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Kanadi Sumapradja
Departemen Kebidanan Dan Penyakit Kandungan, Fakultas Kedokteran, Universitas Indonesia, Rumah Sakit Cipto Mangunkusumo, Jakarta; Human Reproductive, Infertility And Family Planning Research Center, Indonesia Medical Education And Research Institute
Biochemistry, Genetics & Molecular Biology Engineering Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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Postoperative Pain Survival and Correlating Factors in Endometriosis Patients: Kesintasan Keluhan Nyeri Pasca Pembedahan pada Pasien Endometriosis serta Faktor-Faktor yang Mempengaruhi Kanadi Sumapradja; Fitriana M. Nuryadi
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 4 October 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (71.074 KB) | DOI: 10.32771/inajog.v7i4.1038

Abstract

Abstract Objective: To determine the survival of pain complaints at 3, 6, 9 and 12 months and the correlation between age at diagnosis, age of menarche, parity, stage of disease and post-operative medication in endometriosis patient at RSUPN Dr. Cipto Mangunkusumo. Methods: This was a prospective cohort study with survival analysis method of 139 women of productive age with endometriosis who came to Gynecology Outpatient Clinic in Dr. Cipto Mangunkusumo Hospital from January 2015 to January 2017. The patients were observed at 3 months, 6 months, 9 months and 12 months after the surgery. Results: Survival of pain complaints at 3, 6, 9 and 12 months after endometriosis operation was 99.2%, 96.6%, 93% and 88.4% respectively. There was no significant correlation between post-operative pain survival and age of diagnosis (p=0.138), age of menarche (p=0.492), parity (p=0.110) and stage of disease (p=0.908). There was a significant correlation between post-operative medical therapy and pain complaints survival. Subjects who were given medication had a risk of 0.26 times (CI 95% 0.081-0.857) pain recurrence compared to those who were not. Conclusion: Pain complaints survival were significantly associated with post-operative medical therapy, but not associated with age, age of menarche, parity and stage of disease. Keywords: endometriosis, postoperative medical therapy, postoperative pain, survival Abstrak Tujuan: Mengetahui kesintasan keluhan nyeri pada 3, 6, 9 dan 12 bulan dan hubungan antara usia saat diagnosis, usia menarke, paritas, stadium penyakit dan terapi medisinalis pasca pembedahan pada pasien endometriosis di RSUPN Dr. Cipto Mangunkusumo. Metode: Penelitian kohort prospektif pada 139 wanita usia produktif dengan metode analisis kesintasan pada pasien endometriosis yang datang ke Poliklinik Ginekologi RSUPN Cipto Mangunkusumo pada bulan Januari 2015 hingga Januari 2017. Pasien kemudian diobservasi pada bulan ke 3, 6, 9 dan 12 setelah operasi. Hasil : Kesintasan keluhan nyeri pada bulan ke 3, 6, 9 dan 12 berturut-turut adalah 99,2%, 96,6%, 93% dan 88,4%. Tidak ada hubungan yang bermakna antara kesintasan nyeri pasca pembedahan dengan usia saat diagnosis (p=0,138), usia saat menarke (p=0,492), paritas (p=0,110) dan stadium penyakit (p=0,908). Terdapat hubungan yang bermakna antara terapi medisinalis pasca pembedahan dan kesintasan keluhan nyeri. Subyek yang mendapatkan terapi medisinalis pasca pembedahan memiliki risiko 0,26 kali mengalami kekambuhan nyeri dibandingkan dengan yang tidak. Kesimpulan : Kesintasan keluhan nyeri memilki hubungan yang bermakna dengan terapi medisinalis pasca pembedahan namun tidak memiliki hubungan dengan usia saat diagnosis, usia menarke, paritas dan stadium penyakit. Kata kunci: endometriosis, kesintasan, nyeri pasca pembedahan, terapi medisinalis pasca pembedahan
Profile of D-dimer in Uncomplicated Pregnancy: Profile D-dimer Kehamilan tanpa Komplikasi Rahajuningsih Dharma; Mercy T. Panjaitan; Kanadi Sumapradja; Rianto Setiabudy
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 4 October 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (80.527 KB) | DOI: 10.32771/inajog.v7i4.1065

