Hubungan Anti-Mullerian Hormone (AMH) pada Long dan Short Protocol Terhadap Fertilization Rate Pasien In Vitro Fertilization (IVF)

Rizki Amalia Wahid, Edwin Armawan, Tono Djuwantono

Abstract


Tujuan: Untuk mengevaluasi pengaruh kadar anti-mullerian hormone (AMH) dengan fertilization rate (FR) dan menilai perbedaan pengaruh jenis protokol (long protocol (LP) dan short protocol (SP)) pada tiap tingkat cadangan ovarium terhadap FR pada pasien in vitro fertilization (IVF) dengan Intracytoplasmic Sperm Injection.
Metode: Data sekunder dari rekam medis pasien yang menjalani IVF di Aster Fertility Clinic Rumah Sakit Umum Pendidikan dr. Hasan Sadikin pada tahun 2016-2020 dan Bandung Fertility Centre Rumah Sakit Ibu Anak Limijati pada tahun 2018-2019. Penelitian ini analitik observational dengan metode Cohort retrospektif. Hubungan antara dua data kategorik diuji dengan uji chi-square dan uji Kruskal-Wallis digunakan pada data numerik dengan distribusi yang tidak rata pada lebih dari 2 kelompok,
Hasil: Hasil data diperoleh nilai rerata kadar AMH secara keseluruhan adalah 3.30 ng/ml dengan rerata capaian FR sebesar 71.97%. Berdasarkan metode IVF yang dipilih, mayoritas pasien menjalani pengobatan SP 54.4% (rerata FR 72.80%) dibandingkan dengan LP 45.6% (rerata FR 70.97%). Tidak ditemukan hubungan yang bermakna antara kadar AMH dengan FR, dinyatakan dengan nilai p=0.977. Kadar AMH terhadap FR bila dipisahkan menurut protokol terapi yang diberikan tidak menunjukkan perbedaan yang bermakna pada masing-masing protokol (LP p=0,763; SP p=0,843). Mengenai hubungan antara protokol IVF dengan FR juga tidak diperoleh perbedaan yang signifikan secara statistik dengan nilai p=0,27 (RR 1.17 (0.62-2.15); CI 95%). Penggobatan menggunakan LP (p=0,770) maupun SP (p=0.845) tidak memberikan pengaruh yang bermakna terhadap FR pada setiap kategori AMH.
Kesimpulan: Tidak ada pengaruh kadar AMH dan protokol terapi terhadap FR.

Relation of Anti-Mullerian Hormone (AMH) in Short and Long Protocol Againts Fertilization Rate of in Vitro Fertilization (IVF) Patients

Abstract
Objective:To evaluate the effect of anti-mullerian hormone (AMH) levels on the success of fertilization rate (FR) and assess the effect of different types of protocols (long protocol (LP) and short protocol (SP)) at each level of ovarian reserve on fertilization rate of in-vitro fertilization (IVF) patients using Intracytoplasmic Sperm Injection.
Method: Secondary data from the medical records of patients undergoing IVF at the Aster Fertility Clinic, Hasan Sadikin Hospital in 2016-2020 and Bandung Fertility Center Limijati Hospital. This study was an observational analytic study with a retrospective cohort approach. The relationship between two categorical data was analyzed by chi-square and Kruskal-Wallis on numerical data that were not normally distributed in more than 2 groups.
Result: The result of obtained data is an average overall AMH level of 3.30 ng/ml with a mean FR achievement of 71.97%. Based on chosen IVF method, more patient underwent short protocol 54.4% (mean FR 72.80%) than long protocol 46.6% (mean FR 70.97%). There was no significant relationship between AMH levels and FR, expressed by the value of p = 0.977.  AMH levels against FR when separated according to the given therapy protocol did not show any significant difference in each protocol (LP p=0.763, SP p=0.843). Regarding the relationship between the IVF protocol and FR, there was also no statistically significant difference with p value =0.27 (RR 1.17 (0.62-2.15) 95% CI), as well as treatment using LP (p=0,770) or SP (p=0.845) did not have a significant effect on FR at each AMH category (p=0.599).
Conclusion: There was no significant relationship between AMH levels and therapy protocol on FR.

Key word: In Vitro Fertilization, Fertilization Rate, Anti-Mullerian Hormone, Ovarian Stimulation Protocol


Keywords


In Vitro Fertilization; Fertilization Rate; Anti-Mullerian Hormone; Protokol Stimulasi Ovarium

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DOI: http://dx.doi.org/10.24198/obgynia/v4n2.295

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