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"after the world witnessed groundbreaking early advances in assisted reproduction that utilized conventional in vitro fertilization in the human, more complex invasive techniques of oocyte and embryo manipulation were introduced to treat human subfertility. amongst these were numrous micromanipulation techniques such as partial zona dissection (PZD; 1988), subzonal insemination (SUZI, 1988) and subsequently ICSI, which became the most powelful tool of assisted fertilization (1992). ICSI requires micromanipulation of both the male and the female gamete. another importand approach is laser-assisted opening of the zona pellucida at different stages of preimplantation development either; to assist hatching (1990) or to remove cells for preimplantation genetic diagnosis (1989), or fragments to restore the integrity of an embryo (1999). sometimes even blastocysts considered for vitrification need further manipulation in order to artificially shrink the blastocoel which facilitates survival of expanded blastocyst (2002). other methods for reproductive purposes, however, failed to gain acceptance in population, such as cytoplasm transfer (1997), nuchler transfer (1998) and cloning (1996), to name but a few"

"Keberhasilan IVF-ICSI salah satunya dipengaruhi oleh tingkat pembelahan zigot hasil pembuahan dari sel telur dan sel sperma pasangan yang mengikuti program IVF-ICSI. Tingkat pembelahan zigot itu sendiri dipengaruhi oleh kualitas sel sperma dan sel ovum yang digunakan dalam program IVF-ICSI. Morfologi, konsentrasi, dan motilitas sperma merupakan parameter umum yang menjadi patokan dalam menentukan kualitas sperma dalam program IVF-ICSI. Namun, aspek kematangan dan kepadatan kromatin sperma yang juga berpengaruh pada kualitas sperma pun sangat perlu untuk diteliti apakah memiliki kaitan dengan tingkat keberhasilan pembelahan zigot pada program IVF-ICSI. Berdasarkan masalah tersebut, maka tujuan penelitian ini adalah untuk mengetahui hubungan antara kematangan dan kepadatan kromatin sperma dengan tingkat pembelahan zigot pada program IVF-ICSI. Jenis penelitian ini menggunakan metode observasional. Sampel semen berasal dari pasien yang mengikuti program IVF-ICSI di Klinik Infertilitas Yasmin RSCM Kencana (Juni-November 2013) yang memenuhi kriteria inklusi dan eksklusi. Jumlah sampel pada penelitian ini adalah 33. Sampel semen dibuat sedian hapus dan dipulas dengan pewarnaan biru anilin untuk mengetahui kematangan kromatin sperma dan dipulas dengan pewarnaan biru toluidin untuk mengetahui kepadatan kromatin sperma. Data primer diambil dari hasil observasi kematangan dan kepadatan kromatin sperma sedangkan tingkat pembelahan zigot dari pasangan infertil diambil dari data skunder yang berasal dari rekam medis. Selanjutnya dilakukan uji statistik dan uji korelasi dari data primer dan data sekunder yang telah didapatkan. Persentase rata-rata kematangan kromatin secara umum adalah 82,69 ± 7,42% sedangkan untuk kepadatan kromatin sperma adalah 83,27 ± 8,16%. Berdasarkan hasil analisa semen, sampel yang digunakan pada penelitian ini terdiri dari 23 sampel normozoospermia, 8 sampel oligo zoospermia, 1 sampel astenozoospermia dan 1 sampel oligoasteno zoospermia. Tingkat fertilisasi pada penelitian ini adalah 67,21 ± 21,06% dan tingkat pembelahan zigotnya adalah 51,47 ± 28,14%. Tidak terdapat hubungan antara kematangan dan kepadatan kromatin sperma dengan tingkat pembelahan sel pada program IVF-ICSI. Terdapat korelasi positif yang kuat dan signifikan (r = 0,739) antara kematangan kromatin sperma dengan kepadatan kromatin.

