Hubungan peningkatan kadar progesteron pada saat pengambilan oosit terhadap keberhasilan Fertilisasi In Vitro

https://doi.org/10.22146/jkr.64359

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


progesteron; oosit; Fertilisasi In Vitro

Full Text:

PDF


References

  1. Fritz MA, Speroff L. Female infertility. In: Clinical Gynecologic Endocrinology and Infertility. 8th editio. Philadelphia: Lippincott Williams and Wilkins; 2011. p. 1137–90.
  2. Soebijanto S, Muharam R. Fertilisasi In Vitro dan Transfer Embrio. In: Samsulhadi, Herndarto H, editors. Aplikasi Klinis Induksi Ovulasi dan Stimulasi Ovarium. Bandung: Sagung Seto; 2009. p. 111–24.
  3. PERFITRI. Arah dan kebijakan PERFITRI 2016-2019 [Internet]. 2015. p. 1–51. Terdapat pada situs di: http://iwww.ia-ivf.org/publication/documentation
  4. Hiferi-Perfitri-Permi. Profil ART dan angka keberhasilannya [Internet]. 2016. Terdapat pada situs: http://sisterindo.org/profil-art-dan-angka-keberhasilannya/
  5. Salehnia M, Zavareh S. The effects of progesterone on oocyte maturation and embryo development. Fertil Steril. 2013;7(2):74–81.
  6. Al-Azemi M, Kyrou D, Kolibianakis EM, Humaidan P, Van Vaerenbergh I, Devroey P, et al. Elevated progesterone during ovarian stimulation for IVF. Reprod Biomed Online. 2012;24:382–8.
  7. Li R, Qiao J, Wang L, Zhen X, Lu Y. Serum progesterone concentration on day of HCG administration and IVF outcome. Reprod Biomed Online. 2008;16(5):627–31.
  8. Bosch E, Labarta E, Crespo J, Simón C, Remohí J, Jenkins J, et al. Circulating progesterone levels and ongoing pregnancy rates in controlled ovarian stimulation cycles for in vitro fertilization: analysis of over 4000 cycles. Hum Reprod. 2010;25(8):2092–100.
  9. Venetis CA, Kolibianakis EM, Bosdou JK, Tarlatzis BC. Progesterone elevation and probability of pregnancy after IVF: a systematic review and meta-analysis of over 60000 cycles. Hum Reprod Updat. 2013;19(5):433–57.
  10. Kolibianakis EM, Venetis CA, Bontis J, Tarlatzis BC. Significantly lower pregnancy rates in the presence of progesterone elevation in patients treated in GnRH antagonists and gonadotropins: A systematic review and meta-analysis. Curr Pharm Biotechnol. 2011;13(3).
  11. Nayak S, Ochalski ME, Fu B, Wakim KM, Chu TJ, Dong X, et al. Progesterone level at oocyte retrieval predicts in vitro fertilization success in a short-antagonist protocol: a prospective cohort study. Fertil Steril. 2014;101(3):33–5.
  12. Andersen CY, Bungum L, Andersen AN, Humaidan P. Preovulatory progesterone consentration associates significantly to follicle number and LH concentration but not to pregnancy rate. Reprod Biomed Online. 2011;(23):187–95.
  13. Xu B, Li Z, Zhang H, Jin L, Li Y, Ai J, et al. Serum progesterone level effects on the outcome of in vitro fertilization in patients with different ovarian response: An analysis of more than 10,000 cycles. Fertil Steril. 2012;97(6):1321–7.
  14. Shechter A, Lunenfeld E, Potashnik G, Glezerman M. The significance of serum progesterone levels on the day of hCG administration on IVF pregnancy rates. Gynecol Endocrinol. 1994;8(2):89–94.
  15. Elnashar AM. Progesterone rise on the day of HCG administration (premature luteinization) in IVF: an overdue update. J Assist Reprod Genet. 2010 Apr;27(4):149–55.
  16. Duleba AJ, Hausman N, Jones EE, Olive DL. Preretrieval predictors of pregnancy in IVF. J Assist Reprod Genet. 1997;14(4):205–11.
  17. Dovey S, McIntyre K, Jacobson D, Catov J, Wakim A. Is a premature rise in luteinizing hormone in the absence of increased progesterone levels detrimental to pregnancy outcome in GnRH antagonist in vitro fertilization cycles. Fertil Steril. 2011;96(3):585–9.
  18. Zhu H, Liu L, Yang L, Xue Y, Tong X, Jiang L, et al. The effect of progesterone level prior to oocyte retrieval on the numbers of oocytes retrieved and embryo quality in IVF treatment cycles: an analysis of 2,978 cycles. J Assist Reprod Genet [Internet]. 2014 Sep [cited 2015 Sep 9];31(9):1183–7.
  19. Donarini G, Omodei U, Falllo L, Dordoni D, Tombesi S, Suss G. Serum progesterone level on the day of oocyte retrieval correlates with the ovarian response but not predict pregnancy rate. Fertil Steril. 2010;(A):390.
  20. Niu Z, Feng Y, Zhang A, Sun Y, Zhang H. Progesterone levels on oocyte retrieval day can predict the quantity of viable embryos but not pregnancy outcome of intracytoplasmic sperm injection. Gynecol Endocrinol. 2008;24:452–458.
  21. Achache H, Revel A. Endometrial receptivity markers , the journey to successful embryo implantation. Hum Reprod Updat. 2006;12(6):731–46.
  22. Gardner DK, Rizk BRM., Tommaso F, editors. Human Assisted Reproductive Technology: Future Trends in Laboratory and Clinical Practice. Cambridge: Cambridge University Press; 2011.
  23. Van Loendersloot LL, Van Wely M, Limpens J, Bossuyt PMM, Repping S, van der Veen F. Predictive factors in in vitro fertilization (IVF): a systematic review and meta-analysis. Hum Reprod Updat. 2010;16(6):577–89.
  24. Sastroasmoro S, Aminullah A, Munazir Z, Rukan Y. Dasar-dasar metodologi penelitian klinis. 5th ed. Sastroasmoro S, Ismael S, editors. Jakarta: Saung Seto; 2016. 301-327 p.
  25. Zhu H, Liu L, Yang L, Xue Y, Tong X, Jiang L, et al. The effect of progesterone level prior to oocyte retrieval on the numbers of oocytes retrieved and embryo quality in IVF treatment cycles: an analysis of 2,978 cycles. J Assist Reprod Genet. 2014;31(9):1183–7.
  26. Liu L, Zhao L, Li TC, Zhu H, Lin X, Jin X, et al. Comparison of progesterone measurement on day of, and day after, HCG administratiion in IVF-embryo transfer cycles. Reprod Biomed Online. 2014;12(1):23–30.
  27. Martinez F, Rodriguez I, Devesa M, Buxaderas R, Gómez MJ, Coroleu B. Should progesterone on the human chorionic gonadotropin day still be measured? Fertil Steril. 2016;105(1):86–92.



DOI: https://doi.org/10.22146/jkr.64359

Article Metrics

Abstract views : 2464 | views : 9396

Refbacks

  • There are currently no refbacks.


Copyright (c) 2021 The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Jurnal Kesehatan Reproduksi Indexed by:

 

 



SEKRETARIAT JURNAL KESEHATAN REPRODUKSI
Departemen Obstetri dan Ginekologi, FK-KMK, UGM/RS Dr. Sardjito
Jl. Kesehatan No. 1, Sekip Utara, Yogyakarta 55281
Tlp: (0274) 511329 / Faks: (0274) 544003
Email: jurnal.kesehatanreproduksi@ugm.ac.id
Cp: Dwi Astuti +6281802698043