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All Journal Majalah Obstetri dan Ginekologi The Indonesian Biomedical Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Narra J eJournal Kedokteran Indonesia Jurnal Ilmu Kesehatan Masyarakat (The Public Health Science Journal)
Andon Hestiantoro
Department Of Obstetrics And Gynecology, Faculty Of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Clinical Pregnancy Rate in in-Vitro Fertilization (IVF) among Endometrioma Patients Underwent Cystectomy Laparoscopy : Kejadian Kehamilan Klinis setelah Fertilisasi In Vitro pada Pasien Endometrioma Postsistektomi Laparoskopi Andrew Kurniawan; Maryam Ulfa; Raymond Surya; Andon Hestiantoro
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 3 July 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i3.1566

Abstract

Abstract Objective: to discuss the clinical pregnancy rate and factors influencing fecundity among endometriosis women having cystectomy laparoscopically who underwent IVF. Methods: The search was conducted on Pubmed®, EBSCOhost®, and Proquest®, Cochrane Library®, ClinicalKey® using MeSH. Case : A 38-years woman, P0A0 come to the gynecology clinic with a chief complaint of primary infertility for eight years. The patient had undergone a bilateral endometrial cyst resected with laparoscopy and failed for two cycles of IVF. What is the clinical pregnancy rate of women that undergo IVF with a history of ovarian endometrioma cystectomy? Results:, There were six articles appropriate to the inclusion criteria and further appraised using the Centre for Evidence-Based Medicine, University of Oxford appraisal tools. The studies consisted of five prognostic studies and one meta-analysis. The studies were appraised for their validity, Importance, and Applicability. Conclusion: The pregnancy rate in patients undergoing IVF after ovarian cystectomy ranges from 14%-45.2%. A prudent consideration and carefulness during cystectomy surgery are essential for patients that wish to be fertile. Keywords: clinical pregnancy rate, endometrioma, in vitro fertilization, laparoscopy, ovarian cystectomy Abstrak Tujuan: Untuk menelaah tentang kemungkinan terjadinya kehamilan secara klinis pada perempuan yang menjalani IVF dengan riwayat laparoskopi sistektomi dan faktor-faktor yang mempengaruhi kesuburannya. Metode: Pencarian jurnal dilakukan dengan menggunakan search engine Pubmed®, EBSCOhost®, dan Proquest®, Cochrane Library®, ClinicalKey® menggunakan MeSH. Kasus: Perempuan P0A0 berusia 38 tahun datang ke poliklinik dengan keluhan utama infertilitas selama delapan tahun. Pasien memiliki riwayat kista endometrioma bilateral yang sudah di kistektomi dengan laparoskopi dan dua kali gagal menjalani siklus IVF. Berapa kemungkinan terjadinya kehamilan secara klinis pada perempuan yang menjalani IVF dengan riwayat kistektomi endometrioma? Hasil: Dari hasil pencarian didapatkan enam artikel jurnal yang sesuai dengan kriteria inklusi dan dianalisis lebih lanjut menggunakan telaah kritis Evideence-Based Medicine, University of Oxford. .Terdapat lima jurnal studi prognostic dan satu meta-analisis. Studi-studi tersebut akan ditelaah kritis lebih lanjut berdasarkan validitas, kepentingan, dan aplikabilitasnya Kesimpulan: Kemungkinan terjadinya kehamilan secara klinis pada pasien yang menjalani IVF setelah kistektomi endometrioma ovarium adalah 14%-45,2%. Pertimbangan yang bijaksana dan hati-hati diperlukan untuk melakukan operasi kistektomi pada pasien yang mengalami endometrioma dan ingin tetap subur. Kata kunci: endometrioma, fertilisasi in vitro, kehamilan klinis, kistektomi ovarium, laparoskopi
Inflammatory markers in lean Polycystic Ovary Syndrome subjects are not associated with the spectrum of dyslipidemia Elisia Atnil; Andon Hestiantoro; Oki Riayati; Ririn Rahmala Febri; Naylah Muna
Majalah Obstetri & Ginekologi Vol. 30 No. 2 (2022): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V30I22022.66-71

