Papers by Andon Hestiantoro
International journal of reproductive biomedicine, Jul 2, 2024
Background: Since kisspeptin (KISS1) in the hypothalamus is affected by the inhibitory effect of ... more Background: Since kisspeptin (KISS1) in the hypothalamus is affected by the inhibitory effect of dynorphin, it raises questions about the controlled balance of these 2 neuropeptides in women with and without polycystic ovary syndrome (PCOS). Objective: This study compares the expression levels of KISS1, dynorphin, neurokinin-B, leptin, and neuropeptide-Y in women with and without PCOS. Materials and Methods: In this cross-sectional study, the peripheral blood samples of 20 women with PCOS and 20 women without PCOS who referred to Yamin Kencana Clinic, Cipto Mangunkusumo hospital, Jakarta, Indonesia were enrolled from August-December 2022. mRNA relative expression of genes related to the central factors associated with PCOS, such as leptin, neuropeptide-Y, KISS1, tachykinin-3, and prodynorphin (PDYN), in PCOS and non-PCOS populations were examined. Gene quantification was carried out by the quantitative polymerase chain reaction method. Results: The KISS1/PDYN ratio was significantly higher in the PCOS group than in the control group (p = 0.02), and the PDYN was lower in the PCOS group than the control group (p < 0.001). Moreover, the positive correlation between KISS1 and the KISS1/PDYN ratio was significantly stronger in the PCOS group than in the control group (R = 0.93; p < 0.001 vs. R = 0.66, p < 0.001). Conclusion: Our results suggest that an increased KISS1/PDYN ratio in PCOS women is related to diminished dynorphin expression. Low expression of the gene encoding dynorphin and a high KISS1/PDYN ratio is highly specific to PCOS.
Reproductive Medicine and Biology
This is the first guidelines for adenomyosis from the Asian Society of Endometriosis and Adenomyo... more This is the first guidelines for adenomyosis from the Asian Society of Endometriosis and Adenomyosis.
eJurnal kedokteran Indonesia, Jan 31, 2022
Journal of natural science, biology, and medicine, Nov 1, 2019
Objective: Selecting embryos is an important step in the in vitro fertilization process before tr... more Objective: Selecting embryos is an important step in the in vitro fertilization process before transferring them to the uterus. There are some invasive methods for choosing a good quality embryo, such as embryo grading. This method evaluates the equality and fragmentation of an embryo. However, this method does not adequately evaluate the chromosomal status of the embryos, which is often necessary for high-risk embryos. Here, we evaluated embryo fragmentation and chromosomal numbers using next-generation sequencing. Materials and Methods: Each embryo was biopsied on the 3rd or 5th culture day to obtain a single blastomere cell. DNA was then extracted from each blastomere and whole-genome amplification was carried out. Amplification products were then sequenced to obtain a ploidy number. Results: Among the 30 embryos that were evaluated, 19 embryos had no fragments, 10 embryos had small fragments, and 1 embryo had moderate fragments. However, 12 of 19 embryos, 57.9% with no fragments were detected to have chromosomal abnormality. Aneuploidy was increased in 7 of 10 embryos (70%) with mild fragments. One moderately fragmented embryo included was surprisingly found to have normal ploidy (100%). Gamma correlation test showed that there was no correlation between fragmentation and the incidence rate of aneuploidy (P > 0.05). Although there was no correlation, the study's result exemplifies that aneuploidy rate increased along with higher fragmentation. Conclusion: This research concluded that embryo fragmentation was not correlated with aneuploidy.
International Journal on Advanced Science, Engineering and Information Technology, Jun 29, 2021
Embryo spent culture medium has been intensively investigated, considering its promising feature ... more Embryo spent culture medium has been intensively investigated, considering its promising feature for non-invasive bioanalytical techniques in in-vitro fertilization (IVF). Despite, isolating DNA from such samples is quite challenging due to its small volume. Carrier RNA is reported to exhibit DNA retrieval effects and commonly employed in various limited biological samples, but there are no reports regarding its benefit on embryo media. Therefore, we aim to evaluate the competence of cRNA on isolated DNA from embryo medium and analyzed its optimal volume as there are also no records respecting its ideal volume to obtain decent outcomes. Results showed that cRNA significantly increases DNA amounts in the cRNA treated group (p<0.001), but the D-4/D-5 medium yielded similar (p=0.684). Pearson test demonstrated no correlation between cRNA volume vs. total retrieved DNA (r=0.760, p=0.80), and Whole Genome Amplification (WGA) was shown to increase DNA in the treated group (p=0.022), but not in the untreated group (p=0.128). Additionally, electrophoresis successfully resulting in a thick and thin band of TH01 locus signifies the cRNA competence. In conclusion, our study suggests that cRNA addition is essential in embryo medium extraction as it increases initial DNA that crucial for downstream application. However, the optimal volume could not be determined in the current study since the initial amount of DNA in the medium is unknown. Obtained findings are expected to be a new input for subsequent research on DNA extraction.
