Effects of Levonorgestrel Implants of One Rod and Two Rod on Lipid Profile, Follicle Stimulating Hormone (FSH), and Estradiol Levels in Acceptors : Efek Implan Levonorgestrel Satu Batang dan Dua Batang terhadap Profil Lipid, Kadar Follicle Stimulating Hormone (FSH), dan Estradiol pada Akseptor

Abstract Objective: To find out the comparison of the effect of one-rod and two-rod levonorgestrel implants on FSH, estradiol levels and increase in acceptor lipid profile after a 3-month evaluation in the Mother Hospital of Rika Amelia Palembang.Methods: This study was a phase III clinical trial, "Open" (Open Randomized Clinical Trial), carried out randomization by comparing two types of implant KB, namely levonorgestrel implants, one rod with two rods. This research was conducted at the RSAB Rika Amelia Palembang. Research time is 6 months from November 2018 - April 2019 or until the number of samples is fulfilled.Results: Based on the installation time, the average installation time using one rods LNG was 1.54 ± 0.11 minutes and the LNG for the two rods was 2.49 ± 0.26 minutes. Majority of patients having a normal blood pressure of 89.5% in one rod LNG and 68.4% in two rod LNG. The mean body mass index (BMI) of respondents using LNG implants one rod was 24.19 ± 3.93 kg / m2 and LNG for two rods was 25.09 ± 6.11 kg / m2. Based on the menstrual pattern, it was found that 84.2% of the subjects had regular menstrual patterns in the one-rod LNG group, while there were 63.2 % of subjects who have irregular menstrual patterns. From the statistical test, it was found that there were no differences in cholesterol levels (p = 0.919), HDL (p = 0.793), LDL (p = 0.851) and triglycerides (p = 0.679). There were no differences in FSH levels between respondents using one rod and two rod LNG implants (p = 0.849) and also on estradiol (p = 0.099)Conclusion: There is no difference between the use of one-rod and two-rodlevonorgestrel implants against FSH, Estradiol levels and increased lipid profile after 3 months of implant installation. The unpleasant effect in this study was the decline in HDL, but this was accompanied by a decrease in body weight, total cholesterol, LDL, HDL due to a decrease in all aspects.Keyword: estradiol, FSH, implant contraception, lenovorgestrel, lipid profile, one-rod, two-rod   Abstrak Tujuan:Untuk mengetahui perbandingan efek implanlevonorgestrel satu-batang dan dua-batang pada FSH, kadar estradiol dan peningkatan profil lipid akseptor setelah evaluasi 3 bulan di Rumah Sakit Ibu Rika Amelia Palembang.Metode: Penelitian ini adalah uji klinis fase III, "Open" (Open Randomized Clinical Trial), yang dilakukan secara acak dengan membandingkan dua jenis KB implan, yaitu levonorgestrel implan, satu batang dengan dua batang. Penelitian ini dilakukan di RSAB Rika Amelia Palembang. Waktu penelitian adalah 6 bulan dari November 2018 - April 2019 atau hingga jumlah sampel terpenuhi.Hasil :Berdasarkan waktu pemasangan didapatkan rerata waktu pemasangan yang menggunakan LNG satubatangadalah 1,54±0,11 menitdanpada LNG dua batang adalah 2,49±0,26 menit. Mayoritas pasien memiliki tekanan darah yang normal 89.5% pada LNG satu batang dan 68.4% pada LNG dua batang. Rerata indeks massa tubuh (IMT) responden yang menggunakan implan LNG satu batang sebesar 24,19 ± 3,93 kg/m2 dan LNG dua batang sebesar 25,09 ± 6,11 kg/m2. Berdasarkan pola haid, didapatkan sebanyak 84,2% subjek yang memiliki pola haid teratur pada kelompok LNG satu batang, sedangkan terdapat sebanyak 63,2% subjek yang memiliki pola haid tidak teratur. Dari uji statistik didapatkan bahwa tidak terdapat perbedaan kadar kolesterol (p = 0,919), HDL (p = 0,793), LDL (p = 0,851) dan trigliserida (p = 0,679). Tidak terdapat perbedaan kadar FSH antara responden yang menggunakan implan LNG satu batang dan dua batang (p = 0,849) dan juga pada estradiol (p=0.099)Kesimpulan: Tidak terdapat perbedaan antara penggunaan implan levonorgestrel satu batang dan dua batang terhadap kadar FSH, Estradiol serta peningkatan profil lipid setelah 3 bulan pemasangan implan. Efek yang tidak menyenangkan dalam penelitian ini adalah terjaidnya penurunan HDL, namun hal ini disertai dengan penurunan berat badan, kolesterol total, LDL, HDL dikarenakan terjadi penurunan pada seluruh aspek.Kata Kunci: dua batang, estradiol, FSH, kontrasepsi implan, lenovorgestrel, profil lipid, satu  batang. &nbsp