Abstract

Abstract Objective: To obtain the profile of D-dimer in uncomplicated pregnancy. Methods: A cross sectional study was done on 90 uncomplicated pregnant women consisted of 30 women in each trimester and 30 healthy, nonpregnant women as control group from July to August 2012. D-dimer level was measured by particle enhanced immunoturbidimetry method using Innovance D-dimer and Sysmex CA 1500 in the Department of Clinical Pathology, Dr. Cipto Mangunkusumo Hospital, Jakarta. Results: All women in the control group showed normal D-dimer level (<0.,5 mg/L FEU). The median and range of D-dimer level in the 1st trimester, 2nd trimester, and 3rd trimester were 0.42 mg/L FEU and 0.1-1.07 mg/L FEU, 0.97 mg/L FEU and 0.6-3.34 mg/L FEU, and 1.56 mg/L FEU and 0.69-3.75 mg/L FEU, respectively. Increased D-dimer level was found in 27% of pregnant women in 1st trimester, 87% in 2nd trimester, and 100% in 3rd trimester. Conclusion: Increased D-dimer level was found in 27% of pregnant women in 1st trimester, 87% in 2nd trimester, and 100% in 3rd trimester. The range of D-dimer level in the 1st trimester was 0.1-1.07 mg/L FEU, in the 2nd trimester was 0.6-3.34 mg/L FEU, and in the 3rd trimester was 0.69-3.75 mg/L FEU. Keywords: D-dimer, trimester, uncomplicated pregnancy Abstrak Tujuan : Untuk mendapatkan profil D-dimer pada kehamilan tanpa komplikasi. Metode : Penelitian potong lintang dilakukan pada 90 perempuan hamil tanpa komplikasi yang terdiri atas 30 perempuan pada tiap trimester dan 30 perempuan sehat yang tidak hamil, sebagai kelompok kontrol dari bulan Juli sampai Agustus 2012. Kadar D-dimer diukur dengan cara particle enhanced immunoturbidimetry menggunakan reagen InnovanceÃ’ D-dimer dan koagulometer SysmexÃ’ CA 1500 di Deparemen Patologi Klinik, Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, Jakarta. Hasil: Seluruh perempuan dalam kelompok kontrol mempunyai kadar D-dimer dalam batas normal (<0.,5 mg/L FEU). Median (rentang) kadar D-dimer pada trimester pertama, kedua, dan ketiga berturut-turut 0.42 mg/L FEU (0.1-1.07 mg/L FEU), 0.97 mg/L FEU (0.6-3.34 mg/L FEU), dan 1.56 mg/L FEU (0.69-3.75 mg/L FEU). Peningkatan kadar D-dimer ditemukan pada 27% perempuan hamil trimester pertama, 87% trimester kedua, dan pada 100% trimester ketiga. Kesimpulan: Peningkatan kadar D-dimer ditemukan pada 27% perempuan hamil trimester pertama, 87% trimester kedua dan 100% pada trimester ketiga. Rentang kadar D-dimer level pada trimester pertama adalah 0.1-1.07 mg/L FEU, pada trimester kedua 0.6-3.34 mg/L FEU, dan pada trimester ketiga 0.69-3.75 mg/L FEU. Kata kunci: D-dimer, kehamilan tanpa komplikasi, trimester
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
The Role of Oxidative Stress in adverse uterine environment: The new explanation on developmental origin of adult diseases Kanadi Sumapradja
Indonesian Journal of Obstetrics and Gynecology Volume. 36, No. 3, July 2012
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v36i3.1474

Abstract

N/A
The mIRNA519a-3p and NKG2D in endometriosis. Cepi Teguh Pramayadi; Muharam Natadisastra; Kanadi Sumapradja; Aria Kekalih
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 4 Oktober 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i4.1638

