1.Executive summary: indonesian guidelines on polycystic ovary syndrome management
Mila MAIDARTI ; Achmad Kemal HARZIF ; Amalia SHADRINA ; Nafi'atul UMMAH ; Wiryawan PERMADI ;
Obstetrics & Gynecology Science 2025;68(3):221-236
Objective:
Polycystic ovary syndrome (PCOS) is a gynecological, endocrine condition characterized by ovulatory disorders, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology. PCOS has significant metabolic and reproductive implications that affect the quality of life of women. This PCOS guideline summary is based on the Indonesian Reproductive Endocrinology and Fertility Association guidelines for PCOS. This guideline is expected to guide the diagnosis and long-term management of PCOS.
Methods:
We searched scientific evidence on the Cochrane and PubMed databases using the keyword “polycystic ovary syndrome”. This evidence was reviewed by experts in the field of obstetrics and gynecology, and recommendations were made based on scientific evidence while considering patient values, costs, and resources.
Results:
A total of 127 recommendations and practice points were made regarding the diagnosis and management of PCOS. The levels of available health services and management algorithms for PCOS in Indonesia are also included.
Conclusion
The first-line treatment for managing hyperandrogenism and menstrual disorders in patients with PCOS is combined oral contraceptives. The first-line treatment for ovulation induction is letrozole, while clomiphene citrate, metformin, gonadotropins, and ovarian surgery serve as the second-line treatment. The third-line treatments included in vitro fertilization, with or without in vitro maturation.
2.Executive summary: indonesian guidelines on polycystic ovary syndrome management
Mila MAIDARTI ; Achmad Kemal HARZIF ; Amalia SHADRINA ; Nafi'atul UMMAH ; Wiryawan PERMADI ;
Obstetrics & Gynecology Science 2025;68(3):221-236
Objective:
Polycystic ovary syndrome (PCOS) is a gynecological, endocrine condition characterized by ovulatory disorders, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology. PCOS has significant metabolic and reproductive implications that affect the quality of life of women. This PCOS guideline summary is based on the Indonesian Reproductive Endocrinology and Fertility Association guidelines for PCOS. This guideline is expected to guide the diagnosis and long-term management of PCOS.
Methods:
We searched scientific evidence on the Cochrane and PubMed databases using the keyword “polycystic ovary syndrome”. This evidence was reviewed by experts in the field of obstetrics and gynecology, and recommendations were made based on scientific evidence while considering patient values, costs, and resources.
Results:
A total of 127 recommendations and practice points were made regarding the diagnosis and management of PCOS. The levels of available health services and management algorithms for PCOS in Indonesia are also included.
Conclusion
The first-line treatment for managing hyperandrogenism and menstrual disorders in patients with PCOS is combined oral contraceptives. The first-line treatment for ovulation induction is letrozole, while clomiphene citrate, metformin, gonadotropins, and ovarian surgery serve as the second-line treatment. The third-line treatments included in vitro fertilization, with or without in vitro maturation.
3.Executive summary: indonesian guidelines on polycystic ovary syndrome management
Mila MAIDARTI ; Achmad Kemal HARZIF ; Amalia SHADRINA ; Nafi'atul UMMAH ; Wiryawan PERMADI ;
Obstetrics & Gynecology Science 2025;68(3):221-236
Objective:
Polycystic ovary syndrome (PCOS) is a gynecological, endocrine condition characterized by ovulatory disorders, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology. PCOS has significant metabolic and reproductive implications that affect the quality of life of women. This PCOS guideline summary is based on the Indonesian Reproductive Endocrinology and Fertility Association guidelines for PCOS. This guideline is expected to guide the diagnosis and long-term management of PCOS.
Methods:
We searched scientific evidence on the Cochrane and PubMed databases using the keyword “polycystic ovary syndrome”. This evidence was reviewed by experts in the field of obstetrics and gynecology, and recommendations were made based on scientific evidence while considering patient values, costs, and resources.
Results:
A total of 127 recommendations and practice points were made regarding the diagnosis and management of PCOS. The levels of available health services and management algorithms for PCOS in Indonesia are also included.