Effects of Metformin Therapy on Anti-Mullerian Hormone (AMH) Levels in Polycystic Ovary Syndrome Patients with Insulin Resistance at Palembang

Anti-Mullerian Hormone is useful in examining folliculogenesis and ovarian abilities. Previous research found that follicular fluid and serum in PCOS women containing high AMH levels. As therapy in PCOS with insulin resistance, metformin, an insulin sensitizer agent can be given. The efficacy of metformin therapy in inducing ovulation is more due to the local action of metformin on the ovaries rather than the systemic improvements that result both metabolically and hormonally. We conducted this study to evaluate the levels of Anti-Mullerian Hormone (AMH) in women with polycystic ovarian syndrome (PCOS) with insulin resistance before and after metformin therapy. An analytic observational study with cross-sectional design. Seventy PCOS women with insulin resistance, taking metformin for 3 months, were enrolled in this study. Serum levels of AMH was assessed before and after treatment, and the difference between them was analyzed with student t-test. Diagnosis of PCOS is made based on Rotterdam criteria and insulin resistance by HOMA-IR calculation. This study was conducted at the Fertility and Reproductive Endocrinology Polyclinic of Dr. Mohammad Hoesin Palembang hospital and Imaya clinic. The mean age of PCOS patients with insulin resistance ranges from 25-30 years, with a mean age of 28.61±3.883. The mean AMH levels prior metformin therapy was 7.6957±0.6001 ng/ml; mean AMH after therapy was 7.5914±0.57678 ng/ml; and there are significant differences (p <0.001). The mean AMH levels in all patients were 0.10429. Based on body mass index (BMI), a total of 52 respondents (74.29%) met the criteria for obesity and 18 respondents (25.71%) nonobese. There is a relationship between AMH levels and the number of follicles (p <0.01), with an OR of 1.5. AMH levels decreased significantly after metformin therapy in PCOS patients with insulin resistance

Effectiveness, Safety and Obedience of Dienogest and Leuprolide Acetate in Postlaparoscopic Endometriosis Patients: Efektivitas, Keamanan dan Kepatuhan terhadap Dienoges dan Leuprolide Asetat pada Pasien Endometriosis Pascalaparoskopi

Abstract Objective: Comparing therapeutic effectiveness, safety profile, and adherence between Dienogest and postoperative Leuprolide Acetate in women with endometriosis who underwent laparoscopy. Methods: This study was a randomized clinical trial comparing the open label study to compare the effectiveness of therapy, safety profile, and obedience between postoperative dienogest and leuprolide acetate in women with endometriosis who underwent laparoscopy. Result: From the statistical test it was found that there was effectiveness of dienogest after 4 weeks of therapy (p = 0.004), after 8 weeks of therapy (p = 0.004) and after 12 weeks of therapy (p = 0.004). In the leuprolide acetate group it was also found that there was effectiveness of administration after 4 weeks of therapy (p = 0.004), after 8 weeks of therapy (p = 0.004) and after 12 weeks of therapy (p = 0.003). There was no difference in systolic blood pressure (p = 0.481), diastolic blood pressure (p = 1,000) and pulse frequency (p = 0.125) breath frequency (p = 1,000) and temperature (p = 0.236) between patients who received dienogest and leuprolide acetate. From the statistical analysis it was found that there were no differences in side effects in patients who received dienogest and leuprolide acetate (p = 0.238). Conclusion: There was no difference in therapeutic effectiveness, and the safety profile assessed by side effects as well as obedience of postoperative Dienogest and Leuprolide Acetate in endometriosis women undergoing Laparoscopy because in both groups there was a decrease in VAS scores from week to week. Key Word: Dienogest, Leuprolide Acetate, Endometriosis, Post-Laparoscopy, Therapy &nbsp; Abstrak Tujuan: Membandingkan efektivitas terapi, profil keamanan, dan kepatuhan antara Dienogest dengan Leuprolid Asetat pascaoperatif pada wanita endometriosis yang menjalani Lapararoskopi. Metode: Penelitian ini merupakan uji klinik acak berpembanding dengan open label study untuk membandingkan efektivitas terapi, profil keamanan, dan kepatuhan antara dienogest dan leuprolid asetat pascaoperatif pada wanita endometriosis yang menjalani lapararoskopi. Hasil: Dari uji statistik didapatkan hasil terdapat efektivitas pemberian dienogest setelah 4 minggu terapi (p = 0,004), setelah 8 minggu terapi (p = 0,004) dan setelah 12 minggu terapi (p = 0,004). Pada kelompok leuprolid asetat juga didapatkan hasil terdapat efektivitas pemberian setelah 4 minggu terapi (p = 0,004), setelah 8 minggu terapi (p = 0,004) dan setelah 12 minggu terapi (p = 0,003).&nbsp; Tidak terdapat perbedaan tekanan darah sistolik (p = 0,481), tekanan darah diastolik (p = 1,000) dan frekuensi nadi (p = 0,125) frekuensi napas (p = 1,000) dan suhu (p = 0,236) antara pasien yang mendapatkan dienogest dan leuprolid asetat. Dari analisa statistik didapatkan hasil tidak terdapat perbedaan efek samping pada pasien yang mendapatkan dienogest dan leuprolid asetat (p = 0,238). Kesimpulan: Tidak terdapat perbedaan efektivitas terapi, dan profil keamanan yang dinilai dari efek samping serta kepatuhan Dienogest dan Leuprolid Asetat pascaoperatif pada wanita endometriosis yang menjalani Lapararoskopi karena pada kedua kelompok terdapat penurunan VAS skor dari minggu ke minggu. &nbsp