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One of successful ICSI is influenced by the level of cleavage zygote, as the product of conception sperm and ovum. The level of cleavage zygote is influenced by the quality of sperm and ovum that used in IVF-ICSI programmed. Morphology, concentration, and sperm motility are the general parameters as the standard in deciding the quality of sperm in IVF-ICSI programmed. But, the maturity aspect and the packaging of sperm chromatin are also important to be analyzed, whether it has correlation with the successful of the level of cleavage zygote in IVF-ICSI programmed. According to that case, the goal of this research is to analyze the correlation between the maturity and the packaging of sperm chromatin with the level of cleavage zygote in IVF-ICSI programmed.

The research is using observational prospective method. The semen sample that used in this research is taken from patient who participated in IVFICSI programmed in Yasmin Infertility Clinic RSCM Kencana (June- November 2013) who fulfills inklusi and ekslusi’s criteria. There are 33 people in total as the sample of this research. The semen sample was made a smear slide and stained with aniline blue to know the maturity of sperm chromatin and stained with toluidine blue to know the packaging of sperm chromatin. Primary data is taken from maturity and packaging of sperm chromatin’s observation. Whereas, the level of cleavage zygote is secondary data that is taken from medical record of infertility’s couple. Next step, is conducted statistic test and correlation test from primary and secondary data that has been collected.

The result of the research is showing that percentage of maturity chromatin is 82,69 ± 7,42%. Whereas, the packaging of sperm chromatin is 83,27 ± 8,16%. According to the result of semen analyzes, the sample that is used in this research consist of 23 samples of normozoospermia, 8 samples of oligozoospermia and 2 samples of astenozoospermia. The level of cleavage zygote is 51,47 ± 28,14%. There is no correlation between maturity and packaging sperm chromatin with the level of cleavage zygote in IVF-ICSI programmed. There is positive correlation between maturity of sperm chromatin and packaging of sperm chromatin with interpretation of strong and significant correlation (r=0,739)."

"This review article gives a brief history of the classical experiments that led to the development of the embryo culture medium and in vitro embryo culture. It proposes that, in view of the outstanding and significant pioneering contributions of Wesley Kingston Whitten to the development of embryo culture medium, he be considered the “Father of Embryo Culture Medium”. Furthermore, it describes the nutritional requirements of early embryos and how these requirements with specific references to carbohydrates, amino acids, phosphates, growth factors, etc, have been utilized to formulate increasingly more complex embryo culture media. This has led to the development of progressively more efficacious embryo culture media including the formulation of completely defined and synthetic protein-free embryo culture medium. The review also describes physical factors, growth factors, insemination methods for the fertilization of oocytes and culture methods affecting embryo growth, development, metabolism, oxygen embryotoxicity and survival. In procedural terms, the review also summarizes the evolution of embryo culture techniques from tube culture to, microdrop culture under oil to co-culture to ultra microdrop culture techniques. It includes techniques of in vitro maturation and for the selection of potentially viable embryos of various developmental stages"