Conclusion
The first-line treatment for managing hyperandrogenism and menstrual disorders in patients with PCOS is combined oral contraceptives. The first-line treatment for ovulation induction is letrozole, while clomiphene citrate, metformin, gonadotropins, and ovarian surgery serve as the second-line treatment. The third-line treatments included in vitro fertilization, with or without in vitro maturation.
4.Executive summary: indonesian guidelines on polycystic ovary syndrome management
Mila MAIDARTI ; Achmad Kemal HARZIF ; Amalia SHADRINA ; Nafi'atul UMMAH ; Wiryawan PERMADI ;
Obstetrics & Gynecology Science 2025;68(3):221-236
Objective:
Polycystic ovary syndrome (PCOS) is a gynecological, endocrine condition characterized by ovulatory disorders, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology. PCOS has significant metabolic and reproductive implications that affect the quality of life of women. This PCOS guideline summary is based on the Indonesian Reproductive Endocrinology and Fertility Association guidelines for PCOS. This guideline is expected to guide the diagnosis and long-term management of PCOS.
Methods:
We searched scientific evidence on the Cochrane and PubMed databases using the keyword “polycystic ovary syndrome”. This evidence was reviewed by experts in the field of obstetrics and gynecology, and recommendations were made based on scientific evidence while considering patient values, costs, and resources.
Results:
A total of 127 recommendations and practice points were made regarding the diagnosis and management of PCOS. The levels of available health services and management algorithms for PCOS in Indonesia are also included.
Conclusion
The first-line treatment for managing hyperandrogenism and menstrual disorders in patients with PCOS is combined oral contraceptives. The first-line treatment for ovulation induction is letrozole, while clomiphene citrate, metformin, gonadotropins, and ovarian surgery serve as the second-line treatment. The third-line treatments included in vitro fertilization, with or without in vitro maturation.
5.Executive summary: indonesian guidelines on polycystic ovary syndrome management
Mila MAIDARTI ; Achmad Kemal HARZIF ; Amalia SHADRINA ; Nafi'atul UMMAH ; Wiryawan PERMADI ;
Obstetrics & Gynecology Science 2025;68(3):221-236
Objective:
Polycystic ovary syndrome (PCOS) is a gynecological, endocrine condition characterized by ovulatory disorders, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology. PCOS has significant metabolic and reproductive implications that affect the quality of life of women. This PCOS guideline summary is based on the Indonesian Reproductive Endocrinology and Fertility Association guidelines for PCOS. This guideline is expected to guide the diagnosis and long-term management of PCOS.
Methods:
We searched scientific evidence on the Cochrane and PubMed databases using the keyword “polycystic ovary syndrome”. This evidence was reviewed by experts in the field of obstetrics and gynecology, and recommendations were made based on scientific evidence while considering patient values, costs, and resources.
Results:
A total of 127 recommendations and practice points were made regarding the diagnosis and management of PCOS. The levels of available health services and management algorithms for PCOS in Indonesia are also included.
Conclusion
The first-line treatment for managing hyperandrogenism and menstrual disorders in patients with PCOS is combined oral contraceptives. The first-line treatment for ovulation induction is letrozole, while clomiphene citrate, metformin, gonadotropins, and ovarian surgery serve as the second-line treatment. The third-line treatments included in vitro fertilization, with or without in vitro maturation.
6.Pregnancy outcomes after all modes of conception in patients with genital tuberculosis: a systematic review and meta-analysis
Dian TJAHJADI ; Jenifer Kiem AVIANI ; Kevin Dominique TJANDRAPRAWIRA ; Ida PARWATI ; Wiryawan PERMADI ; Tono DJUWANTONO ; Tin Chiu LI
Obstetrics & Gynecology Science 2025;68(2):109-130
This systematic review and meta-analysis aimed to summarize the pregnancy outcomes of women diagnosed with genital tuberculosis (GTB) who spontaneously conceived or underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) after being treated with antitubercular therapy (ATT). Publications from the PubMed, Medline, Embase, Ovid, Scopus, Web of Science, and Google Scholar databases were searched from December 20, 2021 to March 5, 2022. The outcomes are presented as pooled averages with 95% confidence intervals. The inconsistency index (I2) test was used to measure the heterogeneity between studies. The certainty of the evidence was assessed using GRADEPro (https://www.gradepro.org/). Of the numerous articles identified, 33 met the inclusion criteria and were included in this systematic review. Generally, there was a significant increase in pregnancy rates among patients who underwent IVF compared with those who underwent ATT (37.9% vs. 23.8%; p=0.02). Conversely, there was no significant difference in pregnancy rates between patients who underwent IUI and those who conceived spontaneously (18.1% vs. 23.8%; p=0.65). In cases in which no abnormalities were found on hysterosalpingography or hysterolaparoscopy, pregnancy rates were comparable between spontaneous and IVF conceptions (48.4% vs. 49.2%). There were no significant differences in pregnancy or live birth rates between patients with GTB and those with other infertility factors undergoing IVF treatment (p>0.05). ATT, which is administered during the early stages of GTB is effective in achieving pregnancy outcomes comparable to IVF. However, in patients with advanced-stage disease, IVF is a superior treatment modality, resulting in increased pregnancy rates.