CRC Press eBooks, Sep 10, 2003
Journal of physics, Aug 1, 2018
Endometriosis, a chronic inflammatory disorder, is characterized by the presence of hormone-respo... more Endometriosis, a chronic inflammatory disorder, is characterized by the presence of hormone-responsive, endometrial-like tissue outside of the uterine inner wall, such as in the peritoneum and ovaries. Progesterone (P) resistance, due to altered expression of progesterone receptor (PR), is known as a disruptive condition in response to P in eutopic endometrial tissue. Gene promoter DNA methylation, a gene silencing mechanism, has been associated with the etiology of endometriosis. The aim of this cross sectional study was to assess the DNA methylation status of the PR-B promoter in various tissues (eutopic endometrium, ectopic peritoneal, and ovarian lesions) from endometriosis patient. This study involved 20 samples for each tissue type (eutopic endometrium, peritoneal, and ovarian lesion from women with endometriosis), as compared with 20 eutopic microcurettage samplings of normal endometrial tissue. DNA was isolated from each sample and subjected to bisulfite conversion. The DNA methylation level of the PR-B gene promoter was analyzed by the methylation-specific PCR (MSP) method. Band intensities in agarose gels were measured with ImageJ software. The ratio of the band intensity of samples to that of the positive control was considered as the DNA methylation level. The Mann–Whitney U test and Wilcoxon test were conducted, and P-values were considered significant at < 0.05. There were significant differences in the methylation levels of the PR-B gene promoters in ectopic peritoneal endometrial tissue (72.40% methylated), ovarian tissue (85% methylated), and eutopic endometrial tissue (72.21% methylated), as compared to normal endometrium (P = 0.000). Moreover, there were no significant differences in methylation levels of the endometriosis samples, i.e., peritoneal vs. eutopic endometrial tissue, peritoneal vs. ovarian endometrial tissue, and ovarian vs. eutopic endometrial tissue (P = 0.636, 0.241, and 0.441, respectively). Hypermethylation of the PR-B gene promoter could cause P resistance in different types of endometriosis lesions and might be a potential biomarker for diagnosis of endometriosis.
Objective: To study the endometrial thickness and embryo quality during In Vitro Fertilization (I... more Objective: To study the endometrial thickness and embryo quality during In Vitro Fertilization (IVF) cycles in predicting IVF outcome. Methods: This retrospective study involved 206 infertile patients undergoing 218 IVF cycles in Yasmin Clinic, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia. All IVF cycles were performed from January 2005 until May 2009. The outcome of this study is the clinical pregnancy following IVF cycles. The endometrial thickness was measured on the day of human chorionic gonadotrophin (hCG) administration. The number of embryos that developed ≥ 8 cells on cleavage II represented as the embryo quality. Results: There were 51 among 218 cycles (23.4%) resulted in pregnancy. The endometrial thickness on day of hCG administration was significantly higher in pregnant group compared to non-pregnant group (11.49±1.97 mm versus 10.13±1.93mm; p<0.0001). The number of embryos with ≥ 8 cells on cleavage II was higher in pregnant group than non-pregnant group {3 embryos (1-11) versus 1 embryos (0-11); p<0.0001}. From the ROC curve, the endometrial thickness cut-off value ≥ 10.95 mm was the best value to predict pregnancy outcome. This value had 64.7% sensitivity, 62.3% specificity, 34.4% positive predictive value, and 85.2% negative predictive value. Conclusion: Both embryo quality and endometrial thickness significantly have contribution to IVF outcome prediction. [Indones J Obstet Gynecol 2010; 34-1:39-42] Keywords: IVF cycles, endometrial thickness, embryo quality
Indonesian Journal of Obstetrics and Gynecology, Oct 2, 2020
Objective: To investigate health information quality about PCOS on the internet in Indonesian lan... more Objective: To investigate health information quality about PCOS on the internet in Indonesian language. Methods: Top website from two separate search engines (Google and Bing) was collected using the keyword of "sindrom ovarium polikistik" (polycystic ovarian syndrome). Analysis of health information quality on those websites was performed. Results: Sixty-nine websites were included for analysis. The majority of those websites have good information quality in terms of content accuracy and website credibility. There was no difference in quality between the two search engines. The website was found at the top two pages in each search engine to have better quality than the later pages (p=0.02). The educational website had better quality (p=0.05). The website made by healthcare organizations had better quality (p=0.04). The non-commercial website had better information quality (p=0.01). Conclusions: Criteria affecting health information quality on the internet were as follows: found at the top two pages on a search engine; educational website; made by healthcare organization; and non-commercial purpose.