"Latar Belakang: Dengan tingginya angka kasus infertilitas, terdapat beberapa teknologi yang dapat digunakan sebagai tata laksana. Salah satunya adalah teknologi Fertilisasi In Vitro (IVF), yang dilakukan dengan menstimulasi pasien dengan hormon FSH untuk mengembangkan lebih banyak oosit dan mengambil oosit tersebut setelahnya untuk menginduksi fertilisasi dengan sel sperma. Kualitas oosit dievaluasi dengan mengukur ekspresi oocytes-secreting factors yang salah satunya adalah gen BMP15. Penelitian ini dilaksanakan untuk melihat korelasi antara dosis rFSH dan ekspresi gen BMP15 pada pasien IVF. Tujuan: Mengetahui korelasi dosis rekombinan FSH terhadap ekspresi gen BMP15 sel granulosa pada pasien Fertilisasi In Vitro. Metode: Penelitian ini merupakan penelitian potong lintang yang dilaksanakan di Klinik Yasmin, Rumah Sakit dr. Cipto Mangunkusumo, Jakarta sejak bulan Juli 2019 hingga bulan Juli 2020. Terdapat 20 wanita berusia 25-40 tahun tanpa endometriosis dan Sindrom Ovarium Polikistik yang menjadi subjek penelitian ini. Pada pasien, dilakukan pengambilan cairan folikel dan kemudian dilakukan pengukuran ekspresi gen BMP15 pasien. Data ekspresi gen BMP15 kemudian dievaluasi dan diuji korelasinya dengan dosis rFSH menggunakan aplikasi SPSS. Hasil: Sebanyak 17 pasien IVF berpartisipasi dalam penelitian ini. Median jumlah ekspresi gen BMP15 adalah sebanyak 6.49 x 10-10 ng/ml dan rata-rata dosis rFSH yang diberikan pada pasien adalah sebanyak 2660.29±165.24. Berdasarkan hasil uji korelasi, terdapat korelasi positif antara dosis rFSH dan ekspresi BMP15 dengan signifikansi sedang (r = 0.419, p = 0.047). Kesimpulan: Terdapat korelasi positif dengan signifikansi sedang antara dosis rFSH dan ekspresi gen BMP15.

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Background: With the high number of infertility cases, there are technologies that are used as the management of infertility. One of them is in vitro fertilization, which is done by stimulating the patients to develop more oocytes using FSH hormones and taking the oocytes soon after to induce a fertilization with the sperm cells. We can evaluate the quality of the oocytes by measuring the expression of oocytes-secreting factors, one of which is the BMP15 gene. This study is conducted to see the correlation between the dose of rFSH and the expression of BMP15 genes in the IVF patients. Aim: To find out the correlation between the dose of recombinant FSH and the expression of BMP15 Gene in the Granulosa Cells of IVF Patients. Methods: A cross sectional study was held in Klinik Yasmin, Dr. Cipto Mangunkusumo General Hospital, Jakarta since July 2019 to July 2020. 20 women aged 25-40 years old without the conditions of endometriosis and PCOS participated in this study. Follicular fluids were taken from the patients and the BMP15 gene expression were measured. The data were then evaluated with the amount of rFSH using SPSS. Results: About 17 IVF patients were included in this study. The median amount of BMP15 gene expression was 6.49 x 10-10 ng/ml and the average amount of rFSH dose given to the patients was 2660.29±165.24. According to the correlation test, there was a positive correlation between the rFSH dose and the expression of BMP15 gene with medium significance (r = 0.419, p = 0.047). Conclusion: This study showed a positive correlation between the dose of rFSH given to the IVF patients and the expression of BMP15 gene in the granulosa cells."

"Infertilitas adalah gangguan reproduksi yang menyebabkan pasangan suami-istri sulit untuk mendapat kehamilan. Penatalaksanaan infertilitas dengan invasif adalah bayi tabung. Proses tindakan bayi tabung terdiri dari petik sel telur, preparasi sperma, inseminasi oosit, dan transfer embrio. Analisis tarif di rumah sakit semakin penting sejalan dengan kebijakan pengembangan contohnya tarif pelayanan Tindakan bayi tabung. Tarif yang berlaku dikaji dan dianalisis untuk dapat menyesuaikan dan rekomendasi tarif. Tujuan penelitian ini untuk menganalisis biaya satuan tarif tindakan bayi tabung di Morula IVF Pontianak Rumah Sakit Anugerah Bunda Khatulistiwa. Penelitian ini menggunakan pendekatan retrospektif. Desain penelitian ini dengan metode Metode Activity Based Costing (ABC). Hasil penelitian ini didapatkan besaran biaya satuan aktual untuk perhitungan unit cost tindakan In-Vitro Fertilization di Morula IVF Pontianak sebesar Rp 136.682.495,-, sedangkan biaya satuan normatif untuk perhitungan unit cost tindakan In-Vitro Fertilization di Morula IVF Pontianak sebesar Rp 117.578.928,-.

