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Ayuandari, Sarrah
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Cumulative cyclophosphamide dose and serum anti-Mullerian hormone levels in adolescent cancer survivors in Indonesia Mulatsih, Sri; Ayuandari, Sarrah; Rahmawati, Naafi Rizqi; Oktasari, Rizki; Dewanto, Agung
Paediatrica Indonesiana Vol. 63 No. 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.376-82

Abstract

Background As both the prevalence and survival rates of cancer in children and adolescents has risen, longer-term effects of cancer treatment must be investigated. High-risk gonadotoxic chemotherapeutic agents such as cyclophosphamide may affect the ovarian reserve and impact female adolescent fertility. Anti-Mullerian hormone is a reliable marker to assess ovarian reserve. Objective To assess for a possible correlation between the cumulative dose of cyclophosphamide and serum anti-Mullerian hormone (AMH) levels among adolescent cancer patients. Methods This cross-sectional study included 12-18-year-old adolescent female cancer patients who had experienced menarche and received cyclophosphamide therapy. We recorded the patients’ full history, including menstrual history, computed the cumulative dose of cyclophosphamide received, and measured serum AMH levels. The correlation test was performed to evaluate for a possible correlation between the cumulative dose of cyclophosphamide and ovarian reserve as represented by AMH levels. Results Out of 12 female adolescent cancer patients, three complained of disturbances in their menstrual cycles. Low levels of AMH (<1.5 ng/mL) were noted in five patients. Median cumulative cyclophosphamide dose was 1,000 mg/m2 (range 1,000 to 5,250 mg/m2). Cumulative cyclophosphamide dose was negatively correlated with serum AMH levels, but this correlation was not statistically significant (r=-0.316, P=0.318). Conclusion This study has not been able to show a correlation between cumulative cyclophosphamide dose and serum AMH level. Regular evaluation of fertility and involvement of fertility team is recommended in adolescents receiving high-risk gonadotoxic chemotherapeutic agents.
Histeroskopi dalam Diagnosis dan Terapi Adhesi Alat Kontrasepsi Dalam Rahim pada Pasien Uterus Bikorporeal: Laporan Kasus Novita, Devie; Ayuandari, Sarrah; Attamimi, Ahsanudin; Widad, Shofwal
JURNAL KESEHATAN REPRODUKSI Vol 12, No 3 (2025)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.114776

Abstract

Latar Belakang: Pelepasan alat kontrasepsi dalam rahim (AKDR) pada uterus bikorporeal merupakan tantangan klinis akibat kompleksitas anatomi uterus. Kondisi patologis seperti adhesi AKDR dapat meningkatkan risiko kegagalan pelepasan secara konvensional. Tujuan: Untuk melaporkan peran histeroskopi sebagai modalitas diagnostik dan terapeutik dalam penatalaksanaan adhesi alat kontrasepsi dalam rahim (AKDR) pada pasien dengan uterus bikorporeal setelah kegagalan pelepasan secara konvensional.Metode: Seorang perempuan 33 tahun, multipara P2A0 dengan uterus bikorporeal, dirujuk ke Poliklinik Obstetri dan Ginekologi RSUP Dr. Sardjito Yogyakarta dengan dugaan adhesi AKDR setelah satu tahun pemasangan. Pasien mengeluhkan nyeri perut di luar siklus menstruasi disertai keputihan. Ultrasonografi transvaginal menunjukkan uterus bikorporeal dengan dua AKDR intrauterin.Hasil dan Pembahasan: Histeroskopi memungkinkan visualisasi langsung kavum uteri, konfirmasi adhesi AKDR, serta tindakan terapeutik secara simultan, sehingga menurunkan risiko komplikasi dan meningkatkan keberhasilan pelepasan.Kesimpulan: Histeroskopi merupakan modalitas minimal invasif yang efektif, aman, dan cost-effective dalam penatalaksanaan kegagalan pelepasan AKDR, terutama pada pasien dengan kelainan kongenital uterus.
Co-Authors Ahsanudin Attamimi Dewanto, Agung Naafi Rizqi Rahmawati, Naafi Rizqi Novita, Devie Oktasari, Rizki Shofwal Widad Sri Mulatsih