Indonesian Journal of Obstetrics and Gynecology, Aug 20, 2018
Nowadays, the Internet is a part of everyone's life. Many information could be easily accessed th... more Nowadays, the Internet is a part of everyone's life. Many information could be easily accessed through the Internet including health topics. A study conducted by the Internet World Statistics (2007) revealed that two third of the UK population used the Internet. Meanwhile, a survey conducted by the Harris Poll Group (2007) suggested that 60-80% of Internet users search
Media dermato - venereologica Indonesiana, Feb 15, 2022
Penuaan merupakan proses perubahan dinamis yang ditandai oleh kemunduran progresif berbagai siste... more Penuaan merupakan proses perubahan dinamis yang ditandai oleh kemunduran progresif berbagai sistem tubuh disertai penurunan kapasitas fisiologis. Salah satu faktor intrinsik penuaan kulit pada perempuan adalah penurunan kadar hormon estrogen di dalam tubuh saat memasuki masa pascamenopause. Estrogen merupakan hormon yang memiliki peran penting dalam regulasi fisiologis kulit. Berkurangnya kadar estrogen dapat mempercepat proses penuaan kulit yang ditandai dengan penurunan ketebalan, elastisitas, dan hidrasi kulit. Selama ini pemberian terapi hormon estrogen terbukti dapat mengurangi gejala penuaan kulit pada perempuan pascamenopause, namun terapi ini berpotensi meningkatkan risiko terjadinya efek samping berat contohnya kanker payudara, kanker endometrium, dan kanker ovarium. Fitoestrogen merupakan senyawa nonsteroid berasal dari tanaman yang memiliki aktivitas biologik serupa dengan estrogen. Setiap jenis fitoestrogen memiliki aktivitas biologik yang berbeda satu sama lain. Studi terkini menunjukkan bahwa fitoestrogen dapat menjadi terapi alternatif untuk mengatasi penuaan kulit pada perempuan pascamenopause. Fitoestrogen yang diberikan baik secara oral maupun topikal terbukti dapat meningkatkan elastisitas, ketebalan, dan kelembaban kulit serta mengurangi pigmentasi dan proses inflamasi pada kulit.Â
The Journal of Clinical Endocrinology and Metabolism, Apr 1, 2004
The expression of estrogen receptor (ER)␣ and- in the infundibular nucleus of the hypothalamus w... more The expression of estrogen receptor (ER)␣ and- in the infundibular nucleus of the hypothalamus was studied immunocytochemically in 28 control subjects and 14 patients with Alzheimer's disease (AD). A shift was found from more nuclear staining of ER␣ in young female controls to more cytoplasmic staining in elderly female controls, whereas no such change was observed in elderly male controls. The shift of ER␣ from nucleus to cytoplasm in elderly female controls was accompanied by a relative absence of AD neuropathology, i.e. hyperphosphorylated tau stained by hyperphosphorylated tau protein (AT8). In contrast, male and female AD patients showed more nuclear ER␣ and a much stronger AD neuropathology. It is proposed that the shift of ER␣ from nucleus to the cytoplasm may reflect activation of neurons and that hyperactivity decreases the risk that neurons in the course of aging develop AD neuropathology. In contrast, the presence of nuclear ER␣ seems to predispose to reduced activity and increases the risk of some neurons to develop AD neuropathology. ER in basket-like terminals was preferentially observed in elderly male controls and AD patients, a novel phenomenon. This suggests that the presence of basket-like ER may reflect reduced activity, which is-associated with an increase in hyperphosphorylated tau staining. However, the neurons inside the basket-like ER showed signs of hyperactivity and did not stain for AT8. All AT8-positive neurons in the infundibular nucleus contained ␣MSH as a marker for proopiomelanocortin neurons. These neurons produce -endorphin that inhibits GnRH release. Because they diminish in activity in postmenopausal women, this may contribute to the hyperactivity of GnRH neurons. The regulation of the gonadal axis may thus be affected by AD neuropathology independent of AD neuropathology in cognition-related brain structures.