Compatibility between Menstrual Pictogram Assessment and Haemoglobin Assessment in Abnormal Uterine Bleeding: Uji Kesesuian Pemeriksaan Piktogram Menstruasi dengan Pemeriksaan Hemoglobin pada Pasien Perdarahan Uterus Abnormal

Objective: To determine the amount of wasted blood and diagnosedAUB and determine amount of decrease in haemoglobinlevels by adjusting the examination of menstrual pictogramwith haemoglobin.Methods: Diagnostic test was conducted in the DepartmentObstetrics and Gynecology Dr. Mohammad Hoesin/Faculty ofMedicine Universitas Sriwijaya Palembang, start from January 2015through January 2017. Sample was obtained from 39 patients withabnormal uterine bleeding who meet the inclusion and exclusioncriteria. Frequency and distribution of data are described in tablesand cross analyze (cut-off point) to find cut points differencemenstrual pictogram and a decrease in haemoglobin levels usingROC curve. Accuracy is measured by the value of Kappa. Dataanalysis using SPSS version 21.Results: From 39 samples that obtained, majority characteristicsage &gt; 35 years (59%), ideal BMI (59%) and multiparous(48.7%). From statistical analysis, there was significanceassociation between haemoglobin measurement toolsand menstrual pictogram (p = 0.063). Both measuring deviceshave compatibility in predicting the type of AUB (p = 0.047),with the degree of conformity is weak (Kappa = 0.232).Conclusion: Accuracy of menstrual pictogram examination andhaemoglobin has a weak degree of conformity, so menstrualpictogram examination can’t be used to determine a decrease inhaemoglobin levels. Menstrual pictogram menstruation only usedas an evaluation of therapeutic response.[Indones J Obstet Gynecol 2018; 6-3: 172-178]Keywords: abnormal uterine bleeding, haemoglobin, menstrual pictogra

Effectiveness, Safety, and Side Effect of Depo Progestin and Depo Vigestron Contraception

Introduction: Trends in contraceptive injections increased in the last two decades. Hormonal contraceptive injection is available in single or combination dose. However, the products are available more than 1 ml (more than recommendation of WHO). This study aims to determine the effectiveness, safety and side effects of the contraceptive injection Depo Progestin® 3 ml, Depo Vigestron® 3 ml and Depo Vigestron® 1 ml. Method: This study used randomized controlled clinical trial and open label. The research subject were 900 people in two center, Surabaya and Palembang. The samples were divided into 3 (three) groups, group Depo Progestin® vial 3 ml, group Depo Vigestron® vial 3 ml, and group Depo Vigestron® vial 1 ml. Each of consist 300 women using the "random permutation block". Analysis was performed 5 times, when an initial injection and a schedule of repeated injections in the 3rd, 6th, 9th and 12th month. The data analyzed include weight, blood pressure, menstrual pattern, and the complaints of the patients. Results: From the 900 only 862 valid samples. The results showed no signi fi cant difference between groups Depo Progestin® 3ml, Depo Vigestron® 3 ml and Depo Vigestron® 1 ml. The majority of respondents experienced an increase in weight, but still within normal limits, did not have increased blood pressure, increased menstrual blood volume, Pregnancy didn\u27t occured to all respondents and found no abnormalities in cervical cytology. Conclusion: Contraceptive injection of Depo Progestin® 3 ml, Depo Vigestron® 3 ml dan Depo Vigestron® 1 ml, have used during 12 months can be concluded that those tree kind of contraception were efective, safe and had no side effect

