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All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Muharam Natadisastra
Department Of Obstetrics And Gynecology Faculty Of Medicine Universitas Indonesia Dr. Cipto Mangunkusumo General Hospital
Health Professions Medicine & Pharmacology Public Health

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Post-menopausal Women: The Tip of an Iceberg R Muharam Natadisastr Natadisastra, R. Muharam
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 1, January 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v2i1.1086

Abstract

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Pentoxifylline as a Therapy for Thin Endometrial Lining in Infertility Muharam Natadisastra; Riyan H Kurniawan; Devi M Malik
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 3, July 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (78.549 KB) | DOI: 10.32771/inajog.v3i3.45

Abstract

Objective: To evaluate the effect of pentoxifylline as a single regimen therapy for thin endometrial lining in infertility. Method: A cross-sectional retrospective research was held in Yasmin Clinic - Kencana, Dr. Cipto Mangunkusumo Hospital from 2010 until 2011. Our respondents were women with infertility problem. Result: There was significant improvement of endometrial lining in respondents who received pentoxifylline in the first month (p
PPARy Expression in Eutopic and Ectopic Endometrium of Reproductive Age Women with Endometriosis Adya F Dilmy; Muharam Natadisastra; Kanadi Sumapradja
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (173.729 KB) | DOI: 10.32771/inajog.v3i4.55

Abstract

Objective: To evaluate the expression of PPARy receptor and to compare its expression in eutopic and ectopic endometrium in women with endometriosis. Method: This is a cross sectional study. Ten female subjects with endometriosis that underwent laparoscopy or laparotomy who fulfilled the inclusion criteria were recruited by consecutive sampling. Two samples were taken, eutopic endometrium and ectopic endometrium from endometriosis cyst wall during surgery of each subject. PPARy expression was examined by two-step RT-qPCR. Our data was statistically examined using the paired t-test and Pearson’s correlation test. Result: PPARy was found to be expressed in eutopic and ectopic endometrium of women with endometriosis using the RT-qPCR method. The expression of PPARy was not statistically different in eutopic and ectopic endometrium (1.16 relative fold vs 1.25 relative fold; p=0.26). By Pearson’s correlation there was a weak positive correlation between PPARy expression of eutopic and ectopic endometrium (r=0.16). Conclusion: PPARy was detected by two-step RT-qPCR in eutopic and ectopic endometrium of women with endometriosis. Semiquantification of PPARy expression showed that there was no significant difference between PPARy expression in eutopic and ectopic endometrium of women with endometriosis. There was a weak positive correlation between PPARy expression in eutopic and ectopic endometrium of women with endometriosis. [Indones J Obstet Gynecol 2015; 3-4: 200-205] Keywords: endometriosis, PPARy, two-step RT-qPCR
Homocysteine Level in the Blood and Follicular Fluid is Higher in Infertile Women with Endometriosis Muharam Natadisastra
Indonesian Journal of Obstetrics and Gynecology Volume. 37, No. 2, April 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (132.231 KB) | DOI: 10.32771/inajog.v37i2.344

Abstract

Objective: To compare and determine the differences in the level of homocysteine in the blood and follicular fluid in infertile women with and without endometriosis, then analyze the effect of homocysteine levels to oocyte quality. Methods: This study was cross-sectional study. Fifty-nine subjects following the in-vitro fertilization program are included in the admission criteria were divided into two equal groups, ie groups of endometriosis and without endometriosis consecutively (consecutive sampling). Each subject taken from the blood and follicular fluid then measured the levels of homocystein levels with immuoassay method. The mean of each group was statistically tested with an independent t test. Result: The mean levels of homocysteine in the blood is higher in the endometriosis group than without endometriosis group and it was statistically significance (8.34 ± 2.68 vs 6.71 ± 1.56, p=0.007; 95% CI: 0.02417-0.14657). Similarly, the levels of homocysteine in follicular fluid , the endometriosis group is higher and statistically significance (6.19 ± 1.67 vs 3.46 ± 1.03; p= 0.000; 95% CI: 0.19310-0.32353). All oocytes are in good quality in both groups, maturation grade 3. There is a correlation between the levels of homocysteine in the blood and follicular fluid in the endometriosis group and assessed with Pearson test, and it found significant (p = 0.002) and the correlation value 0.553 (moderate correlation strength) and direction of a positive correlation. Conclusion: The mean levels of homocysteine in the blood and follicular fluid in infertile women with endometriosis is higher than without endometriosis and were statistically significantly different. These homocysteine levels does not affect the quality of oocytes. There is a positive correlation between the levels of homocysteine in the blood and follicular fluid in endometriosis group. [Indones J Obstet Gynecol 2013; 37-2: 92-8] Keywords: endometriosis, homocysteine, infertility, oocyte quality
Ovarian Reserve In Infertile Women with and without Endometriosis Measured with Anti Müllerian Hormone: Cadangan Ovarium pada Perempuan Infertil dengan dan tanpa Endometriosis Diukur dengan Anti Müllerian Hormone Naivah Harharah; Muharam Natadisastra; Teuku Z Jacoeb
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 4, October 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (115.723 KB) | DOI: 10.32771/inajog.v2i4.405