Abstract

HIGHLIGHTS 1. Polycystic ovarian syndrome (PCOS) might be a condition of chronic low degree inflammation and dyslipidemia.2. Association between inflammation markers and dyslipidemia in PCOS patients was investigated.3. Dyslipidemia and chronic low degree inflammation were present in lean PCOS patients, but inflammation markers related insignificantly with dyslipidemia.   ABSTRACT Objectives: This study aimed to address the detailed lipid profile in lean woman with PCOS and investigate the relationship between chronic low grade inflammation (using NLR, PLR, and monocyte/HDL ratio) and dyslipidemia (defined as total cholesterol level > 190 mg/dL). Materials and Methods: This study was a cross-sectional study conducted from June – December 2020 at the Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia, involving 45 women aged 18 – 35 years old, diagnosed as having PCOS with normal BMI (18.5 – 22.9 kg/m2). To compare quantitative variables, data analysis was carried out using the t-test or Mann-Whitney U test as appropriate; whereas, to compare categorical variables, the Chi-square test was used. Results: We found that although the median BMI was within normal limits at 21.48 kg/m2, the mean values of the lipid profiles were found to be either abnormal or borderline, indicating the high possibility of dyslipidemia. No statistically association between NLR, PLR and MHR with dyslipidemia. Conclusion: Dyslipidemia and chronic low-grade inflammation were found in lean PCOS subjects, but there was no significant association between inflammation markers (NLR, PLR and MHR) and dyslipidemia. Further studies should investigate other factors that cause the inflammation.
Effect of pH and neutrophil count on the motility and persistence of spermatozoa in the vagina of candidiasis rat models Iswara, Raja AW.; Hestiantoro, Andon; Budiningsih, Yuli; Werdhani, Retno A.; Birowo, Ponco; Wuyung, Puspita E.; Afandi, Dedi
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.823

Abstract

Sexual violence is a global issue affecting individuals regardless of their relationship to the perpetrator or the setting. Microscopic examination of spermatozoa from vaginal swabs is crucial in investigating cases of sexual intercourse to determine the time of the crime. Factors such as vaginal pH and neutrophil count influence the motility and persistence of spermatozoa in the vagina, particularly in conditions like candidiasis, highlighting the need for further research in this area. This study aimed to determine the effect of pH and neutrophil count on the motility and persistence of spermatozoa in the vagina with candidiasis. An experimental study was conducted using white rats (Rattus norvegicus) of the Wistar strain, with four male rats providing spermatozoa samples and 32 female rats receiving treatment. The female rats were divided into two groups: the normal group and the candidiasis model group. In both groups, the female rats were given vaginal insemination of spermatozoa. Variables measured included pH, neutrophil count, motility, and persistence of spermatozoa in the vagina. Data were analyzed using the Mann-Whitney test, followed by the Spearman correlation test. The findings revealed that spermatozoa motility lasted up to three minutes in normal rats, whereas in the candidiasis model, it was reduced to two minutes. Additionally, spermatozoa persistence in the vagina lasted up to six days in the normal group compared to up to three days in the candidiasis model. There were significant differences in pH, neutrophil count, motility, and persistence of spermatozoa in the vagina between the normal group and the candidiasis model (all had p<0.001). There was a correlation between pH and neutrophil count with the motility and persistence of spermatozoa in the rat’s vagina (p<0.001). In conclusion, vaginal pH and neutrophil count influence the motility and persistence of spermatozoa in the vagina of candidiasis rat models.
Current Trends in Contraceptive Use and Fertility Concerns Among Women of Reproductive Age in Indonesia Muharam Natadisastra, Raden; Christopher Yo, Edward; Nurdya Irzanti, Alisha; Sumapraja, Kanadi; Kemal Harzif, Achmad; Pratama, Gita; Maidarti, Mila; Hari Kurniawan, Riyan; Wiweko, Budi; Hestiantoro, Andon
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 1 January 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i1.2508