A Randomized FiveYear Comparative Study of Two LevonorgestrelReleasing Implant Systems: Norplant® Capsules and Jadena® Rods

Objective: To provide a randomized comparison between Jadena® and Norplant® in terms of efficacy and acceptability among Indonesian women. Method: This study was a phase IV, open label, randomized, multicenter study throughout Indonesia. Subjects were Indonesian adult women who were randomized to receive Jadena® or Norplant® as their contraceptive method. The subjects were recruited from 6 large cities in Indonesia, such as Medan, Palembang, Jakarta, Semarang, Surabaya, and Makassar. Result: Of 600 subjects, 301 women getting to Jadena® and 299 women to Norplant® were enrolled between August 1998 and February 1999. The mean age was 29.8 (SD 5.3) years old, ranging from 18 to 40 years old. We did not find the pregnancy during the study. Non-pregnancy probability at the end of one year was similar between Jadena® (0.920 (SD 0.016)) and Norplant® users (0.916 (SD 0.084)). The continuation rates of Jadena® at one and three-year were 95.3% and 66.8%; whereas, the continuation rates of Norplant® was 94.3% at year-1 and 70.2% at year-3. Conclusion: The new two rod levonorgestrel subdermal system (Jadena®) showed similar efficacy with the old six capsule levonorgestrel subdermal system (Norplant®) in term of birth control. Both implant systems also have similar tolerability profile. Jadena® is easier to insert and remove than Norplant®. Keywords: birth control, efficacy, implan

ANALISIS INTERLEUKIN-1, INTERLEUKIN-6, MATRIX METALLOPROTEINASE-13, TUMOR NECROSIS FACTOR-, PROSTAGLANDIN DAN RESEPTOR PROGESTERON PADA ENDOMETRIUM AKSEPTOR ALAT KONTRASEPSI DALAM RAHIM CuT 380ª

Menstrual pattern disorder such as heavy and prolonged cyclic menstrual bleeding in contraceptive IUCD CuT 380A acceptors in which underlying factors has not been completely yet understood. Presumably, There is a change in endometrial line, cytokine expression and activity and protease in IUCD CuT 380A acceptors endometrium. Objective: the objective of this study is to analyze the expression of IL-1, IL-6, TNF-, MMP-13, prostaglandin, progesterone in the endometrium of IUCD CuT 380A acceptors and normal women. Results: according to study analysis found that IL-1 of bleeding IUCD CuT 380A acceptors was higher than control group (p=0,000). In non-bleeding IUCD CuT 380A suggested no significant difference compared to non-bleeding control group (p=0,067). IL-6 of bleeding IUCD CuT 380A acceptors was higher than non-bleeding IUCD CuT 380A acceptors (p=0,000). IL-6 of non-bleeding IUCD CuT 380A acceptors is not different from bleeding-control (0,594). TNF- of IUCD CuT 380A acceptors was higher than control group (p=0.000). In non-bleeding IUCD CuT 380A acceptors suggested no difference in TNF- of non-bleeding control group (p=0.406). MMP-13 of bleeding IUCD CuT 380A acceptors was higher than control group (p=0,000). In non-bleeding IUCD CuT 380A acceptors, MMP was not different from bleeding control group (p=0,868). Prostaglandin of bleeding IUCD CuT 380A acceptors was higher than control group, in non-bleeding IUCD CuT 380A acceptors suggested that there was mean difference of prostaglandin in control group (0,009). Progesterone receptor in bleeding IUCD CuT 380A acceptors was lower than control (p=0,017), in IUCD CuT 380A acceptors was not different from bleeding IUCD CuT 380A acceptors group (p=1.000). Conclusion: it is suggested that the increased expression of IL-1, IL-6, TNF-, MMP-13, prostaglandin, in bleeding IUCD CuT 380A acceptors. There was not difference in expression of progesterone receptor in either bleeding or non-bleeding IUCD CuT 380A acceptors. Increased IL-6 contribute to the occurrence of menorrhagia in IUCD acceptors CuT 380A. Endometrial progesterone receptor is a protective factor against the occurrence of menorrhagia