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Infertility is a reproductive disorder that makes it difficult for married couples to get pregnant. Invasive infertility treatment is IVF. The IVF procedure consists of ovum pick-up, sperm preparation, oocyte insemination, and embryo transfer. The analysis of rates in hospitals is increasingly important in line with development policies, for example, rates for IVF services. Applicable rate are reviewed and analyzed in order to be able to adjust and rates recommend. The purpose of this study was to analyze the unit cost of IVF treatment at the Morula IVF Pontianak Anugerah Bunda Khatulistiwa Hospital. This study uses a retrospective approach. This research design uses the Activity Based Costing (ABC) method. The results of this research showed that the actual unit cost for calculating the unit cost of the In-Vitro Fertilization procedure at Morula IVF Pontianak was IDR 136.682.495,00 for each procedure, while the normative unit cost for calculating the unit cost of the In-Vitro Fertilization procedure at Morula IVF Pontianak is IDR 117.578.928,00."

"after the world witnessed groundbreaking early advances in assisted reproduction that utilized conventional in vitro fertilization in the human, more complex invasive techniques of oocyte and embryo manipulation were introduced to treat human subfertility. amongst these were numrous micromanipulation techniques such as partial zona dissection (PZD; 1988), subzonal insemination (SUZI, 1988) and subsequently ICSI, which became the most powelful tool of assisted fertilization (1992). ICSI requires micromanipulation of both the male and the female gamete. another importand approach is laser-assisted opening of the zona pellucida at different stages of preimplantation development either; to assist hatching (1990) or to remove cells for preimplantation genetic diagnosis (1989), or fragments to restore the integrity of an embryo (1999). sometimes even blastocysts considered for vitrification need further manipulation in order to artificially shrink the blastocoel which facilitates survival of expanded blastocyst (2002). other methods for reproductive purposes, however, failed to gain acceptance in population, such as cytoplasm transfer (1997), nuchler transfer (1998) and cloning (1996), to name but a few."

"Fertilisasi invitro (FIV), atau yang biasa dikenal oleh masyarakat awam sebagai “program bayi tabung”, adalah metode Assisted Reproductive Therapy (ART) yang dilakukan saat metode lain untuk mengatasi masalah infertilitas telah mengalami kegagalan (end of the line treatment). Terapi ini menghabiskan banyak waktu, biaya, tenaga, serta digambarkan sebagai emotional roller-coaster bagi pasangan yang menjalaninya.Penelitian ini merupakan studi kuantitatif dan kualitatif untuk mengetahui fenomena psikologis yang terjadi pada pasangan suami istri dengan masalah infertilitas yang menjalani program FIV di Klinik Yasmin RSCM Kencana dan mengetahui bagaimana pasangan suami istri memaknai masalah infertilitas dan terapi FIV yang mereka jalani.Hasil penelitian menunjukkan bahwa gejala kecemasan merupakan gambaran yang paling banyak ditemukan. Pada uji statistik tidak didapatkan hubungan yang bermakna antara faktor demografi yaitu suku dan agama, durasi infertilitas, riwayat terapi FIV sebelumnya serta tahapan FIV yang sedang dijalani dengan adanya psikopatologi. Hal ini kemungkinan besar berhubungan dengan kesiapan mental pasangan sebelum menjalani terapi FIV, penerimaan pasangan terhadap kondisi infertilitasnya, serta religious coping positif yang dilakukan oleh pasangan dalam memaknai hasil dari terapi yang mereka jalani.

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In vitro fertilization (IVF), is a method of therapy which was done after other methods to overcome infertility problems had failed (end of the line treatment). This therapy is time-, cost-, energy-consuming, and also described as an emotional roller-coster for the couples.

This research is a quantitative and qualitative study to discover psychological phenomenon that occurs in couples with infertility problems who underwent the program in Yasmin Clinic at RSCM Kencana and to explore how the couples experience this problem and IVF therapy. The results showed that anxiety are the most common symptoms.

