Budi Wiweko
Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta

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Genotype distribution of methylenetetrahydrofolate reductase A1298C and C677T gene in Indonesian infertile men Suryandari, Dwi A.; Yurnadi, Yurnadi; Wiweko, Budi; Yunaini, Luluk
Medical Journal of Indonesia Vol 21, No 1 (2012): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (926.764 KB) | DOI: 10.13181/mji.v21i1.470

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Background: Methylenetetrahydrofolate reductase (MTHFR) is an important enzyme of folate and methionin metabolism, making it crucial for DNA synthesis and methylation. Variants of MTHFR C677T and A1298C gene result in reduced plasma folate levels and increase the susceptibility to spermatogenic arrest. This research aims to analyses MTHFR C677T and A1298C gene polymorphism in Indonesian infertile men with azoospermia and oligozoospermia.Methods: This cross sectional study takes 3 mL of blood from 150 infertile men with oligozoospermia and azoospermia. MTHFR gene is analyzed using polymerase chain reaction technique (PCR) with specific primers. PCR-RFLP analysis of the MTHFR gene using restriction enzymes MboII and HinfI determines allotypes, both of SNP A1298C and C677T in oligozoospermia and azoospermia in Indonesian population.Results: The results show that the distribution of allotypes of MTHFR gene SNP A1298C and A677T is not significantly different (p>0.05) between patient groups with oligozoospermia and azoospermia.Conclusion: MTHFR gene polymorphisms, both of SNP A1298C and C677T are not associated with male infertility in Indonesian men including patients with severe oligozoospermia and azoospermia. (Med J Indones 2012;21:23-7)Keywords: DNA methylation, MTHFR, spermatogenic arrest
Fertility Preservation: Save Our Hope for the Future It’s Time to Rethink... Wiweko, Budi
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (61.461 KB) | DOI: 10.32771/inajog.v3i4.51

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Basal follicle stimulating hormone and leptin on the day of hCG administration predict successful fertilization in in vitro fertilization Hestiantoro, Andon; Wiweko, Budi; Purwaka, Robert H.
Medical Journal of Indonesia Vol 25, No 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (398.786 KB) | DOI: 10.13181/mji.v25i1.1215

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Background: Successful pregnancy in in vitro fertilization (IVF) program depends on multiple factors. This study aimed to determine whether age, body mass index (BMI), basal follicle stimulating hormone (FSH), estradiol, and leptin on the day of trigger ovulation with human chorionic gonadotropin (hCG) might be used as predictor for successful oocyte fertilization in in vitro fertilization (IVF) program.Methods: This is a cross sectional study conducted in Yasmin Fertility Clinic, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Forty participating patients underwent IVF program, excluding smokers, patients with diabetic, morbid obesity, and severe oligospermia or azoospermia. Age, BMI, basal FSH, estradiol, leptin on the day of hCG administration, oocyte count on oocyte retrieval, the number of mature oocyte, and fertility rate were analyzed using bivariate and multivariate analysis to determine which eligible factors play role in predicting the successful of fertilization.Results: Significant correlation was found between basal FSH level and serum leptin/oocyte ratio on the day of hCG administration with successful fertilization. We found probability formula as follows: 1/(1+exp –(6.2 - 0.4(leptin serum/oocyte ratio) - 0.8(basal FSH)), with 77.8% sensitivity, 77.8% specificity, and AUC levels of 85.6% indicating strong predictability. Probability of successful fertilization related to basal FSH level of 5.90 mIU/mL and leptin serum/oocyte ratio of 3.98.Conclusion: The formula consisting of basal FSH and leptin serum/oocyte ratio on the day of trigger ovulation was capable in predicting the probability of successful fertilization in IVF procedure.
Association between varicocele grade and semen analysis parameter Ariyati, Ira; Mulyadi, Rahmad; Birowo, Ponco; Wiweko, Budi; Prihartono, Joedo
Medical Journal of Indonesia Vol 26, No 4 (2017): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (660.212 KB) | DOI: 10.13181/mji.v26i4.1623