Sensitivity and Specificity of Vascular Endothelial Growth Factor A (VEGF-A) against Endometriosis

Background.&nbsp; Endometriosis is a benign disorder defined by the presence of endometrial glands and stroma outside the uterus. Endometriosis occurs in 10-15% of women during their reproductive years. Angiogenesis and the inflammatory response are important factors in the development of endometriosis. The formation of a new blood supply is a crucial step in the formation of endometrial lesions. Angiogenesis is induced by a growth factor peptide, namely vascular endothelial growth factor A (VEGF-A). VEGF-A is known as a vascular permeability factor that plays an important role in the pathological angiogenesis process and is a more specific and prominent angiogenesis factor among the VEGF family. The purpose of this study was to determine the sensitivity and specificity of examination&nbsp;&nbsp;&nbsp; VEGF-A&nbsp;&nbsp; of menstrual blood in diagnosing endometriosis compared to laparoscopy. Methods. This diagnostic test research has been carried out at the gynecology polyclinic, especially the division of Fertility, Endocrinology and Reproduction, Faculty of Medicine, Sriwijaya University- Dr. Central General Hospital. Mohammad Hoesin from August to November 2018, there were 45 patients who met the inclusion criteria. VEGF-A examination in instrumental blood based on ELISA examination. Data analysis to measure sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy using Medcalc statistics. Results. From the results of this study, it is known that the majority of the study samples were aged 31.69 years (24-38 years) 75.6%, body mass index (BMI) 51.1% with normal BMI, experienced infertility by 82.2% of the sample, most of the samples did not smoke (95.6%) and most experienced mild pain 55.6% using the VAS pain scale. From this study, it is known that 84.4% or 38 of the study samples had endometriosis with a cut off point value of VEGF-A &gt; 347 pg/mL. From the results of this study, it is known that the sensitivity of VEGF-A in diagnosing endometriosis is 84.2%, specificity is 85.7%, positive predictive value is 97%, negative predictive value is 50% and accuracy is 84%. Conclusion. VEGF-A menstrual blood can be used as a diagnostic tool for endometriosis

The Correlation Between CYP19 Levels, VAS of Dysmenorrhea, and the Grading Score ASRM of Endometriosis

Objective: We aim to assess the correlation between the CYP19 level, the visual analogue scale (VAS) pain and endometriosis American Society for Reproductive Medicine (ASRM)  grading scale.Method: An observational analytic study with a cross–sectional design was conducted at the Obstetrics/Gynecology Department, RSUP Dr. Moh Hoesin Palembang, Laboratory of Biomedical and Biomolecular of the Faculty of Medicine, Universitas Sriwijaya from July–December 2022. Subjects who were diagnosed with endometriosis and met the inclusion and exclusion criteria underwent a histopathological examination to measure the degree of disease according to ASRM. Using the same sample, the CYP19 levels were assessed by enzyme linked immunosorbent assay (ELISA). Univariate and bivariate statistical analyses were performed to see the correlation.Results: This study involved 37 subjects aged 20–48 (Mean: 32 years). We found there was a significant correlation between the degree of VAS score and ASRM grading (p<0.001). In addition, although CYP19 expression was found in ectopic endometrial tissue, there was no significant correlation between the level of CYP19 expression in the tissue and the VAS score dysmenorrhea (p= 0,618) and ASRM grading (p=0.604).Conclusion: There is no significant correlation between CYP19 levels and the degree of pain in VAS or ASRM grading in patients.Hubungan Kadar CYP19, Visual Analogue Score (VAS) Dismenorea, dan Grading Score American Society for Reproductive Medicine (ASRM) Endometriosis Abstrak    Tujuan: Penelitian ini bertujuan untuk menilai hubungan kadar CYP19, skala nyeri visual analogue scale (VAS) dan grading berdasarkan American Society for Reproductive Medicine (ASRM) pada pasien endometriosis.Metode: Sebuah studi analitik observasional dengan rancangan cross–sectional dilakukan di Bagian/KSM Obstetri Ginekologi, RSUP Dr. Moh Hoesin Palembang dan Laboratorium Biomedis dan Biomolekuler Fakultas Kedokteran Universitas Sriwijaya, pada periode Juli–Desember 2022. Subjek penelitian yang terdiagnosis endometriosis dan memenuhi kriteria inklusi dan eksklusi, dilanjutkan pemeriksaan histopatologis untuk mengukur derajat penyakit sesuai rASRM. Dengan menggunakan sampel yang sama dilakukan penilaian kadar CYP19 melalui pemeriksaan enzyme linked immunosorbent assay (ELISA). Analisis statistik univariat dan bivariat dilakukan untuk melihat hubungan tersebut. Hasil: Penelitian ini melibatkan 37 subjek dengan rentang usia 20–48 (Median: 32 tahun). Pada penelitian, terdapat hubungan yang bermakna antara derajat nyeri VAS endometriosis terhadap derajat endometriosis (p<0,001). Selain itu, walaupun ditemukan adanya ekspresi CYP19 pada jaringan endometrium ektopik, namun tidak terdapat hubungan yang bermakna antara tingkat kadar CYP19 pada jaringan dengan derajat VAS score dismenorea (p=0,618) dan derajat ASRM endometriosis (p=0,604).Kesimpulan: Tidak terdapat hubungan bermakna antara kadar CYP19 dengan derajat nyeri VAS maupun derajat ASRM endometriosis pada pasien.Kata kunci: ASRM, Kadar CYP19, Endometriosi

