Correlation between Sperm Motility and Morphology in the Success Rate of in Vitro Fertilization Procedure

Background: In vitro fertilization (IVF) is one of the assisted reproductive technology that has been used in treating infertility. Unfortunately, not every IVF procedure achieves 100% success in fertilizing the oocyte. It has been studied that the percentage of normal motile sperm and percentage of normal sperm morphology play a key role in this process. This study was conducted to evaluate correlation between sperm motility and morphology in the success rate of IVF. Methods: This study was an observational analytic involving medical records of infertile couples who were treated by IVF procedure in Dr.Hasan Sadikin General Hospital Bandung in 2009–2014. The variables that were used in this study were percentage of sperm motility, percentage of sperm morphology and fertilization rate.The collected data was analyzed using nonparametric Mann Whitney test and Spearman correlation test.Result: This study showed that there was a significant difference between the fertilization rate group and sperm motility (p=0,048) but there was no significant correlation between motility and the entire fertilization rate (p=0,319). This study also indicated that there was no significant difference between fertilization rate group and sperm morphology (p=0,232) and there was no significant correlation between sperm morphology and fertilization rate (p=0,720).Conclusions: Motility might has a role in determining the success rate of in vitro fertilization; meanwhile morphology does not have any role in determining the success rate of in vitro fertilization. [AMJ.2016;3(4):520–5] DOI: 10.15850/amj.v3n4.95

E-MONITORING INTERAKTIF MENINGKATKAN REFLEKSI DIRI, MOTIVASI BELAJAR DAN HASIL BELAJAR MAHASISWA DIII KEBIDANAN

The proportion of practice in Midwifery education has 60% of capacity, more than the proportion of theories which is only 40%. The biggest proportion of practice makes the Clinical Advisor and Academic Advisor try to provide immediate feedback to students in every skill learned in the practice field. Interactive, effective and corrective feedback can help students to do self-reflection so while in the practice field students expected to be motivated to improve learning outcomes. The purpose of this study was to define the effect of Interactive E-Monitoring implementation on self-reflection, motivation and learning outcomes of the student.A research population of this study is students of midwifery diploma program in thirdh semester of 2018/2019 Akademic year who take part in second Laboratory Learning Practices, which are spread over in 13 of independent midwife practice fields (PMB). Samples were taken in based on inclusion criteria, students who were guided by PK that included in the criteria and in aged 19-20 years were 56 students. Data analyzed, if the data is normally distributed then it uses paired t test and if the data is not normally distributed then it uses the Wilcoxon Test.The results showed that students self-reflection increased from 74.9 to 80.5 (

Correlation between Estrogen Receptorβ (ERβ), Neurofilament Protein (NF), and Protein Gene Product 9.5 (PGP9.5) Expressions as a Marker of Pain on Adenomyosis Etiopathogenesis

Adenomyosis is a pathological condition characterized by the presence of endometrial glands and stroma within the myometrium. Endometrial like cells development was influenced by local inflammatory reactions, increases local estradiol due to asynchromatized estrogen synthesis (ERβ) and then stimulated to proliferation and fibrosis, are also irritation on small nerve fibers in women with painful characterized symptoms on adenomyosis. There are expressions of neurofilament protein (NF) and protein gene product 9.5 (PGP 9.5) is a highly specific pan-neuronal marker for microfilament nerve fibers and is related to presenting pain with adenomyosis symptoms. A retrospective immunohistochemical study of thirty samples histopathological of adenomyosis as study groups and 30 with control groups between 25–49 ages which were established at Dr. Hasan Sadikin General Hospital and the satellites in April 2014–May 2015. This case-control analyzed ERβ, NF, and PGP 9.5 expressions compared and correlation between study groups and controls. The results showed there were significant differences in expression of ERβ, NF, and PGP 9.5 on adenomyosis higher than the control study (p6(sensitivity 66.7%; specificity 70%), NF>3 (sensitivity 93%; specificity 46%), PGP 9.5>4 (sensitivity 90%; specificity 67%). Odds Ratio (CI 95%) ERβ>6= 4.67; NF >3=12.25; PGP 9.5 >4=24.75 (p<0.001). The value of histoscore of ERβ and PGP9.5 have correlates to adenomyosis, the differences were statistically significant (p<0.05). The conclusion were that the adenomyosis had higher ERβ, NF, and PGP 9.5 expressions. There are simultant correlates and positive values between ERβ, NF, and PGP9.5 based on etiophatogenesis of pain on adenomyosis