Abstract

Objective: To compare serum Anti Müllerian Hormone (AMH) levels in infertile women with and without endometriosis, and to determine the mean levels of serum AMH in every stage of endometriosis. Method: We performed a cross-sectional study. Sixty-eight subjects who have undergone laparoscopy and fulfilled both inclusion and exclusion criteria are recruited consecutively. They are divided into two groups, namely group with endometriosis and without endometriosis. Blood samples are taken from each subject before laparoscopy, where serum AMH levels are then measured. The difference in mean levels of each group are tested with Mann-Whitney test. Result: The mean levels of serum AMH were significantly lower in the endometriosis group than those in the group without endometriosis (2.30 1.8 ng/ml vs 3.75 2.13 ng/ml; p=0.005). Using Kruskal-Wallis test, it was found that there was a statistically significant difference among endometriosis groups based on the severity of endometriosis. There was no significant difference in the mean serum AMH levels between the minimal-mild endometriosis group and without endometriosis group (p=0.34), but the mean levels of serum AMH were significantly lower in the moderate-severe endometriosis compare to the group without endometriosis (p<0.005). Conclusion: The mean levels of serum AMH in infertile women with endometriosis were significantly lower than those in women without endometriosis. There was no significant difference in the mean serum AMH levels in minimal-mild endometriosis group and those without endometriosis; while in moderate-severe endometriosis group, it was significantly lower than in the group without endometriosis. Keywords: endometriosis, infertility, serum AMH
The Outcome on Conservative Surgical Treatment of Adenomyosis Budi Wiweko; Ario Legiantuko; Achmad Kemal; Gita Pratama; Herbert Situmorang; Kanadi Sumapraja; Muharam Natadisastra; Andon Hestiantoro
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (87.501 KB) | DOI: 10.32771/inajog.v4i4.448

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Objective: To understand the outcome on conservative surgical treatment of adenomyosis. Methods: A retrospective cohort study followed for 2 years from 2010 to 2012 of women with adenomyosis were diagnosed by transvaginal sonography and confirmed histologically. Subjects divided into women who were treated by adenomyosis resection (with/without Osada’s technique) and who were underwent hysterectomy. Results: After the surgery, as many as 40 patients (81.63%) did not feel any pain (VAS 0), and 9 patients (18.37%) still felt pain. For the fertility outcome, we had 8 patients (20.51%) getting pregnant naturally without any fertility intervention. Two patients (5.13%) had successfully conceived by IVF. According to the type of surgery, from 8 natural pregnancy, 7 patients (87.50%) was underwent conventional resection of adenomyosis and 1 patients (12.50%) underwent Osada’s procedures. Two patients who were conceived by IVF, both of them were underwent Osada’s resection. Conclusion: Adenomyosis resection both conservative or Osada’s procedures actually has a better outcome for relieving pain; therefore, some patients can still have a child. Keywords: adenomyosis resection, conventional resection, infertility, Osada’s procedure
Methylation Profile of HOXA 11 Gene in Eutopic Endometrium on Endometriosis Patient with Infertility Muharam Natadisastra; Valencia Yuwono; Ririn Febri; Asmarinah Asmarinah
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 2 April 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (88.747 KB) | DOI: 10.32771/inajog.v6i2.771

Abstract

Objective: To investigate the HOXA11 gene profile on endometriosispatients with infertility in Indonesia.Methods: This cross sectional study was conducted in Dr. CiptoMangunkusumo Hospital from July 2015- June 2016. The subjectswere endometriosis patients with infertility who have beenconfirmed histopathological. The control group was taken fromnon-endometriosis and fertile patients. Eutopic endometriumsamples were taken and examined for the methylation of HOXA 11gene.Results: Both groups consist of six patients. The difference ofmethylation of HOXA 11 gene between those two groups isstatistically significant (p=0.03). There was hyper methylation inendometriosis group.Conclusion: There is a hyper methylation of HOXA 11 gene ineutopic endometrium of endometriosis patients with infertility.Thus, possibly can explain the poor endometrial receptivityin endometriosis patient and give a broad research area inepigenetic therapy of endometriosis.[Indones J Obstet Gynecol 2018; 6-2: 110-113]Keywords: endometriosis, epigenetic, HOXA 11, infertility,methylation
Post-menopausal Women: The Tip of an Iceberg R Muharam Natadisastr R. Muharam Natadisastra
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 1, January 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v2i1.1086