Indonesian Journal of Obstetrics and Gynecology, 2008
Journal of physics, Aug 1, 2018
Polycystic ovary syndrome (PCOS) is defined as a complex hormonal disorder that is commonly found... more Polycystic ovary syndrome (PCOS) is defined as a complex hormonal disorder that is commonly found in reproductive-age women. The pathogenesis and etiology of PCOS have not been fully understood. It is strongly believed that PCOS is caused by the interaction of numerous complex factors, both environmental and genetic. One factor that is known to play a role in the pathogenesis of PCOS is an increase in anti-Mullerian hormone (AMH). In this study, we analyzed the methylation levels of the AMH gene as it relates to elevation of AMH levels in PCOS patients. In this cross-sectional study we used MSP-PCR method to amplify the DNA samples, which are obtained from the granulosa cells of 13 women with PCOS and 9 women without PCOS. The methylation levels then measured using ImageJ software. We found that there was a statistically significant difference between the methylation percentage of DNA from patients in the PCOS group compared to the control group, (p = 0.001). The PCOS group had a lower methylation percentage compared with the normal group. Our results suggest that a decreased methylation level of the AMH gene may cause an increase in AMH concentration in ovarian follicles and has a correlation with the pathogenesis of PCOS. AMH methylation level could therefore be used as a biomarker for diagnosis of PCOS.
PubMed, Aug 7, 2023
Background: In vitro fertilization (IVF) remains a main treatment for infertility cases. Post-inj... more Background: In vitro fertilization (IVF) remains a main treatment for infertility cases. Post-injection human chorionic gonadotropin (hCG) level is an essential factor in determining oocyte maturation rate in IVF. This study aimed to determine the relationship between 12 hours post-injection serum hCG level and oocyte maturation rate among IVF participants. Materials and methods: A cross-sectional study on IVF participants was done at a tertiary hospital in Indonesia from January 2020 to December 2021. Subjects were injected with 250 μg of recombinant-hCG (r-hCG) subcutaneously. Twelve hours post-injection serum hCG levels and oocyte maturation rate data were retrieved and analyzed accordingly. Results: Twenty-eight subjects were recruited into the study. Higher 12 hours post-injection serum hCG was related to oocyte maturation rate (P=0.046). The cut-off point of 12 hours post-injection serum hCG to predict better oocyte maturation rate was 90.15 mIU/mL (sensitivity 68.2%, specificity 83.3%). Oocyte maturation rate may be predicted using body mass index (BMI) and 12 hours post-injection serum hCG. Conclusion: Higher 12 hours post-injection serum hCG was associated with a higher oocyte maturation rate in IVF subjects.
Indonesian Journal of Obstetrics and Gynecology, Apr 28, 2022
Objective: To determine which factors influence the rate of oocyte maturation in In Vitro Fertili... more Objective: To determine which factors influence the rate of oocyte maturation in In Vitro Fertilization (IVF) program. Methods: A retrospective cohort study was conducted using secondary data from IVF participants at the Yasmin Fertility Clinic, Dr. RSUP. Cipto Mangunkusumo, Jakarta, Indonesia during the period January 2019 to December 2020, as recorded in the InaRepromed archive. The variables analyzed were age, body mass index, and hormone levels on day 1, day 7, and day hCG, with oocyte maturation rate as the main outcome. Correlation test was performed between several variables and the level of oocyte maturation rate and followed by multivariate analysis to assess the factors that were closely related to oocyte maturation rate. Result: Data from 52 subjects were collected for the study. Positive correlation was observed between oocyte maturation rate and estradiol on day 7 (r = 0.229), while negative correlation was observed between oocyte maturation rate and progesterone/estradiol ratio on day 7 (r =-0.289) and luteinizing hormone on day 1 (r =-0.265). Multivariate analysis revealed that higher estradiol on day-7 was associated with better oocyte maturation rate (p = 0.047). Conclusion: Higher estradiol level on day 7 was associated with better oocyte maturation rate in IVF.
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Papers by Andon Hestiantoro