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Asian Journal of Fertility, Endocrinology, and Reproduction
Published by Pusat Pelatihan Profesional Kesehatan
ISSN : 31644554     EISSN : 31644538     DOI : -
Core Subject : Health, Science, Social,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Social Sciences
The Asian Journal of Fertility, Endocrinology, and Reproduction (AJFER), first launched in 2025, is a peer-reviewed and open-access scientific journal dedicated to advancing knowledge in the fields of fertility, endocrinology, and reproduction health published by the Pusat Pelatihan Profesional Kesehatan, Indonesia. AJFER provides a platform for the dissemination of high-quality, evidence-based research and professional discourse in the field of reproductive health. Encompassing original research articles, review papers, case reports, and clinical as well as basic science studies. The journal embraces a broad interdisciplinary scope within reproductive medical sciences, including but not limited to: Obstetrics and Gynecology, Reproductive Endocrinology, Andrology, Embryology, Urology, Reproductive Medicine, Reproductive genetics, and public health in reproductive care. To ensure timely dissemination of scientific contributions, AJFER maintains four times a year publication schedule, issuing four editions per year (for every three months: January, April, July, and Oktober). All manuscripts submitted to AJFER undergo a comprehensive double-blind peer review system. Accepted articles are promptly published with open-access availability. By embracing this interdisciplinary approach, AJFER aims to bridge clinical practices research, and policymaking to improve reproductive health outcomes in Asia and beyond.
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Articles 18 Documents
 1   2 
The Impact of Flavonoids on Diabetes Therapy in Menopausal Women Dyah Ayu Septika Wijaya; Sutrisno Sutrisno
ASIAN JOURNAL OF FERTILITY ENDOCRINOLOGY AND REPRODUCTION Vol. 1 No. 1 (2026): January 2026
Publisher : Malang Reproductive Training Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66060/ajfer.v1i1.3

Abstract

Introduction: Diabetes constitutes a metabolic anomaly influencing glucose utilization within the body, and the susceptibility to diabetes is heightened among menopausal women as a consequence of hormonal fluctuations. Flavonoids, natural compounds found in various plant-based products, have shown antidiabetic properties. This study aims to explore the effectiveness of flavonoids as a therapy for diabetes in menopausal women. Methods This study used electronic databases searching and blood glucose levels were extracted from the selected articles for analysis. Two primary studies included: Sideritis scardica 70% ethanolic root extract and Argimonia pilosa Ledeb. Aqueous leaf extract in ovariectomized (OVX) rats. Results: Flavonoids extracted from S. scardica and A. pilosa demonstrated a notable decrease in blood glucose levels among the OVX diabetes group in comparison to the control group. Flavonoids have multiple mechanisms of action, including reducing glucose absorption, increasing glucose tolerance, and enhancing insulin receptor sensitivity. They also act as antioxidants and have estrogenic effects. Both S. Scardica and A. pilosa show outstanding excellence as natural remedies for managing diabetes in postmenopausal women. Based on the results of this meta-analysis, the two flavonoid-containing plants containing flavonoids significantly reduced blood glucose in OVX rats in the experimental group (P<0.05). Conclusion: further research can be carried out with clinical trials on the potential of S. scardica and A. pilosa flavonoids to diabetes mellitus (DM) in reduce blood glucose levels in postmenopausal women with diabetes mellitus (as a therapy for metabolic disorders.
Utilization of Cranberries (Vaccinium Macrocarpon) in Menopausal Women With Recurrent Urinary Tract Infections: A Systematic Review and Meta-Analysis Ani Khoirinda; Sutrisno Sutrisno
ASIAN JOURNAL OF FERTILITY ENDOCRINOLOGY AND REPRODUCTION Vol. 1 No. 1 (2026): January 2026
Publisher : Malang Reproductive Training Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66060/ajfer.v1i1.4