7.Pregnancy outcomes after all modes of conception in patients with genital tuberculosis: a systematic review and meta-analysis
Dian TJAHJADI ; Jenifer Kiem AVIANI ; Kevin Dominique TJANDRAPRAWIRA ; Ida PARWATI ; Wiryawan PERMADI ; Tono DJUWANTONO ; Tin Chiu LI
Obstetrics & Gynecology Science 2025;68(2):109-130
This systematic review and meta-analysis aimed to summarize the pregnancy outcomes of women diagnosed with genital tuberculosis (GTB) who spontaneously conceived or underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) after being treated with antitubercular therapy (ATT). Publications from the PubMed, Medline, Embase, Ovid, Scopus, Web of Science, and Google Scholar databases were searched from December 20, 2021 to March 5, 2022. The outcomes are presented as pooled averages with 95% confidence intervals. The inconsistency index (I2) test was used to measure the heterogeneity between studies. The certainty of the evidence was assessed using GRADEPro (https://www.gradepro.org/). Of the numerous articles identified, 33 met the inclusion criteria and were included in this systematic review. Generally, there was a significant increase in pregnancy rates among patients who underwent IVF compared with those who underwent ATT (37.9% vs. 23.8%; p=0.02). Conversely, there was no significant difference in pregnancy rates between patients who underwent IUI and those who conceived spontaneously (18.1% vs. 23.8%; p=0.65). In cases in which no abnormalities were found on hysterosalpingography or hysterolaparoscopy, pregnancy rates were comparable between spontaneous and IVF conceptions (48.4% vs. 49.2%). There were no significant differences in pregnancy or live birth rates between patients with GTB and those with other infertility factors undergoing IVF treatment (p>0.05). ATT, which is administered during the early stages of GTB is effective in achieving pregnancy outcomes comparable to IVF. However, in patients with advanced-stage disease, IVF is a superior treatment modality, resulting in increased pregnancy rates.
8.Pregnancy outcomes after all modes of conception in patients with genital tuberculosis: a systematic review and meta-analysis
Dian TJAHJADI ; Jenifer Kiem AVIANI ; Kevin Dominique TJANDRAPRAWIRA ; Ida PARWATI ; Wiryawan PERMADI ; Tono DJUWANTONO ; Tin Chiu LI
Obstetrics & Gynecology Science 2025;68(2):109-130
This systematic review and meta-analysis aimed to summarize the pregnancy outcomes of women diagnosed with genital tuberculosis (GTB) who spontaneously conceived or underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) after being treated with antitubercular therapy (ATT). Publications from the PubMed, Medline, Embase, Ovid, Scopus, Web of Science, and Google Scholar databases were searched from December 20, 2021 to March 5, 2022. The outcomes are presented as pooled averages with 95% confidence intervals. The inconsistency index (I2) test was used to measure the heterogeneity between studies. The certainty of the evidence was assessed using GRADEPro (https://www.gradepro.org/). Of the numerous articles identified, 33 met the inclusion criteria and were included in this systematic review. Generally, there was a significant increase in pregnancy rates among patients who underwent IVF compared with those who underwent ATT (37.9% vs. 23.8%; p=0.02). Conversely, there was no significant difference in pregnancy rates between patients who underwent IUI and those who conceived spontaneously (18.1% vs. 23.8%; p=0.65). In cases in which no abnormalities were found on hysterosalpingography or hysterolaparoscopy, pregnancy rates were comparable between spontaneous and IVF conceptions (48.4% vs. 49.2%). There were no significant differences in pregnancy or live birth rates between patients with GTB and those with other infertility factors undergoing IVF treatment (p>0.05). ATT, which is administered during the early stages of GTB is effective in achieving pregnancy outcomes comparable to IVF. However, in patients with advanced-stage disease, IVF is a superior treatment modality, resulting in increased pregnancy rates.