Total Serum Level of Calcium and Ion Calcium is Lower in Hypotonic Uterine Inertia

Objectives: To know the correlation between total and ion serum calcium level with the uterine contractility of laboring patient. Methods: This is a cross-sectional analytic correlative study measuring the strength of correlation of total and ion calcium serum level between groups with hypotonic uterine inertia - and normal labor. Each group consists of 20 subjects who met inclusion criteria and presented to Dr. Hasan Sadikin Hospital in August - September 2012. Statistical analysis was performed by using Eta (η) coefficient. Results: Mean total calcium serum level on hypotonic uterine inertia is 6.66 mg/dl, while mean of total calcium serum level on normal labor is 8.56 mg/dl, with Eta (η) correlation coefficient 0.721. Mean ion calcium serum level on hypotonic uterine inertia is 4.14 mg/dl, while mean of total calcium serum level on normal labor is 4.92 mg/dl, with Eta (η) correlation coefficient 0.802. Conclusion: Total serum level of calcium and ion calcium in hypotonic uterine inertia is lower than the level of which in normal labor. There is a strong correlation between total and ion serum calcium level with uterine contractility, the Eta (η) correlation coefficient are 0.721 and 0.802 respectively. [Indones J Obstet Gynecol 2013; 1-3: 145-8] Keywords: hypotonic uterine inertia, ion serum calcium level, normal labor, total serum calcium leve

Apakah Kadar β-hCG Praevakuasi dan Gambaran Proliferasi Sel Trofoblas secara Mikroskopik dapat digunakan untuk Prediksi Transformasi Keganasan pada Mola Hidatidosa?

AbstrakTujuan: Meneliti perbedaan karakteristik umur, paritas, besar uterus, kadar β-hCG, dan hiperproliferasi pada mola hidatidosa (MH) dengan regresi spontan dan pada MH dengan transformasi keganasan di RS Dr.Hasan Sadikin Bandung. Metode: Penelitian cross sectional deskriptif restrospektif mengambil data umur, paritas, besar uterus, kadar β-hCG pre-evakuasi, dan hiperproliferasi dari rekam medis pasien MH periode 2007-2016. Data diolah menggunakan program SPSS versi 20.0 for Windows. Nilai p0,05). Perbedaan kadar βhCG (mIU/mL) dan tingkat proliferasi menunjukkan hasil signifikan (p0.05). Differences on level of βhCG (mIU/mL) and proliferation state showed significant result (p<0.05). Conclusion: Preevacuation level of β-hCG and histopatology (proliferation state) may predict malignancy transformation in HM.Keywords: Hydatidiform mole, risk factors, remission, malignancy transformatio

Correlation between Sperm Motility and Morphology in the Success Rate of in Vitro Fertilization Procedure