Abstract

N/A
Visceral Adipose Tissue was Associated with Increased Risk of Insulin Resistance in Lean Polycystic Ovarian Syndrome, Independent with Retinol Binding Protein-4: Jaringan Adiposa Viseral berkaitan dengan Peningkatan Risiko Resistensi Insulin pada Sindrom Ovarium Polikistik dengan Indeks Masa Tubuh Normal, Independen terhadap Retinol Binding Protein-4 Vita Silvana; Andon Hestiantoro; Muharam Natadisastra; Kanadi Sumapraja; Budi Wiweko
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 3 July 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v8i3.1417

Abstract

Objective: To determine whether visceral adipose tissue or serum RBP-4 were related with the risk increment of insulin resistance in normal BMI PCOS patients. Methods: This was a cross-sectional study conducted in normal body mass index PCOS patients at Yasmin Clinic, RSCM, Jakarta from July 2014 until March 2015. Diagnosis of PCOS was established using Rotterrdam (2003) criteria. Insulin resistance was confirmed by using ratio of HOMA-IR >1.4. Results: Among 40 subjects, 20 subjects (50%) belong insulin resistance group. Serum RBP-4 level was higher in insulin resistance group (p=0.06). After ROC analysis was conducted, area under curve for of serum RBP-4 was 69.9% (CI 95% -3754.77 - (186.60-7696.14, p=0.061)). Cut-off level of serum RBP-4 was 23814.5 ng/mL yielded sensitivity and specificity to a level of 60% and 60%, respectively. After logistic regression were analyzed, visceral adipose tissue demonstrated substantial association with the risk increment of insulin resistance in normal BMI PCOS patients. Conclusions: Visceral adipose tissue demonstrated substantial association with the risk increment of insulin resistance in normal BMI PCOS patients, independent with serum RBP-4 levels. Key words: body mass index, diagnosis, insulin resistance, PCOS, retinol binding protein-4 Abstrak Tujuan: Untuk menentukan apakah jaringan adiposa viseral atau serum RBP-4 berhubungan dengan peningkatan risiko resistensi insulin pada Sindrom Ovarium Polikistik dengan indeks masa tubuh normal. Metode: Studi potong lintang dilakukan pada subjek SOPK dengan IMT normal di Klinik Yasmin, RSCM, Jakarta sejak Juli 2014 sampai dengan Maret 2015. Penegakan diagnosis SOPK dilakukan dengan kriteria Rotterdam (2003). Resistensi insulin dikonfirmasi dengan pemeriksaan rasio HOMA-IR > 1.4 Hasil: Diantara 40 subjek, sebanyak 20 subjek (50%) mengalami resistensi insulin. Kadar serum RBP-4 lebih tinggi pada kelompok resistensi insulin (p=0.06). Setelah dilakukan analisis Receiver Operating Curve (ROC), serum RBP-4 memiliki Area Under the Curve (AUC) sebesar 69.9% (IK 95% -3754.77 - (186.60-7696.14, p=0,061)). Titik potong kadar serum RBP-4 adalah 23814.5 ng/mL dengan sensitivitas dan spesifisitas masing-masing 60% dan 60%. Setelah dilakukan analisis regresi logistik, jaringan adiposa viseral menunjukan asosiasi yang kuat dengan terjadinya resistensi insulin pada pasien SOPK dengan IMT normal. Kesimpulan: Jaringan adiposa viseral menunjukan asosiasi yang kuat dengan terjadinya resistensi insulin pada SOPK dengan IMT normal, independen terhadap kadar serum RBP-4. Kata kunci: diagnosis, indeks masa tubuh, resistensi insulin, retinol binding protein-4, SOPK
Estradiol on Day Seven is a Good Predictor for Oocyte Maturation Rate in In Vitro Fertilization Program: Kadar estradiol hari ketujuh sebagai prediktor tingkat kematangan oosit pada program Fertilisasi In Vitro Andon Hestiantoro; Betaria Putri; Eka R. Gunardi; Yudianto B. Saroyo; Muharam Natadisastra
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 2 April 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i2.1539