9.Pregnancy outcomes after all modes of conception in patients with genital tuberculosis: a systematic review and meta-analysis
Dian TJAHJADI ; Jenifer Kiem AVIANI ; Kevin Dominique TJANDRAPRAWIRA ; Ida PARWATI ; Wiryawan PERMADI ; Tono DJUWANTONO ; Tin Chiu LI
Obstetrics & Gynecology Science 2025;68(2):109-130
This systematic review and meta-analysis aimed to summarize the pregnancy outcomes of women diagnosed with genital tuberculosis (GTB) who spontaneously conceived or underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) after being treated with antitubercular therapy (ATT). Publications from the PubMed, Medline, Embase, Ovid, Scopus, Web of Science, and Google Scholar databases were searched from December 20, 2021 to March 5, 2022. The outcomes are presented as pooled averages with 95% confidence intervals. The inconsistency index (I2) test was used to measure the heterogeneity between studies. The certainty of the evidence was assessed using GRADEPro (https://www.gradepro.org/). Of the numerous articles identified, 33 met the inclusion criteria and were included in this systematic review. Generally, there was a significant increase in pregnancy rates among patients who underwent IVF compared with those who underwent ATT (37.9% vs. 23.8%; p=0.02). Conversely, there was no significant difference in pregnancy rates between patients who underwent IUI and those who conceived spontaneously (18.1% vs. 23.8%; p=0.65). In cases in which no abnormalities were found on hysterosalpingography or hysterolaparoscopy, pregnancy rates were comparable between spontaneous and IVF conceptions (48.4% vs. 49.2%). There were no significant differences in pregnancy or live birth rates between patients with GTB and those with other infertility factors undergoing IVF treatment (p>0.05). ATT, which is administered during the early stages of GTB is effective in achieving pregnancy outcomes comparable to IVF. However, in patients with advanced-stage disease, IVF is a superior treatment modality, resulting in increased pregnancy rates.
10.Pregnancy outcomes after all modes of conception in patients with genital tuberculosis: a systematic review and meta-analysis
Dian TJAHJADI ; Jenifer Kiem AVIANI ; Kevin Dominique TJANDRAPRAWIRA ; Ida PARWATI ; Wiryawan PERMADI ; Tono DJUWANTONO ; Tin Chiu LI
Obstetrics & Gynecology Science 2025;68(2):109-130
This systematic review and meta-analysis aimed to summarize the pregnancy outcomes of women diagnosed with genital tuberculosis (GTB) who spontaneously conceived or underwent intrauterine insemination (IUI) or in vitro fertilization (IVF) after being treated with antitubercular therapy (ATT). Publications from the PubMed, Medline, Embase, Ovid, Scopus, Web of Science, and Google Scholar databases were searched from December 20, 2021 to March 5, 2022. The outcomes are presented as pooled averages with 95% confidence intervals. The inconsistency index (I2) test was used to measure the heterogeneity between studies. The certainty of the evidence was assessed using GRADEPro (https://www.gradepro.org/). Of the numerous articles identified, 33 met the inclusion criteria and were included in this systematic review. Generally, there was a significant increase in pregnancy rates among patients who underwent IVF compared with those who underwent ATT (37.9% vs. 23.8%; p=0.02). Conversely, there was no significant difference in pregnancy rates between patients who underwent IUI and those who conceived spontaneously (18.1% vs. 23.8%; p=0.65). In cases in which no abnormalities were found on hysterosalpingography or hysterolaparoscopy, pregnancy rates were comparable between spontaneous and IVF conceptions (48.4% vs. 49.2%). There were no significant differences in pregnancy or live birth rates between patients with GTB and those with other infertility factors undergoing IVF treatment (p>0.05). ATT, which is administered during the early stages of GTB is effective in achieving pregnancy outcomes comparable to IVF. However, in patients with advanced-stage disease, IVF is a superior treatment modality, resulting in increased pregnancy rates.