Abstract

Introduction: Menopause is a condition in women who experience menstrual cessation for 12 months. The average age of menopausal women is 45 – 55 years. In comparison, early menopause occurs at <40 years. Hormonal changes are one of the characteristics of menopausal women, and these changes can affect the bladder organs, leading to an increase in vaginal pH > 5, which can lead to UTIs. Treatment is needed to prevent recurrent UTIs. Cranberry is one of the treatments that can be given and is included in phytopharmaceutical treatment. In addition, cranberries can be given to menopausal women who have a history of recurrent UTIs or are experiencing UTIs. Methods: A systematic review was used, including journal articles published on Google Scholar, ScienceDirect, and PubMed. The article used is original research. Statistical evaluation for meta-analysis using Review Manager (RevMan) v.5.4, Risk Ratio with a CI95% CI. Results: Four studies that met the inclusion criteria in the relationship of cranberry administration in menopausal women were compared to placebo; the total population in this study was as many as (n = 947). In the combined analysis of cranberry juice and placebo capsules, the incidence of rUTI was significantly lower in the cranberry group than in the placebo group (RR 0.71, 95% CI 0.57-0.89; p = 0.003). In addition, the incidence of rUTI was significantly lower in the cranberry group than in the placebo group (RR 0.74; 95% CI 0.56, 0.98; p = 0.03). Conclusion: In a double-blinded study, it was found that Cranberry administration has an influence on the incidence of rUTI in menopausal women. Cranberry juice obtained significant results in the treatment group compared to the placebo.
Flavonoid Intake and Their Effect to Against Ovarian Cancer in Menopause:  A Systematic Review and Comprehensive Meta-Analysis R.A. Rahmawati Nurul Fadilah; Sutrisno Sutrisno
ASIAN JOURNAL OF FERTILITY ENDOCRINOLOGY AND REPRODUCTION Vol. 1 No. 1 (2026): January 2026
Publisher : Malang Reproductive Training Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66060/ajfer.v1i1.7

Abstract

Introduction: The worst gynecologic malignancy and the fifth-leading cause of cancer-related death in women worldwide is ovarian cancer. New therapeutic agents that are more effective and less likely to cause adverse reactions are urgently needed. Although flavonoids are primarily focused on their cytotoxic anticancer activity, they may also inhibit cell migration and invasion, affect cell cycle progression or induce apoptosis in specific tumor cells. This change may be related to flavonoids and ovarian cancer. That will be discussed in this study regarding the effects of flavonoid intakes on menopausal women to prevent ovarian cancer. Methods: Systematic searches were conducted using Google Scholar, Science Direct, PubMed, DOAJ (Directory of Open Access Journals), Cochrane, and Wiley. PRISMA 2020 rules are used to filter acquired articles. Studies examining the effects of flavonoids on ovarian cancer prevention considered for evaluation. Odds ratios and 95% confidence intervals (CIs) for random-effects meta-analyses were presented. Results: It was discovered that there is a correlation between flavonoids and the incidence of ovarian cancer during menopause among five studies that satisfied the requirements for inclusion in this article (n = 3886). The treatment group given flavonoids to reduce the incidence of apoptosis in ovarian granulosa cells in menopausal rats found that flavonoids reduced ovarian granulosa cell by 0.42 times compared with the placebo group (95% CI, OR=0.42 [0.18, 0.95]; P=0.04). Similarly, an isoflavone diet in menopausal women results in 0.89 times reduction in the risk of ovarian cancer compared with the group that does not follow an isoflavone diet, with OR=0.89 (CI 95%, 0.78, 1.02; P=0.08). When the five studies compared dietary isoflavones with flavonoid derivatives for ovarian cancer incidence, they showed a 0.87 times reduction in ovarian cancer incidence with dietary isoflavones (OR=0.87; CI 95%, 0.77, 0.99; P=0.04). Conclusion: In this meta-analysis, the efficacy of flavonoids compared to placebo can be considered as a preventive measure against ovarian cancer in menopause.
Genistein Acts as an antiangiogenic and Inflammatory Modulator by Inhibits VEGFR2, TGF-β1, and COX-2 Levels in Peritoneal Endometriosis Lesion of Endometriosis Mice Sutrisno Sutrisno; Afiat Aji Wijaya; Effie Masyitha Siregar; Lilis Handayani; Hermawan Wibisono; Pande Made Dwijayasa; Nina Rini Suprobo; I Wayan Arsana Wiyasa
ASIAN JOURNAL OF FERTILITY ENDOCRINOLOGY AND REPRODUCTION Vol. 1 No. 1 (2026): January 2026
Publisher : Malang Reproductive Training Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66060/ajfer.v1i1.8