Background: In vitro fertilization (IVF) is one of the assisted reproductive technology that has been used in treating infertility. Unfortunately, not every IVF procedure achieves 100% success in fertilizing the oocyte. It has been studied that the percentage of normal motile sperm and percentage of normal sperm morphology play a key role in this process. This study was conducted to evaluate correlation between sperm motility and morphology in the success rate of IVF. Methods: This study was an observational analytic involving medical records of infertile couples who were treated by IVF procedure in Dr.Hasan Sadikin General Hospital Bandung in 2009–2014. The variables that were used in this study were percentage of sperm motility, percentage of sperm morphology and fertilization rate.The collected data was analyzed using nonparametric Mann Whitney test and Spearman correlation test.Result: This study showed that there was a significant difference between the fertilization rate group and sperm motility (p=0,048) but there was no significant correlation between motility and the entire fertilization rate (p=0,319). This study also indicated that there was no significant difference between fertilization rate group and sperm morphology (p=0,232) and there was no significant correlation between sperm morphology and fertilization rate (p=0,720).Conclusions: Motility might has a role in determining the success rate of in vitro fertilization; meanwhile morphology does not have any role in determining the success rate of in vitro fertilization. [AMJ.2016;3(4):520–5] DOI: 10.15850/amj.v3n4.95

FACTORS CONTRIBUTING TO MATERNAL MORTALITY IN TASIKMALAYA CITY

Maternal deaths reflect the risks faced by mothers during pregnancy, childbirth, and postpartum were affected by maternal nutritional status, state of ill health during pregnancy, the incidence of various complications in pregnancy, childbirth, and postpartum. Moreover, the availability and use of healthcare facilities, including prenatal and obstetric services, were also very affecting. So it is necessary to minimize the occurrence of maternal deaths. The government had made various efforts to reduce maternal mortality, but the results were still not optimal yet. If maternal mortality could be prevented as early as possible with appropriate identification, it could significantly reduce maternal mortality. The research aims to analyze the cause of maternal death in Tasikmalaya city in 2015. The research design used a quantitative approach in the form of observation. The population was all maternal deaths in Tasikmalaya City Health department in 2015. The study's affordable population was all maternal mortality data with a precise address and recorded in the OVM as many as 20 cases of death. Factors associated with maternal mortality were the problem relating to patients, health professionals, health infrastructure, and referrals. Moreover recording and reporting of maternal mortality also influenced the determination of proper diagnosis to decrease the number of maternal mortality. Maternal mortality was a problem that has never finished with the complexity of the cause. It requires efforts that involve many parties, not only the health authorities alone, but all stakeholders were supported by government regulation. This study could be the basis for further research on maternal mortality and can be used to enhance the knowledge of researchers, health professionals, and stakeholders about the factors that cause maternal deaths. This study's results are expected to know the causes of maternal mortality and used as guidelines in making policy to reduce maternal mortality.Keywords: Maternal mortality, related factors

Maturation of Vaginal Epithelium and Dyspareunia Symptoms in Equol Producing and Non-Producing Menopausal Women

