Hubungan peningkatan kadar progesteron pada saat pengambilan oosit terhadap keberhasilan Fertilisasi In Vitro
Martha Chaterince Silitonga(1*), Shofwal Widad(2), Ova Emilia(3)
(1) Departemen Obstetri dan Ginekologi, FK-KMK,UGM
(2) Departemen Obstetri dan Ginekologi, FK-KMK,UGM
(3) Departemen Obstetri dan Ginekologi, FK-KMK,UGM
(*) Corresponding Author
Abstract
Latar belakang:Fertilisasi In Vitro (FIV) semakin banyak digunakan dalam penanganan infertilitas di Indonesia. Banyak penelitian yang mempelajari pengaruh peningkatan kadar progesteron saat pengambilan oosit dalam keberhasilan FIV, namun hasil yang diperoleh masih bersifat kontroversi.
Tujuan: Mengetahui hubungan peningkatan kadar hormon progesteron saat pengambilan oosit dengan keberhasilan FIV.
Metode: Penelitian ini menggunakan metode kohort retrospektif melibatkan 210 siklus FIV dari Januari 2014 sampai Desember 2016. Subyek penelitian dibagi menjadi dua kelompok berdasarkan kadar progesteron saat pengambilan oosit. Kelompok pertama dengan kadar progesteron < 12 ng/ml sebanyak 151 subyek, sedangkan 59 lainnya masuk dalam kelompok dengan kadar progesteron ≥12 ng/ml. Luaran kehamilan dinilai dengan mengukur kadar hormon β-hCG.
Hasil dan Pembahasan: Didapatkan hasil bahwa tidak ada perbedaan bermakna untuk luaran kehamlan antara kelompok dengan kadar progesteron rendah dan kadar progesteron tinggi (25,8% VS 23,7%; RR 0,67 IK 0,29-1,56, p>0,05). Pada analisis bivariat, terdapat peningkatan signifikan dari kadar estradiol pasca stimulasi dan jumlah folikel (RR 2,00 IK 1,57-2,55, p<0,0001 dan RR 1,86, IK 1,47-2,36, p<0,0001); jumlah oosit (RR 1,99, IK 1,61-2,48, p<0,0001), dan jumlah embrio (RR 1,99 IK 1,62-2,43; p<0,0001) pada kelompok dengan kadar progesteron tinggi. Dari analisis multivariat, peningkatan jumlah oosit merupakan satu – satunya faktor yang secara signifikan meningkatkan rasio kehamilan pada FIV (RR 3,36 IK 1,04-10,87; p<0,05).
Kesimpulan:Pada penelitian ini tidak terdapat perbedaan signifikan rasio kehamilan pada FIV dengan peningkatan kadar hormon progesteron pada pengambilan oosit. Jumlah oosit yang dipanen secara signifikan meningkatkan keberhasilan kehamilan pada FIV, dan jumlah oosit juga signifikan meningkat pada kelompok dengan kadar progesteron tinggi.
Kata kunci: progesteron; oosit; Fertilisasi In Vitro
Keywords
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DOI: https://doi.org/10.22146/jkr.64359
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