Abstract

Introduction: This research aims to determine whether genistein functions as an antiangiogenic and inflammatory modulator by decreasing levels of VEGFR2, TGF-β1, and COX-2 in the peritoneal fluid of mice with an endometriosis model. Methods: The study involved 32 healthy female Mus musculus mice, 20-30 g in weight and 2-3 months old, divided into eight groups: negative control group (healthy mice without treatment), an endometriosis model group (endometriosis-induced mice without genistein), and six treatment groups that received varying doses of genistein (0.13, 0.26, 0.52, 0.78, 1.04, and 1.3 mg/day, n=4). Measurement of VEGFR-2, TGF-β1, and COX-2 levels in endometriosis lesions in mouse models using an Enzyme Immunoassay (EIA), Mice enzyme-linked immunoassay (ELISA) Kit. Results: This study showed that the endometriosis model exhibited increased levels of VEGFR-2, TGF-β1, and COX-2. Administration of genistein significantly normalized these elevated levels. Genistein markedly reduced VEGFR-2, TGF-β1, and COX-2 levels in all the treatment groups. Conclusion: Genistein decreases levels of VEGFR-2, TGF-β1, and COX-2 in the peritoneal fluid of a mouse model of endometriosis by acting as an antiangiogenic and inflammatory modulator. Consequently, genistein holds potential as a therapeutic agent in the treatment of endometriosis.
The Anti-Inflammatory Effects of Genistein Inhibits Tumor Necrosis Factor-Α Receptor 1 (TNF-R1) and IL-8 Receptor (CXCR-1) Levels in Peritoneal Endometriosis Lesion of Mice Model Endometriosis Sutrisno Sutrisno; Cholid Rochman Riskianto; Yulianto Rapa; Nina Rini Suprobo; Pande Made Dwijayasa
ASIAN JOURNAL OF FERTILITY ENDOCRINOLOGY AND REPRODUCTION Vol. 1 No. 1 (2026): January 2026
Publisher : Malang Reproductive Training Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66060/ajfer.v1i1.9

Abstract

Introduction: Endometriosis is a complex condition that typically causes an inflammatory reaction in the peritoneal cavity. Tumor Necrosis Factor-α receptor 1 (TNF-R1) and IL-8 receptor (CXCR-1) are thought to play a role in the pathophysiology of endometriosis. This study evaluates the effects of genistein at various doses on the content of TNF-R1 and CXCR1 in the peritoneal endometriosis lesions in mice model of endometriosis. Methods: This experiment study, a total 32 female mice (Mus musculus) with induced endometriosis were allocated to the eight groups (n=4 per group), including a control group, endometriosis model group (EM), and six groups treated with different doses of genistein (0.13, 0.26, 0.52, 0.78, 1.04, and 1.30 mg/day) for 14 days. The peritoneal endometriosis lesion was then measured for TNF-R1 and CXCR-1 levels. Results: The level of TNF-R1 and CXCR-1 in the EM group was significantly elevated compared to the control group. Following genistein administration, TNF-R1 and CXCR-1 levels were significantly lower than in the EM group. Conclusion: Genistein has an anti-inflammatory effect, reducing TNF-R1 and CXCR-1 in mice model of peritoneal endometriosis and could be a potential treatment for endometriosis.
The Efficacy and Safety of Neurokinin 3 Receptor Antagonists for Vasomotor Symptoms in Menopausal Women: A Systematic Review and Meta-Analysis Najwa Nidaul Fitroh; Aliyah Redya Mufidah; Regina Amanda Zalika; Latifah Dwi Ratna Ningrum
ASIAN JOURNAL OF FERTILITY ENDOCRINOLOGY AND REPRODUCTION Vol. 1 No. 1 (2026): January 2026
Publisher : Malang Reproductive Training Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66060/ajfer.v1i1.12