Abstract

Abstract Background Family planning remains a key intervention in reducing maternal mortality and creating prosperous families. Assessing the unmet need for family planning allows insight into the progress of family planning programs. On the other hand, there has been much less attention given to the declining fertility rate in Indonesia. To address both the unmet need and declining fertility rate in Indonesia, this study aimed to investigate the most recent trends in contraceptive use in Indonesia as well as evaluate fertility concerns and access to reproductive healthcare service. Methods Women of reproductive age in Indonesia were asked to fill in an online questionnaire. They were asked about sociodemographic characteristics, marital status, pregnancy history, perception towards fertility, and access to healthcare service and information. Descriptive statistics and independent t-test were performed. Results Of 370 women, more than half (57.8%) had used some form of contraception. The most frequently used contraceptive method was natural family planning (30.3%), followed by condom (20%). Women with no prior sexual history, had never been pregnant before, and had not been married cared more about having a child in the future. Internet and social media represented the most popular information source for family planning. Conclusions Many Indonesian women still prefer traditional contraceptive methods over the more effective modern contraceptive methods. Numerous socio-cultural factors are likely to influence the behaviour of reproductive-age women regarding contraceptive use and childbearing in the future. More effort should be put into raising awareness about modern contraceptive methods and addressing fertility concerns. Keywords: contraception; fertility; family planning; awareness; reproduction
Impact of semen insemination on the vaginal microbiome profile of candidiasis rat model: A preliminary forensic study on sexual violence evidence Iswara, Raja AFW.; Hestiantoro, Andon; Budiningsih, Yuli; Werdhani, Retno A.; Birowo, Ponco; Wuyung, Puspita E.; Fadilah, Fadilah; Afandi, Dedi
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1256

Abstract

Sexual violence, including sexual intercourse, can occur in women experiencing vaginal discharge, particularly in cases of vaginal candidiasis. In candidiasis, the vaginal microbiome undergoes changes that could serve as a diagnostic indicator or as evidence of sexual activity.  The aim of this study was to assess the effects of semen insemination on the vaginal microbiome profile of candidiasis rats and to determine its forensic investigations in cases of sexual violence.  An experimental study was carried out using Wistar strain rats (Rattus norvegicus), consisting of four male rats (for spermatozoa donors) and twenty-four female rats. The female rats were divided into four groups: normal condition (control), normal condition post-semen insemination, candidiasis rats, and candidiasis rat post-semen insemination. Vaginal microbiome profiles were examined for each group, using alpha diversity (Chao 1, Shannon, Simpson, and Faith PD indices) and beta diversity (Bray Curtis, Jaccard, Unweighted Unifrac and Weighted Unifrac indices). Data were analyzed using the Kruskal-Wallis test for alpha diversity and the PERMANOVA test for beta diversity. The vaginal microbiome profiles of normal and candidiasis rats showed no significant differences (p>0.05). In candidiasis rats, the microbiome predominantly consisted of the Eukaryota kingdom, particularly Candida albicans. Semen insemination did not significantly affect the vaginal microbiome profile of candidiasis rats in the short term (p>0.05). However, the study highlights that the presence of Eschericia-Shigella, Roseomonas, and Archaea in the vaginal microbiome post-semen insemination potentially serves as an indicator of infection or sexual activity in forensic contexts.
The impact of micronutrient supplementation on the outcome of In Vitro Fertilization: A comprehensive systematic review of current studies Abdullah, Muhammad Raoul Taufiq; Suryoadji, Kemal Akbar; Fakhri, Aldithya; Hestiantoro, Andon
Majalah Obstetri & Ginekologi Vol. 33 No. 1 (2025): April
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V33I12025.65-73