Abstract

Background: Natural killer (NK) cells play a role in pathogenesis of endometriosis. Lower expressions of NK cells receptor group 2D (NKG2D) ligands inhibits cytotoxic activity of NK cells; a common immunity avoidance mechanism in neoplasms. Literatures have proven miRNAs regulatory effect on NKG2D expression. There has been no specific biomarker for diagnosing endometriosis. Non-invasive means of diagnosing endometriosis may reduce well-known risks of invasive method of diagnosis and yield better results. Purpose: To investigate the correlation between miRNA-519a-3p expression with NKG2D ligands (MICA, MICB, ULBP 1-6) on endometriosis and non-endometriosis patients. Methods: This was a cross-sectional study held in five centers: dr. Cipto Mangunkusumo General Hospital, Pelni Hospital, Bunda Hospital, YPK Mandiri Hospital, and Primaya Evasari Hospital from October 2020 to July 2021. miRNA and NKG2DL analysis were done in Human Reproduction, Infertility and Family Planning (HRIFP) cluster at IMERI FKUI. Results: We obtained 19 patients in each study groups. NKG2D ligands and miRNA519a-3p relative expressions were not significantly different (p > 0.05). Increased miRNA519a-3p expression negatively affected NKG2D ligands expression. A decrease in ULBP1 and an increase in ULBP2 increased the probability for endometriosis. NKG2D ligands expression may be influenced by infection, pro-inflammatory cytokine production, dan polymorphism. NKG2D ligands expression level can be different depending on the origin of the sample. Lower expression of miRNA519a-3p indirectly inhibits tumor apoptosis by lowering NKG2D ligands, caspase, or mRNA. Conclussion: We did not manage to establish a correlation between NKG2D ligands with miRNA519a-3p in endometriosis and non-endometriosis patients.
Blood Pressure Elevation Timing Following Hysterectomy Kartiwa Hadi Nuryanto; Kanadi Sumapraja; Marcel Elian Suwito; Eka Rusdianto Gunardi; Seno Adjie; Tofan Widya Utami
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.901

Abstract

Background: Hysterectomy is the most common non-obstetric surgery in adult, reproductive-age women. Hysterectomy with or without ovarian conservation is known to increase the risk of cardiovascular disease. However, only a few studies regarding its immediate and short-term effects on hypertension are available. This study aimed to determine changes in blood pressure after a hysterectomy procedure.Methods: This study is a prospective cohort study of patients who underwent a total hysterectomy procedure with or without ovarian conservation at Cipto Mangunkusumo Hospital, Indonesia, from July 2018 to July 2020. Samples were grouped into patients with total hysterectomy only or hysterectomy with ovarian conservation (HT/HTSOU) and bilateral salpingo-oophorectomy hysterectomy (HTSOB). Statistical analysis was done using paired t-test and Wilcoxon test. Results: There were 80 patients included in this study (40 for each group). A significant increase in all blood pressure components occurred at 12 months after the HT/HTSOU and HTSOB procedures (p < 0.05). After six months of the HTSOB procedure, the increase in blood pressure components only occurred in systolic blood pressure and mean arterial pressure (MAP) (p < 0.05).Conclusions: There was a significant increase in all blood pressure components in the HT/HTSOU and HTSOB group at 12 months following hysterectomy while there was a significant increase in systolic blood pressure and MAP in the HTSOB group at 6 months following hysterectomy.
Anti-Müllerian Hormone Levels as Predictor of In Vitro Fertilization Outcomes Mila Maidarti; Prini Diandara Garinasih; Aprilia Asthasari Siregar; Gita Pratama; Achmad Kemal Harzif; Kanadi Sumapraja; Budi Wiweko
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (328.455 KB) | DOI: 10.23886/ejki.9.43.87

