Tesis

Hubungan Kadar Serum hCG 12 jam Pascapenyuntikan terhadap tingkat Maturitas Oosit pada Fertilisasi in Vitro = Relationship Between 12 Hours Post-injection hCG Serum and Oocyte Maturation Rate on In Vitro Fertilization.

Latar belakang: Fertilisasi in vitro (FIV) merupakan salah satu tata laksana utama dalam penanganan infertilitas. Penyuntikan human Chorionic Gonadotropin (hCG) eksogen merupakan salah satu tahapan penting dalam proses FIV untuk proses maturasi oosit. Walaupun sudah terdapat penelitian sebelumnya mengenai korelasi kedua hal tersebut, namun belum didapatkan suatu model prediksi maturitas oosit. Tujuan: Mengetahui korelasi kadar serum hCG 12 jam pascapenyuntikan terhadap tingkat maturitas oosit pada FIV dan model prediksi maturitas oosit. Metode: Penelitian ini merupakan sebuah penelitian potong lintang yang dilakukan pada peserta program FIV di Klinik Yasmin, RSUPN dr. Cipto Mangunkusumo, Jakarta, Indonesia sejak Januari 2020 hingga Desember 2020. Pasien dengan riwayat prosedur pembedahan ovarium, kemoterapi, radioterapi, dan peserta poor responder dieksklusi dari penelitian. Dilakukan penyuntikan r-hCG 250 µg secara subkutan pada semua subjek. Kadar serum hCG 12 jam pascapenyuntikan dan tingkat maturitas oosit setiap subjek dikumpulkan dan dianalisis. Hasil: Didapatkan sebanyak 28 subjek yang diikutsertakan dalam penelitian. Didapatkan korelasi yang tidak bermakna antara kadar hCG 12 jam pascapenyuntikan dan tingkat maturitas oosit (r = 0,052, p = 0,788). Namun, didapatkan kadar serum hCG 12 jam pascapenyuntikan yang lebih tinggi pada subjek dengan tingkat maturitas > 75% (mean diff 34.78, p = 0.046). Didapatkan titik potong kadar serum hCG 12 jam pascapenyuntikan sebesar 90.15 mIU/mL untuk memprediksi tingkat maturitas yang baik. (sensitivitas 68.2%, spesifisitas 83.3%). Prediksi tingkat maturitas oosit dapat dilakukan dengan mengetahui kadar serum hCG 12 jam pascapenyuntikan dan indeks massa tubuh (IMT) subjek (sensitivitas 83.3%, spesifisitas 68.2%). Simpulan: Kadar serum hCG 12 jam pascapenyuntikan yang lebih tinggi berhubungan dengan tingkat maturitas oosit yang lebih baik pada peserta program FIV. Tingkat maturitas oosit dapat diprediksi melalui kadar serum hCG 12 jam pascapenyuntikan dan IMT.
Kata kunci: Fertilisasi in Vitro, human chorionic gonadotropin hormone, oosit, maturitas oosit


Background: In vitro fertilization (IVF) is one of the main treatments of infertility. Exogenous hCG injection is an important process of IVF for maturation of the oocytes. Although there have been previous studies regarding the correlation of these two things, a model for predicting oocyte maturity has not been obtained. Aim: Determining the correltion between 12 hours post-injection hCG serum and oocyte maturation rate along with oocyte maturity prediction model on IVF participants. Method: This is a cross-sectional study on IVF participants on Yasmin Clinic, dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, during the period of January 2020 to December 2020. Subjects with history of ovarian surgery, chemotherapy, radiotherapy, and poor responder were excluded from this study. Subjects were injected with 250 µg of r-hCG subcutaneously. Twelve hours post-injection hCG serum level and oocyte maturation rate were collected and analyzed accordingly. Result: A total of 28 subjects were included in the study. There was no significant correlation between 12 hours post-injection serum hCG and oocyte maturation rate (r = 0,052, p = 0,788). It was found that higher 12 hours post-injection serum hCG was related with subjects with > 75% oocyte maturation rate (mean diff 23.78, p = 0.046). The cut-off point of 12 hours post-injection hCG serum in order to predict better oocyte maturation rate was found to be 90.15 mIU/mL (sensivity 68.2%, specificity 83.3%). Oocyte maturation rate prediction may be calculated using 12 hours post-injection hCG serum and Body Mass Index (BMI) of the subjects (sensitivity 83.3%, spesificity 68.2%). Conclusion: Higher 12 hours post-injection hCG serum was associated with higher oocyte maturation rate on IVF subjects. Oocyte maturation rate may be predicted using subjects’ 12 hours post-injection hCG serum and BMI.
Keywords: In Vitro Fertilization, human chorionic gonadotropin hormone, oocyte, oocyte maturation