The statistical test found no significant association between demographic factors (race and religion), duration of infertility, history of previous treatment and the stages of IVF in relation with the presence of psychopathology. This is most likely related to the mental preparation of couples before undergoing IVF, partner acceptance of the condition of infertility, and positive religious coping were performed by couples in defining the outcome of their treatment."

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Latar Belakang: Prosedur transfer embrio merupakan salah satu langkah pada teknologi reproduksi berbantu, dapat dilakukan transfer embrio beku atau embrio segar. Kemanan teknologi ini masih menjadi perhatian. Sehingga penting untuk mengetahui pengaruhnya terhadap luaran dalam hal ini tumbuh kembang anak.

Tujuan: Penelitian ini bertujuan untuk melihat hubungan transfer embrio beku dibandingkan embrio segar terhadap tumbuh kembang anak usia 0-3 tahun.

Metode: Metode penelitian ini adalah analitik komparatif dengan desain penelitian cross sectional, membandingkan tumbuh kembang anak hasil FIV dengan transfer embrio beku dibandingakan embrio segar. Pertumbuhan menggunakan parameter berdasarkan WHO Child Growth Standards 2006 atau WHO Anthro 2006. Sedangkan perkembangan menggunakan Kuesioner Praskrining Perkembangan (KPSP).

Hasil: Dari 2 kelompok subjek penelitian anak hasil FIV dengan transfer embrio beku (n=30) dibandingkan dengan embrio segar (n=30), tidak ada perbedaan pertumbuhan dan perkembangan. Nilai OR sebesar 0,64 (95% CI: 0,10-4,15) menunjukkan tidak ada perbedaan risiko gangguan gizi pada FIV dengan transfer embrio segar dibandingkan dengan embrio beku. Nilai OR sebesar 0,36 (0,06-2,01) menunjukkan tidak ada perbedaan risiko anak perawakan pendek pada FIV dengan transfer embrio segar dibandingkan dengan embrio beku. Anak FIV dengan transfer embrio beku memiliki risiko lebih rendah untuk mengalami BBLR dibandingkan kelompok embrio segar dengan OR sebesar 0,17 (95% CI: 0,03-0,85). Semua anak, baik pada kelompok embrio segar dan embrio beku, memiliki lingkar kepala dan perkembangan yang normal.

Kesimpulan: Tidak ada perbedaan pertumbuhan dan perkembangan anak FIV hasil transfer embrio beku dibandingkan dengan embrio segar. Transfer embrio beku menurunkan risiko bayi lahir BBLR.

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Background: Embryo transfer procedure is one step in assisted reproduction technology, it can be done frozen or fresh embryo transfer. This technological security is still a concern. So it is important to know the effect on outcomes in this case the growth and development of children.

Objective: This study aims to find out correlation of frozen embryo transfer versus fresh embryo on the growth and development of children aged 0-3 years.

Methods: This research method is comparative analytic with cross sectional research design, comparing the growth and development of children resulting from FIV with frozen embryo transfer compared to fresh embryo. For the growth, we use parameters based on the WHO Child Growth Standards 2006 or WHO Anthro 2006. While the development using KPSP (Pre-Screening Developmental Questionnaire).

Results: From the 2 groups of child research subjects frozen embryo transfer (n = 30) compared with fresh embryo (n = 30), there were no differences in growth and development. OR value of 0.64 (95% CI: 0.10-4.15) shows no difference in the risk of nutritional disorders in IVF with fresh embryo transfer compared with frozen embryo. OR value of 0.36 (0.06-2.01) indicates there is no difference in the risk of short stature in IVF with embrio segar transfer compared with frozen embryo. IVF children with frozen embryo transfer had a lower risk of developing low birth weight compared to the fresh embryo group with an OR of 0.17 (95% CI: 0.03-0.85). All children, both in the fresh and frozen embryos, have normal head circumference and development.

Conclusions: There was no difference in the growth and development of IVF children resulting from frozen embryo transfer compared with fresh embryo. The risk of low birth weight infants was lower in frozen embryo transfer.

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