Effects of Combined Laparoscopic Cystectomy and Leuprolide Acetate Therapy on Anti-Mullerian Hormone Level and Antral Follicle Count Profile in Endometriosis

Objective: This study examines the effectiveness of combined laparoscopic cystectomy and leuprolide acetate therapy on AMH level and AFC profile in endometriosis.Method: This study is a randomized controlled clinical trial with open label form. The subjects were divided into control and therapy groups, with the therapy group receiving leuprolide acetate injection following laparoscopic cystectomy. In both groups, the AMH levels and AFC were examined prior to the surgery and six weeks after before they were compared.Results: There were significant pre-post differences of AMH levels(p = 0.000) and AFC (p = 0.000) in the therapy group but not in the control group. In the therapy group, the mean increases of AMH level and AFC were 0.94 (95% CI: 0.63-1.25) and 9.53 (95% CI: 6.83-12.24), respectively. Linear regression model found that AFC level prior to intervention was a significant predictor of endometriosis ASRM grade (p = 0.001) with an R-value of 0.633, suggesting strong correlation.Conclusion: The combined therapy of laparoscopic cystectomy and leuprolide acetate injection for endometriosis provided better outcome concerning ovarian reserve, as opposed to the therapy with laparoscopic cystectomy alone. Peran Kombinasi Laparoskopi Kistektomi dan Terapi Leuprolide Asetat Terhadap Kadar Hormon Anti-Mullerian dan Profil Jumlah Folikel Antral pada Penderita EndometriosisAbstrakTujuan:Studi ini bertujuan menguji keefektifan kombinasi kistektomi laparoskopi dan terapi leuprolide acetate terhadap kadar AMH dan profil AFC pasien endometriosis.Metode: Penelitian ini merupakan uji klinis terkontrol acak dengan bentuk open label. Subjek dibagi menjadi kelompok kontrol dan terapi, dengan kelompok terapi menerima injeksi leuprolide acetate setelah kistektomi laparoskopi. Pada kedua kelompok, kadar AMH dan AFC diperiksa sebelum pembedahan dan enam minggu setelahnya sebelum kemudian dibandingkan.Hasil: Terdapat perbedaan bermakna kadar AMH (p = 0,000) dan AFC (p = 0,000) sebelum dan sesudah pada kelompok terapi tetapi tidak pada kelompok kontrol. Pada kelompok terapi, rata-rata peningkatan kadar AMH dan AFC adalah masing-masing 0,94 (95% CI: 0,63-1,25) dan 9,53 (95% CI: 6,83-12,24). Model regresi linier menemukan bahwa kadar AFC sebelum intervensi merupakan prediktor signifikan derajat endometriosis sesuai ASRM (p = 0,001) dengan nilai R sebesar 0,633 yang menunjukkan korelasi yang kuat.Kesimpulan: Terapi kombinasi kistektomi laparoskopi dan injeksi leuprolide acetate untuk endometriosis memberikan hasil yang lebih baik terhadap cadangan ovarium, dibandingkan dengan terapi dengan kistektomi laparoskopi saja.Kata kunci: endometriosis; leuprolide acetate; kistektomi; hormon anti-mullerian; jumlah folikel antra