Abstract

HIGHLIGHTS Potential benefits of vitamin D3 supplementation >20 ng/ml, along with myo-inositol, folic acid, and melatonin, on implantation rates. Subsequent studies revealed no substantial enhancement in pregnancy rates when specific supplements were used. Further research is needed to provide more definitive conclusions.   ABSTRACT Objective: In vitro fertilization is the most common form of assisted reproductive and fertility technology. However, it is important to note the success rates of IVF generally decrease as a person gets older. Identifying modifiable factors affecting human fertility, including diet, is significant for clinical and community wellness. This systematic review investigates the role of micronutrients supplementation in fertility and its potential impact on in vitro fertilization (IVF) outcomes. Materials and Methods: A systematic search in multiple databases using specific keywords related to in vitro fertilization, micronutrient supplementation, and outcome measures. Results: Out of 1462 retrieved studies, 8 were included in the systematic review. These studies covered a range of micronutrients and their effects on different IVF outcomes. Findings indicated potential benefits of vitamin D3 supplementation. Vitamin D3 supplementation was associated with a significant improvement in implantation rates (p < 0.05) in two studies, while no significant effect was observed in clinical pregnancy rates in other micronutrients. The systematic review highlights the diverse effects of various micronutrient supplements on IVF outcomes. While some supplements showed potential benefits, others did not significantly improve pregnancy rates. Further research with larger cohorts is necessary to establish conclusive evidence. Keywords: micronutrient supplements, IVF outcomes, pregnancy rates. Conclusion: In conclusion, this systematic review sheds light on the impact of micronutrients on IVF outcomes. Some studies suggested potential benefits of vitamin D3 supplementation >20 ng/ml, further research is needed to provide more definitive conclusions. Understanding the function of micronutrients in fertility could have significant implications for IVF treatment and female infertility management.
Long COVID in vaccinated women with Polycystic Ovary Syndrome: A retrospective cohort pilot study Muharam, R; Bagastoro, Aswan; Faradina, Anindita Abigail; Yo, Edward Christopher; Irzanti, Alisha Nurdya; Sumapraja, Kanadi; Harzif, Achmad Kemal; Pratama, Gita; Maidarti, Mila; Silvana, Vita; Wiweko, Budi; Hestiantoro, Andon
Majalah Obstetri & Ginekologi Vol. 33 No. 2 (2025): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V33I22025.89-96

Abstract

HIGHLIGHTS Among women with PCOS, many still reported persistent long COVID symptoms such as hair loss and fatigue. COVID-19 vaccination does not exacerbate symptoms of PCOS, which further emphasizes the importance of completing COVID-19 doses for women with PCOS to avoid long COVID sequelae.   ABSTRACT Objective: Long COVID, or the persistence of symptoms after acute COVID-19 illness, can affect individuals with pre-existing health conditions such as polycystic ovary syndrome (PCOS). Long COVID and PCOS may share overlapping pathogenesis which potentially exacerbate one another. The aim of this study was to evaluate the symptoms of long COVID in women with PCOS who have been vaccinated and investigate whether COVID-19 vaccination or infection worsened PCOS symptoms. Materials and Methods: We carried out a retrospective cohort study on 44 women with PCOS who have been vaccinated and previously diagnosed with COVID-19. Questionnaires were distributed to find out the effect of COVID infection and vaccines in these women, as well as the symptoms of long COVID-19. Results: Of all participants, 28 women (70%) continued to report persistent long COVID symptoms, with the highest number of complaints being fatigue and hair loss. The results, using Mann-Whitney test, showed that there was no difference in PCOS symptoms before and after COVID-19 vaccination (p = 0.520) or after COVID-19 infections (p = 0.241). Although this study revealed a substantial prevalence of long COVID symptoms among women with PCOS, an encouraging finding emerged: neither the administration of COVID-19 vaccination nor prior infection with COVID-19 had a significant impact on PCOS-associated symptoms. Conclusion: This study further underscores the importance of vaccination for all individuals, including women with a history of PCOS. Furthermore, the purpose of COVID-19 vaccination is to mitigate symptom severity, thus potentially diminishing the occurrence of long-term COVID-19 symptoms in future cases.
Body Composition Parameters, Adiponectin, Leptin and Adiponectin/Leptin Ratio are Correlated with LH/FSH Ratio in Women with PCOS but not in Women without PCOS Gita Pratama; Wiweko, Budi; Asmarinah; Widyahening, Indah Suci; Andraini, Trinovita; Hartanto Bayuaji; Andon Hestiantoro
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 1 January 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i1.2031

