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All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Bioscientia Medicina : Journal of Biomedicine and Translational Research MEDICINUS
Riyan Hari Kurniawan
Faculty Of Medicine, University Of Indonesia - Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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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
Unmasking the Culprit: Successful Restoration of Menstrual Function in a Case of Secondary Amenorrhea Due to Tuberculous Endometritis Mimicking Polycystic Ovary Syndrome Riyan Hari Kurniawan; Muhammad Syauqi Mirza; Ilham Utama Surya; Muhammad Dwi Priangga; Cepi Teguh Pramayadi; Herbert Situmorang; Eka Rusdianto Gunardi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1390

Abstract

Background: Secondary amenorrhea presents a significant diagnostic challenge in gynecology. While Polycystic Ovary Syndrome (PCOS) is a common cause, rare etiologies like tuberculous endometritis can be overlooked, especially in patients with features suggestive of PCOS. This phenomenon, known as diagnostic overshadowing, can lead to delayed diagnosis and irreversible reproductive consequences. Case presentation: A 35-year-old nulligravid woman with a diagnosis of Class I Obesity presented with a five-year history of secondary amenorrhea and a desire for fertility. Her clinical and initial ultrasonographic findings were suggestive of PCOS. However, persistent amenorrhea despite hormonal therapy prompted further investigation. Hysteroscopy revealed a fibrotic uterine cavity with micropolyps, and subsequent endometrial biopsy with histopathology, polymerase chain reaction (PCR), and culture confirmed a diagnosis of tuberculous endometritis. The patient was successfully treated with a six-month anti-tuberculosis regimen, cyclical progestin therapy, and a structured lifestyle modification program. Following treatment, she experienced a significant weight loss, resumption of regular menstrual cycles, and marked improvement in endometrial and ovarian ultrasound parameters. Conclusion: This case underscores the critical importance of a comprehensive diagnostic evaluation for secondary amenorrhea, including endometrial sampling, even when a common diagnosis like PCOS is suspected. It highlights the potential for tuberculous endometritis to mimic PCOS and demonstrates the efficacy of a multidisciplinary approach in restoring menstrual and potentially reproductive function. Clinicians in tuberculosis-endemic regions must maintain a high index of suspicion for this insidious pathology to prevent long-term morbidity.
Diagnostic Dilemma in Massive Cellular Leiomyoma with Cystic Degeneration Arya Ady Nugroho; Riyan Hari Kurniawan; Aprilia Asthasari Siregar
MEDICINUS Vol. 38 No. 11 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/qkhd0b31

Abstract

Background: Uterine leiomyomas, commonly known as fibroids, are prevalent benign tumors in women of reproductive age. While often asymptomatic, they can become symptomatic when they enlarge or when degenerative changes occur. Cystic degeneration, which occurs in approximately 4% of leiomyomas, presents a diagnostic challenge, as it can mimic malignancy on imaging due to its solid-cystic appearance on imaging. This case report aims to highlight the diagnostic dilemma posed by large leiomyomas with cystic degeneration and to emphasize the importance of advanced imaging as well as histopathological examination in confirming benign diagnoses and excluding malignancy. Case Presentation: A 27-year-old woman presented with progressive abdominal distension and intermittent lower abdominal pain over thepast year. Imaging revealed a large, solid-cystic mass in the uterine fundus, raising suspicion of malignancy. Further diagnostic workup, including magnetic resonance imaging (MRI) and histopathological examination, confirmed the massas a benign leiomyoma with cystic degeneration. The patient underwent a laparotomy myomectomy, and intraoperative findings confirmed a well-circumscribed subserosal mass with cystic degeneration. Histopathology examination alsoconfirmed a benign leiomyoma, ruling out malignancy. Conclusion: This case underscores the diagnostic challenges of differentiating large leiomyomas with cystic degeneration from malignancies. Advanced imaging, particularly MRI, along with histopathological examination, plays a crucial role in establishing an accurate diagnosis and subsequently, guiding appropriate management.
miRNA-191 and miRNA-548c-3p Expression in Embryo Culture Medium and Their Association with Chromosomal Status Riyan Hari Kurniawan; Raden Muharam Natadisastra; Indah Suci Widyahening; Pritta Ameilia Iffanolida; Budi Wiweko
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2915