Abstract

A decrease in serum anti-müllerian hormone (AMH) concentration suggests the reduction of antral follicle number. AMH serum level was correlated with ovarian stimulation outcomes, oocyte quantity and quality, embryo quality and in vitro fertilization (IVF) outcomes. However, the use of AMH to predict pregnancy rates in IVF is still debatable. This study aimed to determine the role of AMH in predicting ovarian response and pregnancy rates in IVF programs. This was a retrospective cohort study involving patients who underwent a short protocol of ovarian stimulation for IVF at the Yasmin clinic, dr Cipto Mangunkusumo General Hospital. from March 2013 to March 2021. A total of 1,527 out of 3,880 IVF cycles were included. Poor ovarian response was determined as a collection of fewer than four oocytes following ovarian stimulation. The data was then analyzed using the Mann Whitney test if the data distribution was not normal or the unpaired t-test if the data distribution was normal. Median AMH levels were higher in the normal (2.5(0.01-32)) compared to poor responder (0.68(0.01-6.86)) group (p<0.05; Mann Whitney). Serum AMH level and age had predictive value for pregnancy rate (p<0.05; Mann Whitney). Keywords: AMH, ovarian response, pregnancy rate, IVF.   Kadar Hormon Anti-Müllerian sebagai Prediktor Luaran Fertilisasi in Vitro Abstrak Penurunan konsentrasi serum hormon anti-müllerian (HAM) menunjukkan penurunan jumlah folikel antral. HAM serum berkorelasi dengan luaran stimulasi ovarium kuantitas dan kualitas oosit serta kualitas embrio dan luaran fertilisasi in vitro (FIV). Namun, penggunaan HAM untuk memprediksi angka kehamilan dengan stimulasi ovarium pada FIV masih diperdebatkan. Tujuan penelitian ini untuk mengetahui peran serum HAM dalam memprediksi respons ovarium dan laju kehamilan pada program FIV. Penelitian ini adalah studi kohort retrospektif yang melibatkan pasien yang menjalani protokol singkat stimulasi ovarium pada program FIV di klinik Yasmin rumah sakit dr Cipto Mangunkusumo.dari bulan Maret 2013 sampai Maret 2021. Sebanyak 1.527 dari 3880 siklus IVF dimasukkan ke dalam penelitian. Dikatakan perespon buruk apabila diperoleh kurang dari empat oosit setelah stimulasi ovarium. Data kemudian dianalisis dengan menggunakan uji Mann Whitney bila sebaran data tidak normal atau uji t tidak berpasangan bila sebaran data normal. Median kadar HAM lebih tinggi pada kelompok perespons baik (2.5 (0.01-32)) dibandingkan perespons buruk (0.68 (0.01-6.86)) (p<0,05; Mann Whitney). Kadar HAM serum dan usia memiliki nilai prediktif terhadap angka kehamilan (p<0,05; Mann Whitney). Kata kunci: hormon anti-Müllerian, respons ovarium, angka kehamilan, FIV.
Evaluation of Estradiol and Pro-Inflammatory Marker Level with VAS Score After Progestin Therapy in Endometriosis Patients Muthalib, Aidrus; Sumapraja, Kanadi; Harzif, Achmad Kemal; Maidarti, Mila
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 4 October 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i4.2531

Abstract

Objectives: To compare estradiol levels and proinflammatory biomarkers (IL-6, IL-1B, and COX-2) in endometriosis patients with pain and without pain after progestin therapy. Methods: This observational cross-sectional study involved 47 endometriosis patients undergoing three months of progestin therapy at RSUPN Cipto Mangunkusumo from March to June 2024. Serum levels of COX-2, IL-6, IL-1B, and estradiol will be measured using ELISA and Microplate Enzyme Immunoassay, with pain status assessed to determine associations between biomarkers and pain presence. Results: A significant difference in COX-2 levels between patients with pain and those without, with higher levels in the pain group [1.845 (1.24-10.26) vs 1.55 (0.32-3.07), p = 0.004]. A significant positive correlation was found between IL-1Beta and IL-6 (r = 0.471, p = 0.001). COX-2 levels also exhibited a weak but statistically significant positive correlation with VAS scores (r = 0.360, p = 0.013). Conclusion: There is a difference in inflammatory markers IL-6, IL-1 Beta and COX-2 in endometriosis patients with progestin therapy who experience pain and painlessness. Keywords: endometriosis, estradiol, proinflammation, progestin therapy.
Comparison of natural versus artificial cycles for endometrial preparation prior to frozen embryo transfer Tyagitha, Galuh Anindya; Nuryanto, Kartiwa Hadi; Pratama, Gita; Maidarti, Mila; Harzif, Achmad Kemal; Sumapraja, Kanadi; Lestari, Silvia Werdhy; Ampri, Irfan Arieqal Hatta; Talya, Natasha; Yanfaunas, Atika Mahira
Universa Medicina Vol. 43 No. 3 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.304-312