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Background: Varicocele is a condition characterized by elongation, dilatation and tortuousity of spermatic vein in pampiniform plexus. Approximately 50% of infertility cases among men are caused by varicocele. The varicocele may affect the components of sperm. This study aimed to determine the association between varicocele grade based on ultrasound Doppler examination and sperm concentration, sperm motility, and sperm morphology based on semen analysis examination.Methods: This was a descriptive, cross-sectional study which used secondary data from 85 patients that visited Department of Urology, Cipto Mangunkusumo Hospital, then underwent ultrasonography examination at Department of Radiology, Cipto Mangunkusumo Hospital and semen analysis examination at Department of Obstetrics and Gynecology, Cipto Mangunkusumo General Hospital.Results: Varicocele grade was significantly associated with sperm morphology, concentration and motility (all p<0.05). Significant association was found between maximum condition and semen analysis component.Conclusion: Varicocele grade may affect semen analysis component.
EFFICACY OF SURGICAL SPERM RETRIEVAL IN AZOOSPERMIC PATIENT AND ITS CONTRIBUTION TO IN VITRO RERTILIZATION PROGRAM Gde Sanjaya, I Putu; Birowo, Ponco; Rasyid, Nur; Sini, Ivan Rizal; Wiweko, Budi
Indonesian Journal of Urology Vol 22 No 2 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i2.186

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Objective: This study was made to evaluate efficacy and success rate of Percutaneous Epididymal Sperm Aspiration (PESA), Microsurgical Epididymal Sperm Aspiration (MESA), or Testicular Sperm Extraction (TESE) in azoopsermic patients, and evaluate IVF program’s pregnancy rate by comparing methods of sperm retrieval. Material & method: A descriptive retrospective study to azoospermic patients undergone PESA, MESA or TESE and IVF program in Bunda Hospital Jakarta and Cipto Mangunkusumo Hospital Jakarta in 2011–2012. The data were collected from patients’ medical records and IVF program’s database. Results: There were 146 azoospermic patients with mean age 38.97 ± 7.35 years. Viable sperm was found in 46 patients (31.5%) by PESA and 47 patients (32.2%) by MESA and TESE. The IVF program was followed by 72 patients. Sperm was retrieved by PESA in 43 patients (59.7%) and TESE in 29 patients (40.3%). Pregnancy was achieved in 18 patients in PESA group (25%) and 15 patients (20.8%) in TESE group. Conclusion: Sperm can be retrieved from azoospermic patients by PESA, MESA or TESE, and there was good success rate in pregnancy rate of IVF program by using surgically retrieved sperm.
Anti Müllerian Hormone as a Predictor of Metabolic Syndrome in Polycystic Ovary Syndrome Wiweko, Budi; Susanto, Cynthia A.
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 2, April 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (87.788 KB) | DOI: 10.32771/inajog.v5i2.524

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Objective: To evaluate whether Anti Müllerian Hormone (AMH) can be used as a predictor of metabolic syndrome in Polycystic Ovarian Syndrome (PCOS).Methods: This cross-sectional study was conducted in Yasmin Clinic, Dr. Cipto Mangunkusumo General Hospital Jakarta between June and December 2012. Forty-one patients diagnosed with PCOSbased on Rotterdam Criteria were enrolled. Secondary were was taken from medical record..Results: A total of 22 subjects were involved in this study. Mean AMH level in the metabolic syndrome group is compared to the non-metabolic syndrome group (10.72 ± 6.23 ng/ml vs 7.97 ± 4.50ng/ml, p=0.12). AMH was strongly associated with HDL, triglyceride and insulin resistance (r-value of -0.29, 0.23, and 0.21 respectively, p < 0.05).Conclusion: AMH can be used as a predictor of metabolic syndrome in PCOS.[Indones J Obstet Gynecol 2017; 5-2: 83-86]Keywords: anti müllerian hormone, metabolic syndrome, polycystic ovarian syndrome
Fertility Preservation: Save Our Hope for the Future It’s Time to Rethink... Wiweko, Budi
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (61.461 KB) | DOI: 10.32771/inajog.v3i4.51