Abstract

Introduction: Vasomotor symptoms (VMS) are the most common and disruptive menopausal complaints, impairing sleep, daily functioning, and quality of life. Limitations of hormonal therapy and modest benefit of current non-hormonal options underscore the need for targeted alternatives. Neurokinin-3 receptor (NK3R) antagonists represent a novel non-hormonal therapy that modulates hypothalamic KNDy neuron dysregulation linked to estrogen decline. This study aimed to evaluate the efficacy and safety of NK3R antagonists in menopausal women with VMS. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Searches across PubMed, Cochrane, ScienceDirect, Epistemonikos, Scopus, ProQuest, and EBSCO through November 2025 identified clinical trials assessing NK3R antagonists for VMS. Independent reviewers performed data extraction and risk-of-bias assessment using the Cochrane RoB 2.0 tool. Pooled analyses were calculated using standardized mean differences (SMDs) or odds ratios (ORs) with 95% confidence intervals. Results: Sixteen clinical trials met the inclusion criteria. NK3R antagonists significantly improved menopause-specific quality of life (SMD −0.46; 95% CI −0.67 to −0.25), PROMIS sleep-related outcomes (SMD −0.23; 95% CI −0.32 to −0.13), and work productivity (SMD −0.52; 95% CI −0.97 to −0.06). Patients were more likely to report meaningful improvement on PGI-C (OR 6.34; 95% CI 1.25–32.00). Adverse event rates were comparable to placebo (OR 0.84; 95% CI 0.36–1.93), with most events mild and transient. Conclusion: NK3R antagonists effectively reduce vasomotor symptoms and improve quality of life with a safety profile similar to placebo. These findings support NK3R antagonists as a valuable non-hormonal therapeutic option, particularly for women unable or unwilling to use hormonal therapy.
The Evolving Role of Herbal Medicine in Endometriosis Management: A Promising Frontier in Reproductive Health Sutrisno Sutrisno
ASIAN JOURNAL OF FERTILITY ENDOCRINOLOGY AND REPRODUCTION Vol. 1 No. 1 (2026): January 2026
Publisher : Malang Reproductive Training Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66060/ajfer.v1i1.13

Abstract

Endometriosis, a chronic and debilitating gynecological disorder, affects an estimated 10-15% of women of reproductive age worldwide. This condition, characterized by the growth of endometrial-like tissue outside the uterine cavity, often leads to severe pelvic pain, dysmenorrhea, dyspareunia, and infertility, profoundly impacting patients' physical and psychological well-being. Despite existing medical and surgical interventions, such as hormonal therapies and analgesics, conventional treatments frequently present limitations including significant side effects, treatment failures, and high recurrence rates. This persistent challenge underscores the critical need for alternative and complementary therapies that offer improved efficacy, better safety profiles, and enhanced patient-centered approaches. Within this landscape, herbal medicine, deeply rooted in traditional medical systems, is emerging as a promising frontier for endometriosis management, prompting rigorous scientific scrutiny and potential integration into contemporary reproductive health practices.
Causes of Delayed Endometriosis Diagnosis: A Systematic Review ary murti wulandari; Leny Silviana Farida; Sutrisno
ASIAN JOURNAL OF FERTILITY ENDOCRINOLOGY AND REPRODUCTION Vol. 1 No. 3 (2026): July 2026
Publisher : Malang Reproductive Training Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66060/ajfer.v1i3.30

Abstract

Background: Endometriosis is a chronic gynecological condition characterized by the presence of endometrial-like tissue outside the uterus and is frequently associated with substantial diagnostic delay. This delay negatively affects patients' quality of life, exacerbates pain severity, increases disease progression, and imposes significant economic and psychosocial burdens. Despite growing research attention, delayed diagnosis remains a persistent global challenge. Understanding the multifactorial contributors to diagnostic delay is therefore essential to inform effective interventions and improve clinical outcomes. Methods: A systematic review was conducted to identify factors associated with delayed diagnosis of endometriosis. Electronic searches were performed in PubMed, ProQuest, and Web of Science for studies published between January 2020 and December 2024. Eligible studies included original research published in English with full-text availability. Study selection followed PRISMA guidelines using Rayyan AI for screening and duplicate removal. Data were extracted independently and synthesized qualitatively, with quantitative meta-analysis performed where homogeneous data were available. Random-effects models were applied, and heterogeneity was assessed using the I² statistic. Results: From 205 records identified, four studies met the inclusion criteria and were included in the qualitative synthesis and quantitative analysis. The findings revealed that diagnostic delay in endometriosis is driven by interrelated patient related and healthcare provider–related factors. Key contributors included normalization of menstrual pain, stigma surrounding women's health issues, reliance on patient self-advocacy, dismissive attitudes from healthcare providers, limited clinical knowledge and technical competence, and power imbalances within the clinician–patient relationship. These factors collectively contribute to prolonged diagnostic pathways and delayed access to appropriate care. Conclusion: Diagnostic delay in endometriosis is a complex, multifactorial issue requiring systemic, patient-centered, and gender-sensitive approaches to improve early recognition and diagnosis.
CYP17A1 Genetic Polymorphisms Influencing Hyperandrogenism in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis Zelin Patarena Dawi Pramesti; Leny Silviana Farida; Sutrisno
ASIAN JOURNAL OF FERTILITY ENDOCRINOLOGY AND REPRODUCTION Vol. 1 No. 3 (2026): July 2026
Publisher : Malang Reproductive Training Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66060/ajfer.v1i3.31