Abstract

BackgroundThe endometrial preparation phase preceding embryo transfer assumes pivotal significance in achieving optimal endometrial receptivity and ensuring the success of pregnancy. The natural cycle (NC) and artificial cycle (AC) are the preferred methods for many in vitro fertilization (IVF) specialists. The objective of this study was to compare the difference between NC and AC in women undergoing frozen-thawed embryo transfer (FET) after IVF. MethodsA cross-sectional study was conducted involving 150 adult women who underwent FET with a single autologous blastocyst stage embryo in a 5-year period (2014-2019). Bivariate analysis was conducted to discern implantation and pregnancy rates associated with NC and AC for endometrial preparation. Multiple logistic regression was used to assess the association between endometrial preparation and clinical outcomes while adjusting for potential confounders. ResultsOf the 150 subjects meeting study criteria, 19 underwent NC, while 131 underwent AC for endometrial preparation. Natural cycle exhibited a higher biochemical pregnancy rates compared to AC (89.5% vs. 53.4%; p=0.003). Artificial cycle is a significant determinant for biochemical pregnancy rates compared to NC (aOR: 0.132;95% CI: 0.028 – 0.623; p=0.010) ConclusionIn women undergoing FET, NC resulted in higher biochemical pregnancy rates compared to AC. However, clinical pregnancy rates and ongoing pregnancies rates did not exhibit significant disparities between NC and AC. Future studies will hopefully further illuminate which protocol is most suitable for the individual patient. Further multi-center randomized clinical trials are needed to confirm the relationship between biochemical pregnancy rates and NC.
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
Co-Authors Achmad K. Harzif Achmad K. Harzif Achmad Kemal Achmad Kemal Harzif Aldri Frinaldi Ampri, Irfan Arieqal Hatta Andon Hestiantoro Aprilia Asthasari Siregar Aria Kekalih Ario Legiantuko Badruddin, Hilda R Bagastoro, Aswan Bram Pradipta Budi Wiweko Caroline G. Puspita Cepi Teguh Pramayadi Chayadi, Thomas Christopher Yo, Edward Dewi K. Rusly Dilmy, Adya F Eka Rusdianto Gunardi Eliza Mansyur Faradina, Anindita Abigail Farisa Anggreana Fatma Afira Felix Chikita Fredy Fitriana M. Nuryadi Frans Liwang Fransisca Dewi Kumala Gita Pratama Gracia Lilihata Hari Kurniawan, Riyan Herbert Situmorang Herbert Situmorang Irzanti, Alisha Nurdya JM Seno Adjie Kartini Hasballah Kartiwa Hadi Nuryanto Kemal, Achmad Legiantuko, Ario Lestari, Silvia Werdhy Marcel Elian Suwito Mercy T. Panjaitan Mila Maidarti Muharam Natadisastra Muharam Natadisastra Muharam Natadisastra, Raden Muharam, R Muthalib, Aidrus Nurdya Irzanti, Alisha Prini Diandara Garinasih Rahajuningsih Dharma Rajuddin Rajuddin Raymond R. Tjandrawinata Rianto Setiabudy Ronald, Thoeng Setiawati3, Arini Silvana, Vita Suryadi, Angga J Suzanna Immanuel Talya, Natasha Tirsa verani Tita Yuningsih Tofan Widya Utami Tyagitha, Galuh Anindya Vita Silvana Yanfaunas, Atika Mahira Yo, Edward Christopher