Abstract

Objective: To investigate the correlation between body composition parameters, adiponectin, leptin and the adiponectin/leptin ratio and the LH/FSH ratio in women with polycystic ovary syndrome (PCOS). Methods: A cross-sectional study was conducted at Reproductive Cluster Yasmin, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, with sixty women with PCOS and sixty healthy women as controls (matched for age and BMI). Body composition parameters, including body weight, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), percent body fat (PBF), visceral fat area (VFA), percent subcutaneous fat (PSF) and skeletal muscle mass (SMM), were measured; levels of fasting glucose, fasting insulin, testosterone, and sex hormone binding globulin (SHBG) were measured; and homeostatic model assessment for insulin resistance (HOMA-IR) values, anti-Mullerian hormone (AMH), free androgen index (FAI), Ferriman-Gallwey (FG) score, adiponectin levels, leptin levels, adiponectin/leptin ratio, LH, FSH and LH/FSH ratio were measured. Results: Body composition parameters (body weight, BMI, WC, WHR, PBF, VFA, PSF, SMM) were not significantly different between women with PCOS and controls. Fasting insulin (P<0.05), HOMA-IR (P<0.05), AMH (P<0.01), FAI (P<0.01), FG score (P<0.01) and LH/FSH ratio (P<0.05) were higher in PCOS women. Adiponectin (P<0.01) was lower in PCOS women, while leptin and the adiponectin/leptin ratio were not significantly different between groups. Most of body composition parameters, adiponectin, leptin and adiponectin/leptin ratio were correlated with HOMA-IR in both groups. SMM was positively correlated with the LH/FSH ratio, while body weight, BMI, WC, PBF, VFA, and PSF were inversely correlated with the LH/FSH ratio in PCOS patients but not in controls. WHR was not correlated in either group. Leptin (r=-0.278; P<0.05) was negatively correlated with the LH/FSH ratio only in the PCOS group. Adiponectin (r=0.394; P<0.01) and the adiponectin/leptin ratio (r=0.413; P<0.01) were also positively correlated with the LH/FSH ratio only in the PCOS group. AMH was correlated with the LH/FSH ratio, whereas testosterone level, FAI, FG score, fasting insulin level and HOMA-IR value were not correlated with the LH/FSH ratio in PCOS women. Conclusion: Most of the body composition parameters, leptin, adiponectin and the adiponectin/leptin ratio were significantly correlated with HOMA-IR in both groups. However, correlations of those parameters with LH/FSH ratio were found only in PCOS but not in women without PCOS. Adiponectin and leptin may play a significant role in the mechanism of neuroendocrine disorders in PCOS, which is characterized by an increased LH/FSH ratio. Keywords: adiponectin, adiponectin/leptin ratio, body composition, HOMA-IR, leptin, LH/FSH ratio, PCOS
Triglyceride-Glucose Index as A Crucial Marker for Polycystic Ovary Syndrome Women with Insulin Resistance Hestiantoro, Andon; Saraswati, Jaya; Prasetya, David Eka; Sandra, Ferry; Muharam, Raden; Pratama, Gita; Harzif, Achmad Kemal
The Indonesian Biomedical Journal Vol 16, No 1 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i1.2639

Abstract

BACKGROUND: Insulin resistance (IR) is considered as the main driver of polycystic ovary syndrome (PCOS) pathogenesis. In PCOS condition, IR is frequently related to glucose, anthropometric profile, lipid profile, and hormone profile parameters. However, not all PCOS phenotype show IR. Therefore, this study was conducted to determine the association the parameters mentioned above in PCOS subjects with and without IR.METHODS: Fifty PCOS women with IR and 26 PCOS women without IR were recruited. All subjects underwent physical examination for measurement of weight, waist circumference (WC), and body mass index (BMI). Ferriman Gallwey Score (FGS) was used to evaluate hirsutism. Blood sample was taken from each subject for measurement of fasting glucose, postprandial glucose, fasting insulin, low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol, triglyceride (TG), sex hormone binding globulin (SHBG), thyroid-stimulating hormone (TSH), luteinizing hormone (LH), follicle stimulating hormone (FSH), and prolactin. Homeostatic model assessment for IR (HOMA-IR), TG-glucose index (TyGI), and free testosterone index (FTI) were then calculated.RESULTS: From all the parameters examined, only fasting insulin (p<0.001), HOMA-IR (p<0.001), SHBG (p=0.012), TG (p<0.001), and TyGI (p=0.008) that show significant differences between PCOS subjects with and without IR. After multivariate analysis, TyGI was found to have strong association with IR occurrence in PCOS subjects (p=0.005) with an odd ratio of 5.26 (1.65–16.74).CONCLUSION: TyGI appears to have a significant association with the IR occurrence in PCOS subjects. Hence, it can be suggested that TyGI could be an important marker for PCOS women with IR.KEYWORDS: insulin resistance, lipid metabolism, polycystic ovary syndrome, triglyceride-glucose index
mRNA Expression and DNA Methylation of CXCL16 in Menstrual Blood and Endometrium Tissue of Subjects with Endometriosis and Pelvic Pain Febriyeni, Febriyeni; Hestiantoro, Andon; Tulandi, Togas; Muharam, Muharam; Asmarinah, Asmarinah; Sandra, Ferry
The Indonesian Biomedical Journal Vol 16, No 2 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i2.2958

