Infertilitas

Teknologi Reproduksi
Berbantu (Bayi Tabung)
Yasmin RSCM FKUI
FERTILITAS
SPERMA
♂
SEL TELUR
♀
SALURAN
TELUR
RAHIM dan
Lingkungan
Infeksi
2%
More than one
No cause
19%
Male factor
Endometriosis
36%
5%
Dysovulation
5%
16%
Unexplained
17%
Tubal factor
Figure 1 The causes of infertility in a large observational multicenter study in the UK, 2003
McVeigh,ASRM, 2004
Indikasi TRB (Bayi Tabung)
Disfungsion
ovulation
3%
Idiopatic
15%
Male Factor
55%
(Yasmin FKUI-RSCM, 2007)
Tuba
12%
Endometriosis
15%
Pregnancy Rate
(Yasmin FKUI-RSCM, 2007)
56
50
50
39
40
Clinical PR
25
30
20 20
20
Ongoing PR
20
10
0
0 0
Di
s
n
fu
ng
si
on
ov
ul
at
io
Id
io
pa
tic
al
e
M
En
do
m
et
rio
sis
Fa
ct
or
0
Tu
ba
Umur (tahun)
60
Faktor usia wanita dan kesuburan
USIA
Kesuburan
 34 tahun
90%
35-40 tahun
67%
41-45 tahun
15%
Clinical and Ongoing Pregnancy Rate
Based on Age
60
50 50
50
50
43
43
40
%
40
Clinical PR
30
Ongoing PR
20
14
10
0
0
25-30
31-35
36-38
Umur
(Yasmin FKUI-RSCM, 2007)
39-42
Tatalaksana Bayi Tabung
Cancelled
3%
Failed collection
6%
IVF Konvensional
3%
FET
0%
MIX
22%
IVF-ICSI
49%
ICSI-TESE
17%
Yasmin IVF Clinic RSCM FKUI, 2007
Program Bayi Tabung
•
•
•
•
•
Seleksi pasien
Supresi hormonal
Stimulasi indung telur
Persiapan sel mani
Pembuahan sel telur
– Konvensional
– ICSI
• Kultur embrio
• Transfer embrio
• Tahapan dalam Protokol Panjang IVF
Buserelin nasal
3 kali setiap hari
Suntikan gonadotropin
Tes urin
Tiap hari
1 3
21 ± 2 mg
Pemeriksaan
USG vag
Hormonal
± 2 mg
Usg vag
darah
36 jam
2 hari
Suami siap
14 hari
Sperm Collection
Pengelolaan embrio
Konvensional dan ICSI
ICSI
Konvensional
Simpan Beku
• Sperma
• Embrio
Transfer Embrio