Abstract

Objective: To analyze the relationship between the expression levels of miRNA-191 and miRNA-548c-3p in embryo culture media and embryo chromosomal status. Methods: This cross-sectional study was conducted on 30 embryos from 12 patients aged 28–40 years who underwent an in vitro fertilization (IVF) program in three clinics. Embryos were cultured until the blastocyst stage. PGT-A was performed after blastocyst biopsy on day 5 or 6, and chromosomal analysis was carried out using the NGS method. The expression levels of miRNA-191 and miRNA-548c-3p were analyzed from embryo culture media samples using the qPCR method. The relationship between the expression levels of these miRNAs and embryo chromosomal status was then assessed. Results: There were no significant differences in subjects’ characteristics between the euploid and aneuploid embryo groups (p > 0.05). There was no significant difference in the expression level of miRNA-191 between euploid and aneuploid embryos (median quantification 7.260 vs 1.039, p = 0.497). Similarly, there was no significant difference in the expression level of miRNA-548c-3p between the two groups (median quantification 1.919 vs 4.311, p = 0.707). Conclusion: The expression levels of miRNA-191 and miRNA-548c-3p show no relationship with embryo chromosomal status. Their expression in embryo culture media does not appear to be a good biomarker candidate for predicting embryo chromosomal status. Keywords: Chromosomal status, IVF, miRNA-191, miRNA-548c-3p.
Drospirenone–Ethinyl Estradiol and Cyproterone Acetate in Moderate Severe Acne with Hyperandrogenism: A Randomized Double-Blind Trial Eka Rusdianto Gunardi; Irma Bernadette; Riyan Hari Kurniawan; Astri Noviani
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 1 January 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i1.3181

Abstract

ABSTRACT Background: Acne vulgaris is a health problem experienced by 85% of people in Indonesia. The highest prevalence is in women, who attempt to treat acne vulgaris. Unsuccessful acne vulgaris therapy is associated with hormonal influences, the stimulation of the sebaceous glands by androgen hormones. Hyperandrogenism is experienced by 10% of women in Indonesia. The main therapy for hyperandrogens is ciproterone acetate. Drospirenone combined with ethinyl estradiol, apart from sparing pregnancy, is also thought to be effective in treating clinical symptoms of hyperandrogenism. Currently, there is no study on drospirenone for acne and hyperandrogen therapy in Indonesia. Objective: Determine the efficacy of treatment combination 3-mg drospirenone and 20-microgram ethinyl estradiol as management of choice for moderate-severe acne vulgaris and symptoms of hyperandrogenism (hirsutism, secondary amenorrhea, and oligomenorrhea) for 3 cycles. Method: A randomized clinical trial with a double-blind study was done. Consecutive sampling is based on a random allocation table. A total of 42 subjects were diagnosed with moderate-severe acne vulgaris with hirsutism, secondary amenorrhea and/or oligomenorrhea at RSCM, divided into 2 groups, 21 subjects using drospirenone 3 mg combined with 0.030 mg ethinyl estradiol (DRSP/EE) and 21 subjects using 2 mg ciproterone acetate and 0.035 mg ethinyl estradiol (CRPN/EE), followed with examination of free testosterone check in laboratory. There was 1 subject who dropped out (Cyproterone group). The duration of therapy was 3 months then evaluation of acne lesions, Ferriman Gallwey score (FG score), and menstrual period. Results: Characteristics of study subjects with the majority of subjects aged 25-35 years, 51,3%. The education level of most subjects about 57,1%, was a bachelor's degree. Testosterone levels at the start of the study were 1,41±0,64 for the DRSP/EE group and 1,32±0,48 for the CRPN/EE group. For the degree of acne, 85.7% of subjects using DRPS/EE and 85% of subjects using CPRN/EE had reduced acne lesions with a P value of 0.645. For hirsutism by calculating the FG score, 61.9% of the subjects using DRSP/EE and 50% of the subjects consumed CPRN/EE had a decreased FG score with a value of P value 0.443, and their menstrual period became regular for 85.7% of the subjects using DRSP/EE and 90% of the subjects using CPRN/EE with P value 0.645. Conclusion: Drospirenone and ethinyl estradiol are as effective as cyproterone acetate combined with ethyl estradiol as treatment of moderate to severe acne vulgaris, hirsutism, secondary amenorrhea, and oligomenorrhea. Keywords: acne vulgaris, cyproterone acetate, drospirenone, hirsutism, secondary amenorrhea
Co-Authors Achmad Kemal Harzif Andon Hestiantoro Aprilia Asthasari Siregar Arya Ady Nugroho Astri Noviani Budi Wiweko Budi Wiweko Cepi Teguh Pramayadi Christopher Yo, Edward Eka Rusdianto Gunardi Eka Rusdianto Gunardi Gita Pratama Herbert Situmorang Herbert Situmorang Ilham Utama Surya Indah S. Widyahening Irma Bernadette Kanadi Sumapradja Mila Maidarti Muhammad Dwi Priangga Muhammad Syauqi Mirza Nurdya Irzanti, Alisha Pritta Ameilia Iffanolida Raden Muharam Natadisastra Raden Muharam Natadisastra