Abstract

BACKGROUND: The cytokine chemokine ligand 16 (CXCL16) plays an important role in the pathophysiology of endometriosis by regulating the inflammatory response and contributing to the pain-associated endometriosis. Despite this, the impact of epigenetic modifications, such as DNA methylation, on CXCL16 has yet to be fully understood. Therefore, this research was conducted to assess both the mRNA expression and DNA methylation levels of the proinflammatory gene CXCL16 in the endometrium tissue and menstrual blood of patients with and without endometriosis.METHODS: Thirty-five women with and without endometriosis were involved in this research. Subjects' menstrual blood samples were collected using filter paper pads, meanwhile the endometrium tissue were collected by performing biopsy, from which DNA and RNA were extracted. The DNA methylation levels of the CXCL16 were measured using the pyrosequencing method following bisulfite conversion treatment. Meanwhile, the mRNA expression level was measured using the quantitative polymerase chain reaction (qPCR) method and analyzed with the Livak method.RESULTS: The mRNA expression of CXCL16 in menstrual blood of endometriosis subjects was 2.42 times higher compared to control group (p=0.030). Furthermore, the expression of CXCL16 in menstrual blood was identical to that in endometrial tissue (p=0.173). DNA methylation analysis showed that CXCL16 in the menstrual blood of endometriosis subjctes had lower methylation levels compared to controls (p=0.004), indicating hypomethylation.CONCLUSION: Increased mRNA expression and hypomethylation of CXCL16 in the menstrual blood of endometriosis patients could serve as a direct marker for diagnosing endometriosis. However, further study to validate these findings and explore the potential of CXCL16 as a diagnostic tool, and additional research involving larger patient for the cohorts study is necessary.KEYWORDS: CXCL16, DNA methylation, endometrium, menstrual blood, mRNA expression, pain 
Co-Authors A. Abadi Abdullah, Muhammad Raoul Taufiq Achmad K. Harzif Achmad K. Harzif Achmad Kemal Achmad Kemal Harzif Agnes Stephanie Harahap Aldri Frinaldi Ali Baziad Andrew Kurniawan Ario Legiantuko Asmarinah Asmarinah Asmarinah Astuti, Brilliant Putri Kusuma Bagastoro, Aswan Baidah, Priska A Betaria Putri Bram Pradipta Budi Wiweko Caroline G. Puspita Chandra, Tania Maharani Christopher Yo, Edward Danang T. Pamungkas Dedi Afandi Dick F. Swaab Eka R. Gunardi Elisia Atnil Eliza Mansyur Fadilah Fadilah, Fadilah Fakhri, Aldithya Faradina, Anindita Abigail Febriyeni, Febriyeni Ferry Sandra Gita Pratama Hari Kurniawan, Riyan Hartanto Bayuaji Herbert Situmorang Herbert Situmorang Indah S. Widyahening Intan Kusumaningtyas Intan Kusumaningtyas Irzanti, Alisha Nurdya Iswara, Raja AFW. Iswara, Raja AW. Jasirwan, Shanty Olivia Kanadi Sumapradja Kemal, Achmad Legiantuko, Ario Martina Wiwie Setiawan Nasrun Maryam Ulfa Mila Maidarti Muharam Natadisastra Muharam Natadisastra, Raden Muharam, Muharam Muharam, R Muharam, Raden Naylah Muna Nurdya Irzanti, Alisha Nurhadi Ibrahim Oki Riayati Ponco Birowo Prasetya, David Eka Priska A Baidah Puspita E. Wuyung Raymond R. Tjandrawinata Raymond Surya Retno A. Werdhani Ririn Rahmala Febri Robert H. Purwaka, Robert H. Saraswati, Jaya Shadrina, Amalia Silvana, Vita Suryoadji, Kemal Akbar Tita Yuningsih Tommy Dharmawan Trinovita Andraini Tulandi, Togas Vita Silvana Winnugroho Wiratman, Manfaluthy Hakim, Tiara Aninditha, Aru W. Sudoyo, Joedo Prihartono Yo, Edward Christopher Yudianto B Saroyo Yuli Budiningsih