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The Role of Dominant Follicular Diameter and LH in Predicting Ovulation in Cycle with Clomiphene Citrate Wiweko, Budi
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 3, July 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (24.511 KB)

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Objective: To improve diagnostic method to predict ovulation in cycle with clomiphene citrate. Method: This diagnostic research was done in RSUPN Dr. Cipto Mangunkusumo between January 2011 - October 2011 with 31 women who taking CC 50 mg/day and 30 women with normal cycle. Result: Affecting with ovulation in the two groups, it was found that in groups with CC, the follicle diameter is 24.33 ± 3.87 mm with LH 14.21 ± 7.95 IU/l, meanwhile in normal group, follicular diameter is 17.62 ± 3.45 mm with LH 14.42 ± 5.91 IU/l. Cut-off point for follicular diameter simultaneously with ovulation determined by ROC curve was found in 24.33mm (AUC 0.67, sensitivity 0.64, specificity 0.56), meanwhile the cut-off for LH is 14.40 IU/l (AUC 0.61, sensitivity 0.57, specificity 0.43). Conclusion: In group with CC, ovulation occurred in bigger follicular diameter than normal cycle, while LH does not different significantly. [Indones J Obstet Gynecol 2011; 35-3: 128-9] Keywords: clomiphene citrate, follicular diameter, luteinizing hormone
Not only embryo quality but also Endometrial Thickness Contributes to IVF outcome: a retrospective study of all IVF cycles in Yasmin Clinic, Jakarta, Indonesia Wiweko, Budi
Indonesian Journal of Obstetrics and Gynecology Volume. 34, No. 1, January 2010
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (35.141 KB)

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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
Relation between CYP17 Polymorphism and Hyperandrogenemia in Polycystic Ovarian Syndrome Wiweko, Budi
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 1, January 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (62.763 KB)

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Objectives: To find 5-untranslated region polymorphism of CYP17 gene and its connection with hyperandrogenemia in polycystic ovarian syndrome. Methods: A cross sectional descriptive study with consecutive random sampling method. Body mass index, ovarian morphology by ultrasonography, fasting insulin level, fasting blood glucose level, 17-hydroxyprogesterone level, total testosterone level, serum hormone binding globulin level, and CYP17 gene polymorphism in 45 subject with PCOs and 45 control subject who attend Yasmin clinic of Cipto Mangunkusumo General Hospital with menstruation problems were measured. CYP17 gene polymorphism was evaluated using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method with MspA1 restriction enzyme. Results: In PCOs group, the genotype distribution were; 11.1% subject with genotype CC, 71.1% subject with genotype TC and 17.8% subject was wild type TT. In non PCOs group, the genotype distribution for CC, TC and TT respectively were 13.3%, 46.7% and 40%. There was significant difference between both group in distribution of TC and TT genotype, with p value 0.013. Frequencies of allele c and allele t in PCOs group were 47% and 53%. In non PCOs group, frequency of allele c and t were 37% and 63%. There were tendency for higher frequency of allele c in the PCOs group but the difference was not statistically significant. Median FAI value for genotype CC homozygote, TC heterozygote and TT homozygote in PCOs group respectively were; 6.82 (6.07 - 8.23); 5.59 (0.25 -21.45) and 4.74 (3.48 - 8.88). There was tendency for increase FAI value in PCOs group corresponds to variant allele, but the result was not statistically different. Conclusion: There were higher proportion of CC homozygote and TC heterozygote genotype in PCOs patient with tendency of increasing FAI value. [Indones J Obstet Gynecol 2011; 35-1: 3-7] Keyword: polycystic ovarian syndrome, free androgen index, CYP17 polymorphism