Kanadi Sumapraja

Indonesian kalkulator of oocytes (IKO): A smart application to determine our biological age

Background: The use of smartphones and its associated application provides new opportunities for physicians. In current situations, there are still few applications are designed in the field of infertility and Assisted Reproductive Technologies (ART). A study conducted on 1616 subjects proved that AMH (Anti-Mullerian Hormone) could be used to predict a woman’s biological age earlier than Follicle-Stimulating Hormone (FSH) and Antral Follicle Count (AFC). In this study, we describe the AMH nomogram that has been developed into a mobile application as “Indonesian Kalculator of Oocytes” (IKO). The software required to create IKO application was the Android 4.0.3 Ice Cream Sandwich and Java Application Development. The hardware specification that needed to develop the IKO apps were a 4.0-inch screen, 512 MB RAM (random-access memory), and CPU (central processing unit) with dual core 1.2 Ghz. The application is built using the Android SDK (Software Development Kit) and Java Application Development. In this app...

Genetic and clinical predictors of ovarian response in assisted reproductive technology

Several factors are known to influence ovarian response to rFSH stimulation such as age, antral follicle count (AFC), and basal FSH level, Mutation of allele Ser680Asn in FSHR gene was responsible to ovarian resistance toward exogenous FSH. The aim of this study is to develop a prediction model of ovarian response to COS in IVF. This study was a prospective cohort study. One hundred and thirteen women undergoing their first cycle of IVF in Yasmin IVF Clinic Jakarta were recruited to this study. Clinical datas included were age, BMI, and AFC. Basal FSH and E2 as well as serum AMH was measured from peripheral blood taken at second day of cycle. Bsr-1 enzyme is used to identify the polymorphism in exon 10 position 680 with RFLP technique. Three genotype polymorphism, Asn/Asn (255 bp ribbon), Asn/Ser (97 bp and 158 bp), and Ser/Ser (97 bp, 158 bp, and 255 bp). AFC has the highest predictor for ovarian response with AUC 0.922 (CI 95% 0.833-1.000). AMH also showed high predicting value (AUC 0.843 CI 95% 0.663-1.000). The multivariate analysis revealed combination of AFC, AMH, age, and basal FSH is a good model for ovarian response prediction (AUC=0.97). No significant relation between Asn/Asn, Asn/Ser, or Ser/Ser genotype FSHR polymorphism with ovarian response (p = 0.866) and total dose of rRSH (p = 0.08). This study showed that model combination of AFC, AMH, patients age and basal FSH are very good to predict number of mature oocytes.