Introduction: Equol is a metabolite of soy isoflavon called daidzein which is produced by gastrointestinal tract bacteria. This research aims to analyze the maturation of vaginal epithelium and dyspareunia symptoms in producing and non-producing equol menopausal women.Method: This is a cross sectional research. Subject was a community of menopausal women who fulfilled inclusion criteria. Subjects were asked to sign a written informed consent. Subjects underwent vaginal epithelium maturation assessment and were asked whether she experienced dyspareunia. Research was conducted in January 2017.Result: There was a significant difference on the maturation of vaginal epithelium and dyspareunia symptoms between equol producing and non-producing women (p < 0.05). This research found that in equol producing menopausal women, there was a shift-to-the-right vaginal epithelium maturation with more superficial cells compared to parabasal cells produced and less dyspareunia. Meanwhile, in women who did not produce equol, there was a shift-to-the-left vaginal epithelium maturation with more parabasal cells compared to superficial cells produced and more dyspareunia.Conclusion: In equol producing menopausal women, vaginal epithelium will undergo a shift-to-the-right maturation, with more superficial cells produced compared to women who did not produce equol.Maturasi Epitel Vagina dan Gejala Dispareunia pada Wanita Menopause yang Menghasilkan Equol dan Wanita yang Tidak Menghasilkan EquolAbstrakPendahuluan: Equol adalah metabolit isoflavon kedelai yang disebut daidzein yang diproduksi oleh bakteri saluran pencernaan. Penelitian ini bertujuan untuk menganalisis maturasi epitel vagina dan gejala dispareunia pada wanita menopause yang memproduksi dan tidak memproduksi equol.Metode: Penelitian ini merupakan penelitian cross sectional. Subjek penelitian adalah sekelompok wanita menopause yang memenuhi kriteria inklusi. Subjek diminta untuk menandatangani persetujuan tertulis dan menjalani penilaian maturasi epitel vagina dan ditanya apakah mengalami dispareunia. Penelitian dilakukan pada Januari 2017.Hasil: Terdapat perbedaan yang signifikan pada maturasi epitel vagina dan gejala dispareunia antara wanita yang memproduksi equol dan yang tidak memproduksi (p <0,05). Pada wanita menopause yang memproduksi equol, terjadi pematangan epitel vagina shift-to-the-right disertai produksi sel superfisial yang lebih banyak dibandingkan sel parabasal dan lebih sedikit gejala dispareunia. Sementara itu, pada wanita yang tidak menghasilkan equol, terjadi pergeseran shift-to-the-left maturasi epitel vagina dengan produksi sel parabasal lebih banyak dibandingkan sel superfisial dan lebih sering gejala dispareunia.Kesimpulan: Wanita menopause yang memproduksi equol mengalami maturasi epitel vagina shift-to-the-right disertai produksi sel superfisial yang lebih banyak dibandingkan dengan wanita menopause yang tidak memproduksi equol.Kata kunci: Dyspareunia; equol; maturasi epitel vagin

Hubungan Kadar Vitamin D Serum dengan Konsentrasi, Motilitas dan Morfologi Sperma pada Pria Subfertil di Klinik Teknologi Reproduksi Berbantu Aster Rumah Sakit Dr. Hasan Sadikin Bandung

Tujuan: Untuk menganalisis hubungan kadar vitamin D dengan kualitas sperma pada pria subfertil, serta membandingkan kualitas sperma berdasarkan klasifikasi kadar vitamin D serum pada pria normospermia dan pria oligoasthenoteratospermia.Metode: Penelitian ini merupakan penelitian yang bersifat observasional analitik dengan rancangan studi potong lintang. Subjek penelitian adalah pria subfertil yang berusia 20-50 tahun, dibagi menjadi 2 kelompok, yaitu 30 pasien normospermia dan 16 pasien oligoasthenoteratospermia berdasarkan berdasarkan kriteria World Health Organization 2010. Penelitian dilakukan di Klinik Teknologi Reproduksi Berbantu Aster, RSUP Dr. Hasan Sadikin Bandung. Analisis data menggunakan analisis korelasi rank SpearmanHasil: Pada penelitian ini didapatkan korelasi positif antara kadar vitamin D dan motilitas sperma ( r = 0,639, p = 0,05). Perbedaan yang bermakna didapatkan antara kadar vitamin D pada kelompok normospermia dan oligoasthenoteratospermia dengan nilai p 0.05). There was a significant difference between vitamin D levels in normospermic and oligoasthenoteratospermia group with p <0,05. In the sperm quality comparison based on vitamin D serum classification, only sperm motility alone had a significant difference with the value of p <0.05. It was concluded that level of vitamin D serum has positive correlation with sperm motility.Key word: subfertile, vitamin D,  sperm qualit

Oxytocin 10 IU as Prophylactic for Uterine Atony : a Randomized Clinical Trial: Oksitosin 10 IU sebagai Profilaksis Atonia Uteri : suatu Uji Coba Klinis Acak

