Chairman of the Board of Professors (DGB) of Universitas Indonesia (UI), Prof. Harkristuti Harkrisnowo, S.H., M.A., Ph.D. inaugurated Prof. Dr. dr. R Muharam, SpOG, Subsp. F.E.R, MPH as Professor in the Field of Obstetrics and Gynecology, Faculty of Medicine (FK) UI, on Saturday (2/12), at the IMERI Hall FKUI Salemba, Jakarta. Prof. Muharam was inaugurated as a professor after delivering a scientific oration entitled “Comprehensive Transformation of Endometriosis Treatment with Artificial Intelligence as an Effort to Improve Reproductive Quality in the Future”.
In his speech, Prof. Muharam said that endometriosis is one of the causes of maternal morbidity in the field of reproductive immunoendocrinology. Endometriosis is a chronic inflammatory disease in the form of the growth of abnormal tissue such as the endometrium outside the uterine cavity and myometrium which triggers a chronic inflammatory reaction. It is progressive in nature with a high recurrence rate. Symptoms of endometriosis vary, including menstrual pain, infertility, pain during sexual intercourse, disturbances in the menstrual cycle, and discomfort when defecating.
The prevalence of endometriosis is currently quite high, reaching 190 million cases worldwide, of which 6-10 percent are found in women of reproductive age. The recurrence rate for endometriosis is also quite high, namely 23-56 percent. However, Prof. Muharam stated that the diagnosis of endometriosis is often delayed by up to 7-11 years. This is influenced by a number of factors, such as the onset or initial attack of symptoms, pain that is considered normal by doctors, and misdiagnosis. In fact, endometriosis carries great risks to the reproductive system.
“One of the biggest impacts of endometriosis is infertility. Currently, many endometriosis patients are referred to tertiary fertility referral centers, such as Dr. Cipto Mangunkusumo Hospital, in serious condition with very low egg reserves due to late diagnosis, over-treatment and repeated operations, causing the pregnancy success rate for endometriosis patients to be poor,” said Prof. Sacred.
Until now, the main treatment modality of choice for endometriosis is conservative to definitive medical and surgical therapy with the focus of management being fertility preservation. Medical therapy includes the use of contraceptive pills and progestins that are resistant to progesterone resistance, such as dienogest. The second option is conservative or definitive or radical surgery, which is carried out if it has caused interference with other vital organs such as the ureters, intestines and bladder.
Assisted Reproductive Technology (ART) has also shown good results for fertility management in women with endometriosis. Infertility patients with mild endometriosis (stage I/II rASRM) can undergo Intrauterine Insemination (IUI) and ovarian stimulation. Meanwhile, In Vitro Fertilization can be performed for moderate-severe endometriosis (grade III-IV). Furthermore, current management of endometriosis also includes immunotherapy, stem cells and artificial intelligence.
According to Prof. Muharam, artificial intelligence is a necessity in the management of endometriosis to overcome the complex pathophysiology of endometriosis. Armed with the four main roots of artificial intelligence, namely Machine learning (ML), Natural Language Processing (NLP), Artificial Neural Networks (AAN), and Computer Vision, a new artificial intelligence can be created that will help manage endometriosis in the future. Artificial intelligence will be able to improve diagnostic capabilities, improve personalized therapy, improve surgical outcomes, discover pathophysiology and improve the accuracy of the severity of endometriosis.
Before conducting a study on treating endometriosis with artificial intelligence, Prof. Muharam has done a lot of research. Some of them are Downregulation of miR-93 negatively correlates with overexpression of VEGFA and MMP3 in endometriosis: a cross-sectional study (2023), Impact of COVID-19 Vaccination on IVF Outcomes: A Systematic Review (2023), and Cytotoxic activity of peripheral blood mononuclear cells in patients with endometriosis: A cross-sectional study (2022).
Prof. Dr. dr. R Muharam, SpOG, Subsp. F.E.R, MPH completed the FK UI Medical Education Program in 1993; completed the FK UI Obstetrics and Gynecology Specialist Education Program in 2001; completed the Fertility and Reproductive Endocrinology Consultant Program from the Indonesian Collegium of Obstetrics and Gynecology in 2005; obtained a Doctor of Medicine degree at FK UI in 2011; and completed the Public Health Science Program, Gadjah Mada University in 2020. He is Special Staff to the Director of Nursing and Supporting Medical Services, Dr. Cipto Mangunkusumo National Center General Hospital (RSCM) and Head of the Immunoendocrinology Division, Department of Obstetrics and Gynecology RSCM/FKUI.
The inauguration procession of professor Prof. Muharram was also attended by the Minister of Health of the Republic of Indonesia for the 1998-1999 period, Prof. Dr. dr. H. Faried Anfasa Moeloek, Sp.OG(K); Minister of Health of the Republic of Indonesia for the 2014-2019 period, Prof. Dr. dr. Nila Djuwita Faried Anfasa Moeloek, Sp.M(K); First Definitive Dean of the Faculty of Medicine and Health Sciences, Indonesian Defense University, Major General TNI Dr. dr. Sutan Finekri Arifin Abidin, Sp. OG, Subsp. KFm, MARS, M.H; Main Director Hermina Jatinegara, dr. Nienne Aridayanthi Hainun, MARS, M.H; Professor of FK Padjadjaran University/Chair of the Indonesian Reproductive Endocrinology and Fertility Association, Prof. Dr. dr. Wiryawan Permadi, Sp.OG, Subsp.FER; and Professor of FK Airlangga University/Chair of the Indonesian In Vitro Fertilization Association, Prof. Dr. dr. Hendy Hendarto, Sp.OG, Subsp.FER.
Author: Dyra Daniera