Abstract

Introduction : Polycystic ovary syndrome (PCOS) is a prevalent polygenic endocrine disorder affecting women during their reproductive years. It is marked by excessive androgen levels, irregular ovulation, and the presence of multiple ovarian follicles. The CYP17A1 gene has been implicated in androgen overproduction, yet the extent to which CYP17A1 genetic variants influence the susceptibility to PCOS is still uncertain. The following section summarizes studies that have examined the link between the CYP17A1 rs743572 polymorphism and PCOS risk in women of reproductive age. Method:  A thorough literature search was performed across three databases: SCOPUS, ScienceDirect, and PubMed, to identify studies meeting the inclusion criteria. The risk of bias for the included studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Collected data were subsequently analyzed using RevMan version 5.4. Result: Four studies involving 1,542 PCOS cases and 1,438 controls were included in the meta-analysis. CYP17A1 (rs743572) polymorphism was significantly associated with increased PCOS risk across all genetic models: allele model (OR = 1.39, 95% CI: 1.09-1.76, P = 0.007, I² = 51%), dominant model (OR = 1.53, 95% CI: 1.10-2.11, P = 0.01, I² = 43%), and recessive model (OR = 1.52, 95% CI: 1.10-2.10, P = 0.01, I² = 9%), indicating consistent positive associations with low to moderate heterogeneity. Conclusion: The CYP17 T/C (rs74357) polymorphism is a significant factor contributing to heightened susceptibility to polycystic ovary syndrome in individuals carrying the C allele. These findings indicate that CYP17 gene polymorphisms could serve as a potential risk factor for developing polycystic ovary syndrome, or may play an important role in the associated metabolic and hormonal disorders
Impact of Al Driven Clinical Decision Support Tools ( Like Opt - IVF ) on Optimizing Hormone Dosing and IVF Outcomes Septia Kusuma Lestari; Leny Silviana Farida; Sutrisno
ASIAN JOURNAL OF FERTILITY ENDOCRINOLOGY AND REPRODUCTION Vol. 1 No. 2 (2026): April 2026
Publisher : Malang Reproductive Training Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66060/ajfer.v1i2.32

Abstract

Introduction: Artificial intelligence (AI) based clinical decision support systems (CDSS), including tools such as Opt-IVF, are increasingly applied in assisted reproductive technology to support individualized controlled ovarian stimulation. These systems are designed to tailor gonadotropin dosing, enhance oocyte yield, and improve in vitro fertilization (IVF) outcomes while simultaneously reducing adverse effects and treatment costs. However, the overall impact of AI-assisted CDSS on hormone dosing optimization and IVF outcomes has not yet been comprehensively synthesized. Methods: A systematic search of major scientific databases was conducted to identify studies evaluating AI- or machine learning–based decision support tools applied during ovarian stimulation in IVF cycles. Eligible studies included observational studies, retrospective cohorts, and clinical validation studies reporting hormone dosing parameters and IVF-related outcomes. Primary outcomes comprised initial and cumulative gonadotropin doses and the number of retrieved metaphase II (MII) oocytes. Secondary outcomes included indicators of ovarian response and treatment safety. Data were extracted and synthesized, and meta-analytical techniques were applied where appropriate. Result: Six studies fulfilled the inclusion criteria. Across these studies, AI-driven CDSS consistently reduced both starting and cumulative gonadotropin doses compared with conventional clinician-guided dosing. Meta-analysis demonstrated that AI-assisted dosing achieved comparable numbers of retrieved MII oocytes, indicating non-inferior reproductive outcomes despite lower hormone exposure. Several studies also reported enhanced personalization of stimulation protocols based on individual patient characteristics, including age, anti-Müllerian hormone levels, antral follicle count, and body mass index. No increase in adverse events, including ovarian hyperstimulation syndrome, was reported. Conclusion: AI-driven clinical decision support tools effectively optimize hormone dosing during IVF cycles while maintaining comparable reproductive outcomes. These technologies represent a promising strategy for personalized ovarian stimulation, potentially reducing medication burden and treatment costs without compromising efficacy. Further large-scale randomized studies are required to confirm long-term clinical benefits and to standardize AI implementation in IVF practice.

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