Tesis

Perbandingan Luaran Program FIV antara Persiapan Endometrium Metode Alamiah dan Artifisial pada Transfer Embrio Beku di Klinik Yasmin RSCM Kencana = Comparison of FIV Output Program between Endometrial Preparation of Natural and Artificial Methods in Frozen Embryo Transfer at Yasmin Clinic RSCM Kencana.

Latar belakang : Angka kejadian infertilitas di Indonesia diperkirakan kurang lebih mencapai 6% atau terdapat kurang lebih 3-4,5 juta pasangan yang mengalami kesulitan mempunyai keturunan. Pada tahun 2012 dilaporkan bahwa 28,4% siklus merupakan transfer embrio beku dibandingkan pada tahun 2003 dimana dilaporkan siklus embrio beku dilakukan hanya 16,1% pada program Fertilisasi In Vitro (FIV). Walaupun transfer embrio beku telah semakin sering dilakukan, tetapi metode untuk persiapan endometrium yang paling efektif, antara alamiah atau artifisial, masih belum diketahui secara jelas. Tahap persiapan endometrium sebelum transfer embrio merupakan tahap yang sangat penting dalam mencapai reseptivitas endometrium dan keberhasilan kehamilan. Tujuan : Mengetahui luaran program FIV pada transfer embrio beku dengan metode alamiah dan artifisial di Klinik Yasmin, RSCM Kencana. Metode : Penelitian ini merupakan penelitian retrospektif analitik dengan menggunakan metode uji potong lintang, periode 1 Januari 2011 – 31 Desember 2018. Pengambilan sampel dengan cara total sampling. Subjek penelitian ini merupakan seluruh wanita yang mengikuti FIV dengan tranfer embrio beku yang memenuhi kriteria inklusi dan ekslusi yang dilakukan di RSCM. Data yang didapatkan dianalisis secara bivariat menggunakan uji chi-square untuk mengetahui angka implantasi dan kehamilan pada transfer embrio beku dengan metode alamiah dan artifisial Hasil : Dari 147 subyek yang memenuhi kriteria penelitian, didapatkan 19 subyek menjalani persiapan endometrium dengan metode alamiah dan 128 menjalani persiapan endometrium dengan metode artifisial. Angka implantasi metode alamiah vs metode artifisial (32 % vs 29%); angka kehamilan biokimiawi (89,5% vs 53,1%; p < 0,05); angka kehamilan klinis (42,1% vs 34,4%; p > 0,05); serta angka kehamilan lanjutan (36,8% vs 28,9%; p > 0,05). Kesimpulan : Persiapan endometrium secara alamiah memiliki kecenderungan lebih tinggi untuk terjadinya implantasi dan kehamilan biokimiawi dibandingkan persiapan secara artifisial. Sedangkan angka kehamilan klinis dan kehamilan lanjutan tidak berbeda bermakna. Diperlukan penelitian lanjutan untuk menambah besar sampel, terutama pada kelompok persiapan endometrium secara alamiah
Kata kunci : infertilitas, FIV, transfer embrio beku, alamiah, artifisial, angka implantasi, angka kehamilan.


Background: Infertility incidence in Indonesia is estimated to reach approximately 6% or approximately 3-4.5 million couples who have difficulty having children. In 2012 it was reported that 28.4% of cycles were frozen embryo transfers compared to 2003 where it was reported that only frozen embryo cycles performed only 16.1% in the In Vitro Fertilization (FIV) program. Although frozen embryo transfers have increasingly been done, the most effective method for endometrium, between natural or artificial, is still not clearly known. The endometrial preparation stage before embryo transfer is a very important stage in achieving endometrial receptivity and the success of pregnancy. Objective: Knowing the outcome of the FIV program on frozen embryo transfer using natural and artificial methods at the Yasmin Clinic RSCM Kencana. Methods: This research was an restropective analytical study using a cross-sectional test method for the period of January 1, 2011 - December 31, 2018. Sampling by total sampling. The subjects of this study were all women who took part in FIV with frozen embryo transfer that met the inclusion and exclusion criteria performed at RSCM. The data obtained were analyzed bivariately using the chi-square test to determine implantation and pregnancy rates in frozen embryo transfer using natural and artificial methods. Results: 147 subjects who met the study criteria, 19 subjects underwent endometrial preparation by natural methods and 128 were subjects who underwent endometrial preparation by artificial methods. The rate of implantation of natural methods vs. artificial methods (32% vs 29 %); biochemical pregnancy rates (89,5% vs 53,1%; p < 0,05); clinical pregnancy rate (42,1% vs 34,4%; p > 0,05)and on going pregnancy rates (36.8% vs 28,9%; p > 0,05). Conclusion: Natural endometrial preparations have a higher tendency for implantation and biochemical pregnancy, while clinical pregnancy rate and on going pregnancies not significantly difference. Further research is needed to increase sample size, especially in natural preparation group.
Keywords: Infertility, FIV, frozen embryo transfer, natural, artificial, implantation rate, pregnancy rate.