Abstract

Abstract Objective: to determine which factors influence the rate of oocyte maturation in In Vitro Fertilization (IVF) program. Methods: A retrospective cohort study was conducted using secondary data from IVF participants at the Yasmin Fertility Clinic, Dr. RSUP. Cipto Mangunkusumo, Jakarta, Indonesia during the period January 2019 to December 2020, as recorded in the InaRepromed archive. The variables analyzed were age, body mass index, and hormone levels on day 1, day 7, and day hCG, with oocyte maturation rate as the main outcome. Correlation test was performed between several variables and the level of oocyte maturation rate and followed by multivariate analysis to assess the factors that were closely related to oocyte maturation rate. Results: Data from 52 subjects were collected for the study. Positive correlation was observed between oocyte maturation rate and estradiol on day 7 (r = 0.229), while negative correlation was observed between oocyte maturation rate and progesterone/estradiol ratio on day 7 (r = -0.289) and luteinizing hormone on day 1 (r = -0.265). Multivariate analysis revealed that higher estradiol on day-7 was associated with better oocyte maturation rate (p = 0.047). Conclusion: Higher estradiol level on day 7 was associated with better oocyte maturation rate in IVF. Keywords: Assisted reproductive technology (ART), estradiol, in vitro fertilization (IVF), progesterone. Abstrak Tujuan: untuk menentukan faktor-faktor yang mempengaruhi tingkat pematangan oosit dalam program Fertilisasi InVitro (FIV). Metode: Desain penelitian adalah kohort retrospektif, menggunakan data sekunder peserta bayi tabung Klinik Fertilitas Yasmin, RSUP Dr. Cipto Mangunkusumo, Jakarta, Indonesia selama periode Januari 2019 hingga Desember 2020, yang tercatat di dalam arsip InaRepromed. Variabel yang dianalisis adalah umur, indeks massa tubuh, dan kadar hormon pada hari ke-1, hari ke-7, dan hari ke-hCG, dengan tingkat maturasi oosit sebagai luaran utama. Dilakukan analisis korelasi antara beberapa variabel dengan tingkat maturasi oosit, dan dilanjutkan dengan analisis multivariat untuk menilai faktor-faktor yang berhubungan kuat dengan tingkat maturasi oosit. Hasil: Data dari 52 subjek dikumpulkan untuk penelitian ini. Dijumpai korelasi positif antara tingkat maturasi oosit dan estradiol pada hari ke 7 (r = 0,229), sedangkan korelasi negatif diamati pula antara tingkat maturasi oosit dan rasio progesteron/estradiol pada hari ke 7 (r = -0,289) dan hormon luteinisasi pada hari 1 (r = -0,265). Analisis multivariat mengungkapkan bahwa estradiol yang lebih tinggi pada hari ke-7 dikaitkan dengan tingkat maturasi oosit yang lebih baik (p = 0,047). Kesimpulan: Kadar estradiol yang lebih tinggi pada hari ke 7 dikaitkan dengan tingkat pematangan oosit yang lebih baik pada program FIV. Kata kunci : Teknologi reproduksi berbantu (TRB), estradiol, fertilisasi in vitro (IVF), progesteron.
Co-Authors Achmad K. Harzif Achmad K. Harzif Achmad Kemal Adya F Dilmy Aldri Frinaldi Andon Hestiantoro Ario Legiantuko Arleni A. Bustami Arleni Bustami Armand Bensussan Asmarinah Asmarinah Betaria Putri Bram Pradipta Budi Wiweko Caroline G. Puspita Cicilia Febriani Hayuningrum Devi M Malik Dilmy, Adya F Eka R. Gunardi Eliza Mansyur Febri, Ririn Gita Pratama Herbert Situmorang Herbert Situmorang Heri Wibowo Indra G. Mansur Jerome Giustiniani Kanadi Sumapradja Kemal, Achmad Legiantuko, Ario Malik, Devi M Mila Maidarti Naivah Harharah Nasution, Ali Napiah Puspita Eka Wuyung Raymond R. Tjandrawinata Ririn Febri Riyan H Kurniawan Riyan H Kurniawan, Riyan H Solly Aryza Teuku Z Jacoeb Teuku Z. Jacoeb Tita Yuningsih Valencia Yuwono Valencia Yuwono Valerie Schiavon Vita Silvana Wahyu Pangestuti Lestari Winnugroho Wiratman, Manfaluthy Hakim, Tiara Aninditha, Aru W. Sudoyo, Joedo Prihartono Yudianto B Saroyo