebidanan) Indian Journal of Forensic Medicine & Toxicology INDONESIAN MIDWIFERY HEALTH AND SCIENCES JOURNAL PROFESSIONAL HEALTH JOURNAL
Sri Ratna Dwiningsih
Departemen Obstetri Dan Ginekologi Fakultas Kedokteran Universitas Airlangga Surabaya
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Preoperative TNF-a Reduction in Endometriosis Lesions with Combined Oral Contraceptives Thengkano, Irwanto; Yanuari Primariawan, Relly; Hernaningsih, Yetti; Ratna Dwiningsih, Sri
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 2 April 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i2.2547

Abstract

Background: The goals of endometriosis treatment vary greatly depending on the patient's symptoms and reproductive needs. Hormonal therapy to alleviate pain has generally been shown to have positive effects. Combined Oral Contraceptives (COC) are widely available, relatively affordable, and well-known by the public. Objective: This study aims to compare the effects of COC therapy with two newer endometriosis treatments: oral Dienogest 2 mg and injectable Leuprorelin acetate 3.75 mg on TNF alfa levels in serum and peritoneal fluid. Methods: Forty subjects were divided into four groups: three groups receiving medical therapy—COC (0.03 mg ethinylestradiol and 0.15 mg levonorgestrel, taken one active tablet per day continuously), oral Dienogest 2 mg, and intramuscular Leuprorelin acetate 3.75 mg every four weeks—and a control group of endometriosis patients who had not received any hormonal therapy. Peripheral venous blood samples were taken before surgery, and peritoneal fluid was collected at the start of surgery in the pelvic cavity. TNF alfa levels were analyzed using the ELISA method. Data analysis was performed using the Kruskal-Wallis test with a significance level of 0.05. Results: The Kruskal-Wallis test showed significant differences between treatment groups in TNF alfalevels in peritoneal fluid (p:0.023), specifically between the COC group and the control group, and between the Dienogest group and the control group. Conclusion: Preoperative hormonal therapy for estradiol suppression provides limited benefit in reducing systemic inflammatory agents but is effective locally, as evidenced by reduced TNF alfa levels in the peritoneal fluid after preoperative COC and Dienogest therapy. Keywords: COC, Dienogest, Leuprorelin Acetate, Serum, Peritoneal Fluid, TNF alfa
Co-Authors -, Nur Mulyani Amalia Ramadhani Anak Agung Renjani Kanya Kumari Anindya Marcha Angelina Djianto Annisa Trissatharra Arsana Wiyasa Bambang Purwanto Cicilia Valentine Simamora Dhea Hesty Purwaningrum Diana Rahima Hendy Hendarto HERAWATI, LILIK I'tishom, Reny Ilya Krisnana, Ilya Monika Lijuwardi Ninik Darsini Noor Syafaatin Udhma Oktavianti, Anisa Dwi Olvinda Eka Zulfi Pratiwi Dwi Trisnanti Pudji Lestari Putri Lisdiana Rahmawati Rara Yumna Elfrida Ratna Sofaria Munir Ratriana Via Parasti Rida Eka Setiani Samsulhadi Samsulhadi Sari, Gadis Meinar Siti Khaerunnisa Sofia Al Farizi Sudaryanti, Lestari Sulistiawati Sulistiawati Thengkano, Irwanto Tri Hartini Yuliawati Tunjungseto, Arif Vienda Leony Agustina Widjiati Widjiati Yanuari Primariawan, Relly Yetti Hernaningsih Zafirah Delia