Abstract Objective : To compare the effectiveness of oxytocin dose of 10 IU and 20 IU for preventing uterine atony in women undergoing cesarean section. Methods : This was a double-blind, randomized clinical trial with good matching selection with randomization block of patients who had risk factors for the occurrence of uterine atony such as preeclampsia, patients were receiving MgSO4, oxytocin intrapartum and chorioamnionitis who performed stratified randomization prospectively with two kinds of oxytocin doses which are 10 IU and 20 IU as a prophylaxis for uterine atony in women who performed emergency cesarean section with transverse incision and were using a general anesthesia. Results : This study found no any significant differences between the use of 10 IU and 20 IU as prophylaxis for uterine atony during cesarean section either in its action at the time or while in recovery room, especially on the cases without chorioamnionitis thus using oxytocin 10 IU regimen can be considered, besides the effectiveness did no differ, it will cost cheaper than oxytocin 20 IU regimen which frequently used. Conclusions : There were no significant differences in the incidence of blood loss during the cesarean section between the treatment of oxytocin 10 IU group and oxytocin 20 IU group. The additional uterotonic was using during the action of the cesarean section between the treatment of oxytocin 10 IU group, and oxytocin 20 IU group gave no significant differences. The side effects in this study at least form of chills and vomiting found no significant differences between both of groups despite the side effects that arise in oxytocin 20 IU group was higher at 23.08% than oxytocin 10 IU group at 15.19%. Chorioamnionitis would be a risk factor for the occurrence of uterine atony during the action of the cesarean section if it associated with the use of additional uterotonic in oxytocin 10 IU group if compared with oxytocin 20 IU group. Keywords : cesarean section, oxytocin, uterine atony. &nbsp; Abstrak Tujuan : Untuk membandingkan efektifitas penggunaan dosis 10 IU dan 20 IU sebagai profilaksis atonia uteri pada saat seksio sesarea. Metode : Penelitian ini menggunakan uji klinis acak ganda dengan seleksi yang sesuai dengan blok acak pada pasien-pasien yang memiliki faktor risiko terjadinya atonia uteri seperti preeklamsia, pasien yang diberikana MgSO4 dan oxytocin intrapartum sebelumnya serta chorioamnionitis yang dilakukan pengacakan secara prosfektif bertingkat yang diberikan dua jenis dosis oksitosin yaitu 10 IU dan 20 IU sebagai profilaksis atonia uteri pada perempuan yang dilakukan seksio sesarea darurat dengan insisi transversal dan menggunakan anestesi umum. Hasil : Penelitian ini menemukan tidak adanya perbedaan yang bermakna antara penggunaan dosis oksitosin 10 IU dan 20 IU sebagai profilaksis atonia uteri pada seksio sesarea baik saat tindakan operasi maupun saat berada di ruang pemulihan, terutama pada kasus-kasus tanpa khorioamnionitis dimana memerlukan oksitosin tambahan pada kelompok 10 IU, selain efektifitasnya tidak berbeda, akan lebih murah dari pada rejimen oksitosin 20 IU yang sering digunakan saat ini. Kesimpulan : Berdasarkan hasil penelitian ini, tidak ada perbedaan yang bermakna dalam kejadian kehilangan darah selama operasi seksio sesarea antara perlakuan kelompok oksitosin 10 IU dan kelompok oksitosin 20 IU. Penggunaan uterotonik tambahan selama tindakan seksio sesarea antara perlakuan kelompok oksitosin 10 IU dan kelompok oksitosin 20 IU tidak memberikan perbedaan yang signifikan. Efek samping dalam penelitian ini yakni menggigil dan muntah, tidak ditemukan perbedaan yang bermakna antara kedua kelompok meskipun efek samping yang muncul pada kelompok oksitosin 20 IU lebih tinggi 23,08% dibandingkan kelompok oksitosin 10 IU pada 15,19%. Khorioamnionitis merupakan faktor risiko terjadinya atonia uteri selama tindakan seksio sesarea jika dikaitkan dengan penggunaan uterotonika tambahan pada kelompok oksitosin 10 IU jika dibandingkan dengan kelompok oksitosin 20 IU. Kata kunci : atonia uteri, oksitosin, seksio sesarea