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Abstrak :
Latar Belakang: Growth Differentiation Factor 9 (GDF9) adalah salah satu anggota dari superfamili TGF-β yang merupakan salah satu oocyte-secreted factor (OSF). GDF9 memainkan peran penting dalam folikulogenesis ovarium, kompetensi perkembangan oosit, serta sebagai molekul esensial yang mengontrol berbagai proses sel granulosa dan laju ovulasi. GDF9 merupakan OSF yang memainkan peran penting dalam menjaga fertilitas wanita. Penelitian ini bertujuan untuk mengetahui apakah ekspresi GDF9 berkorelasi dengan kualitas oosit dan laju fertilisasi pada pasien fertilisasi in vitro. Tujuan: Mengetahui korelasi ekspresi GDF-9 dengan kualitas oosit dan laju fertilisasi pada pasien Fertilisasi In Vitro Metode: Penelitian ini adalah penelitian potong lintang yang dilaksanakan di Klinik Yasmin, Rumah Sakit dr. Cipto Mangunkusumo, Jakarta sejak bulan Juli 2019 sampai bulan Juli 2020. Terdapat 26 wanita berusia 25-40 tahun pasien Fertilisasi In Vitro tanpa penyakit endometriosis maupun Sindrom Ovarium Polikistik yang menjadi subjek penelitian ini. Cairan folikel pasien diambil, kemudian dilakukan pengukuran ekspresi gen GDF9. Setelah itu, dilakukan evaluasi pada data ekspresi gen GDF9 serta diuji korelasinya dengan kualitas oosit dan laju fertilisasi pasien menggunakan aplikasi SPSS. Hasil: Sebanyak 26 pasien IVF berpartisipasi dalam penelitian ini. Median jumlah ekspresi gen GDF9 adalah sebanyak 2.47 x 10-5 ng/μl dengan median kualitas oosit dan laju fertilisasi pasien IVF sebesar 3.00 dan 0.60. Berdasarkan hasil uji korelasi, terdapat korelasi negatif antara ekspresi GDF9 terhadap laju fertilisasi dengan kekuatan korelasi sedang (r = -0.443, p = 0.012). Sementara, ditemukan korelasi tidak bermakna antara ekspresi GDF9 terhadap kualitas oosit (r = -0.306, p = 0.064). Kesimpulan: Terdapat korelasi negatif dengan kekuatan korelasi sedang antara ekspresi GDF9 dengan laju fertilisasi, sementara hubungan ekspresi GDF-9 dengan kualitas oosit memiliki korelasi tidak bermakna. ......Background: Growth Differentiation Factor 9 (GDF9) is a member of the TGF-β superfamily which is one of the oocyte-secreted factor (OSF). GDF9 plays an important role in ovarian folliculogenesis, the competence of oocyte development, as well as an essential molecule that controls various granulosa cells process and the rate of ovulation. GDF9 is an OSF which plays an important role in maintaining female fertility. This study is conducted to see the correlation between the expression of GDF9 gene with the oocyte quality and the fertilization rate in the IVF patients. Aim: To find out the correlation between the expression of GDF9 with the oocyte quality and the rate of fertilization of IVF Patients Methods: This study is a cross-sectional study which was conducted at Klinik Yasmin dr. Cipto Mangunkusumo General Hospital, Jakarta since July 2019 to July 2020. 26 IVF patients aged 25-40 years without the conditions of endometriosis or Polycystic Ovary Syndrome (PCOS) participated in this study. Follicular fluids are taken from the patients and the GDF9 gene expression were measured. The data were then evaluated for its correlation with the oocyte quality and the fertilization rate using the SPSS application. Results: Abour 26 IVF patients were participated in this study. The median amount of GDF9 gene expression was 2.47 x 10-5 ng/μl. The median of the oocyte quality and the fertilization rate was 3.00 and 0.60. According to the correlation test, there is a negative correlation between the expression of GDF9 gene and the fertilization rate with a moderate statistical correlation (r = -0.443, p = 0.012). Meanwhile, the expression of GDF9 gene has no significance correlation with the oocyte quality (r = -0.306, p = 0.064). Conclusion: This study showed a negative correlation between the expression of GDF9 gene and the fertilizatio rate, while the relation between the GDF9 expression and the occyte quality has no significance correlation.

Abstrak :
Prevalensi infertilitas di Indonesia yang meningkat tiap tahunnya juga memperbesar kebutuhan pasangan infertil terhadap program fertilisasi in vitro (FIV). Diketahui oosit mempunyai peranan penting dalam keberhasilan FIV. Namun pada pelaksanaannya, oosit yang didapat saat tindakan petik oosit mempunyai maturitas yang tidak sama. Dari beberapa penelitian didapatkan stimulasi ovarium terkendali (SOT) dapat meningkatkan apoptosis sel granulosa dan reactive oxygen species (ROS) yang dapat memberikan efek negatif pada maturasi oosit. Penelitian ini bertujuan untuk mengetahui pengaruh elektroakupunktur terhadap maturasi oosit, laju fertilisasi, kadar GDF9 dan BMP15 pada program FIV. Uji klinis acak tersamar ganda dengan kontrol dilakukan terhadap 24 subjek yang menjalani program FIV. Subjek dialokasikan secara acak ke dalam kelompok elektroakupunktur (n=12), dan kelompok elektroakupunktur sham (n=12). Penilaian maturasi oosit dan laju fertilisasi dilakukan secara mikroskopis oleh embriolog, sedangkan pemeriksaan kadar ekspresi mRNA GDF9 dan BMP15 oleh analis lab. Hasil penelitian menunjukkan terdapat perbedaan bermakna maturasi oosit antara kelompok elektroakupunktur dengan elektroakupunktur sham (p=0,02); laju fertilisasi (p=0,03). Tidak didapatkan perbedaan bermakna kadar GDF9 (p=0,34) dan BMP15 (p=0,47) antara kelompok elektroakupunktur dengan elektroakupunktur sham . Kesimpulan penelitian ini adalah elektroakupunktur dapat meningatkan maturasi oosit dan laju fertilisasi pada program FIV.

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Increasing prevalence of infertility in Indonesia every year also increases the need for infertile couples in the in vitro fertilization program (FIV). It is known that oocytes have an important role in the success of FIV. But in its implementation, oocytes obtained during oocyte retrieval have unequal maturity. From several studies it was found that controlled ovarian stimulation (COS) can increase the apoptosis of granulosa cells and reactive oxygen species (ROS) which can have a negative effect on oocyte maturation. This study aims to determine the effect of electroacupuncture on oocyte maturation, fertilization rate, levels of GDF9 and BMP15 in the FIV program. A double blind randomized clinical trial with controls was conducted on 24 subjects who underwent the FIV program. Subjects were randomly allocated to the electroacupuncture group (n = 12), and the electroacupuncture sham group (n = 12). The assessment of oocyte maturation and the rate of fertilization were carried out microscopically by the embryologist, while the examination of the levels of GDF9 and BMP15 mRNA by lab analysts. The results showed that there were significant differences in oocyte maturation between the electroacupuncture group and electroacupuncture sham (p = 0.02); fertilization rate (p = 0.03). There were no significant difference in GDF9 levels (p = 0.34) and BMP15 levels (p = 0.47) between the electroacupuncture group and sham electroacupuncture. The conclusion of this study is electroacupuncture can enhance oocyte maturation and fertilization rate in the FIV program.