Keluhan perdarahan endometrium merupakan efek samping utama yang menjadi alasan akseptor KB susuk menghentikan cara KB yang dipergunakannya. Hal ini merupakan problem penting bagi Program Keluarga Berencana Nasional. Penyebab perdarahan endometrium ini mungkin karena adanya gangguan proses regenerasi jaringan endometrium, termasuk juga gangguan proses angiogenesis.Tujuan dari penelitian ini adalah untuk mengetahui aktivitas angiogenik endometrium peserta KB susk dengan dan tanpa perdarahan. Diharapkan dari hasil penelitian ini dapat mengembangkan cara terapi non hormonal pada perdarahan endometrium.Subyek diambil dari akseptor KB susuk dan telah menggunakan KB susuk selama 3-9 bulan. Untuk pemeriksaan angiogenesis digunakan metoda Folkman. Eksplan endometrium ditanam dalam matriks gel kolagen 3 dimensi yang berisi sel endotel dari umbilikalis manusia dan ditanam selama 96 jam. Potensi aktivitas angiogenik diukur dengan derajat migrasi sel endotel menuju eksplan ( skor 0 - 4 ). Kadar plasma estrogen, progesteron dan SHBG dimonitor selama 2 minggu sebelum biopsi.Telah diperiksa aktivitas angiogenik dari 26 kontrol dan 46 akseptor. Hasilnya menunjukkan skor aktivitas angiogenik dari kontrol lebih tinggi peserta KB susuk. ( skor 1 hampir 0 dengan p C 0,001 ). Skor aktivitas angiogenik pada akseptor dengan perdarahan lebih rendah dari akseptor tanpa keluhan perdarahan, namun perbedaan ini tak bermakna. Kadar plasma estrogen, progesteron tidak mempunyai korelasi yang bermakna dengan aktivitas angiogenik endometrium.

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The Effect Of Vitamin E On Endometrial Angiogenic Response In Implant Contraceptive Users With Bleeding ProblemsThe bleeding problems can be one of the major reason for acceptors discontinuing the use of hormonal contraceptives. The cause of endometrial bleeding may be the disturbances of endometrial regeneration and also the disturbances of angiogenic process.

The aim of this study is to look for the differences in endometrial angiogenic activity from women using Implant contraceptives with and without bleeding. The results of this study may provide the basis for developing non hormonal therapy for patients with endometrial bleeding.

Subjects was selected from implant contraceptive acceptors and they have had an exposure 3-9 month to implant contraceptives. The Folkman method was applied in the angiogenesis assay. The endometrial explants were placed in a 3 dimensional collagen gel matrix containing suspended Human Umbilical Vein Endothelial Cells and culture for 96 hours. The potency of angiogenic activity was measure by the migration of the endothelial cells toward explants ( score 0 - 4 ). Blood serum levels of estrogen, progesteron and SHBG were monitored for 2 weeks prior to biopsy.

The endometrial angiogenic activity from 26 controls and 46 acceptors were measured. The results showed that the endometrial angiogenic activity from controls were significantly higher from Implant contraceptive acceptors (score 1 vs approximately 0 with p t 0,001). The endometrial angiogenic activity in acceptors with endometrial bleeding were lower than the acceptors without bleeding, but the differences was not significant. The plasma levels of estrogen and progesteron have no correlation with the endometrial angiogenic activity.