LIFESTYLE OF POLYCYSTIC OVARY PATIENTS IN TRESNA MATERNITY HOSPITAL, MATARAM CITY IN 2020

ABSTRACT


INTRODUCTION
Every fair sex certainly wants to feel the experience of being a complete woman by conceiving and giving birth to children. That is one of the goals of a pair of human children deciding to tie the rope of love by marriage, to get offspring and build a happy family. But not a few married couples who have to wait a long time to get offspring. There are even those who have given up on having a baby because they have been married for a long time, and their wife has not yet conceived. This situation is usually called infertility or in medical language it is called infertile (Hecker, 2010).
According to the World Health Organization (WHO), infertility is the inability of a married couple to get pregnant after one year of marriage, having regular sexual intercourse and without using any contraceptives (WHO, 2004., Triwani, 2013. The failure of a husband and wife to e-ISSN: 2686-2123 p-ISSN: 2686-0538 get offspring can be caused by problems in men and or women. Approximately 40% of infertility occurs due to female factors, 40% male factors, and 30% male and female factors (Triwani, 2013). Based on a survey in the United States in 2006-2010, there were more than 1.5 million married women aged 15-44 who were infertile (Tammy, 2015). In Iran there are 5.52% of couples of childbearing age who experience infertility, including primary infertility of 3.48% and secondary infertility of 2.04% (Aflatonia, 2009).
From data from the Central Bureau of Statistics (BPS) in Indonesia, it is estimated that 12% of married couples are unable to produce children (Ahsan, 2012). According to the Indonesian Association of Obstetrics and Gynecology, the prevalence of infertility with idiopathic causes is reported to be around 22-28%, as many as 22% in women aged less than 35 years and 26% in those aged more than 35 years (POGI, 2013). According to research put forward by the World Health Organization (World Health Organization, WHO) of 33 patients studied by health centers in 25 countries including eastern and western Europe, Canada, Australia, Scandinavia, Africa, Asia, Latin America and the Mediterranean it was concluded that the causes of infertility are impaired ovarian function 29%, tubal occlusion and tubal attachments 32%, endometriosis 3% and 36% have no known cause. Infertile data worldwide according to WHO and other reports, it is estimated that 8-10% or around 50-80 million married couples worldwide experience infertility problems, thus making infertility an urgent problem, awareness of this matter is increasing rapidly, the number of couples infertile in Indonesia can be calculated from the number of women who have been married and do not have children who are still alive, then according to the population census there are 12% both in villages and in cities, or approximately 3 million infertile couples throughout Indonesia (Wiknjosastro, 2010). Infertility in women is generally caused by ovulation disorders, tubal disorders, uterine disorders and others. One of the causes of ovulation disorders is Polycystic Ovary Syndrome (PCOS) (Putri, 2016). According to Missmer et al. (2013) as many as 30% of PCOS people experience anovulation (Riska Mareta, 2018).
Data at the Tresna Maternity Hospital in 2020 showed that 300 mothers visited and examined themselves in the obstetric room in 2019 from September to December, 66 people were diagnosed with infertility (22.0%) and 234 were not diagnosed people (78.0%). Whereas in 2020 from January to July there were 525 fertile couples, 103 (19.6%) people were diagnosed with infertility, 422 people (80.3%) were not diagnosed with infertility (Tresna Maternity Hospital, 2020). From the data obtained by the author at the Tresna Maternity Hospital, the number of sufferers Polycystic Ovary (PCO) as many as 26 people.
Polycystic ovary syndrome (PCOS or Polycystic Ovary Syndrome) is also known as Stein-Leventhal Syndrome. In 1935 it was first described as amenorrhea associated with bilateral polycystic ovaries (Fahimeh, 2015). However, it is currently interpreted as a metabolic clinical condition that often occurs in women of reproductive age in the short term which will cause reproductive dysfunction. However, if it occurs in the long term it will also cause metabolic disorders (Moran, 2004). One of the diagnostic criteria for polycystic ovary syndrome is the presence of 2 or more of the following criteria, namely irregular menstruation, chronic anovulation, evidence of hyperandrogenism in biochemical examinations and evidence of polycystic ovaries in sonographic examination (Carmina, 2006). The presence of chronic anovulation is a risk factor for ovarian cancer. Therefore, treatment for ovarian cysts is not only limited to correcting shortterm problems such as reproductive problems but also the possible long-term effects.
Infertility can be caused by various factors, both from husband and wife factors. Meanwhile, infertility for husbands is around 40%, including sperm abnormalities, narrowing of the seminal canal, immunological or antibody factors, and nutritional factors. The combined factors caused by both husband and wife are about 3%. Meanwhile due to unexplained factors around 2% (Anwar, 2008). The cause of a woman and a man becoming infertile can also be caused by an increased risk factor, namely an uncontrolled lifestyle that has been applied since their teens. These factors are age, smoking habits, consuming alcohol, stress, poor diet, strenuous exercise, experiencing overweight or underweight, sexually transmitted diseases, poor environmental conditions (air and water pollution), as well as health problems related to hormones. One of the factors causing infertility in women is from the egg, the most common of which is PCO. PCO are small follicles which are usually less than 1.8 cm / 18 mm in size and can be examined through diagnostic tests, namely ultrasonography (USG) transvaginal.
Based on preliminary studies, some patients have received treatment to treat PCO, but many have not had a good effect. One of the causes of infertility is lifestyle, so researchers are interested in examining the lifestyle of sufferers polycystic ovary at the Tresna Maternity Hospital Mataram City, West Nusa Tenggara.

METHOD Design
The design used in this study is a descriptive design which is a research conducted to describe or describe a phenomenon that occurs in society. This research was conducted on September 6-20 2020 at Tresna Maternity Hospital, Mataram City.

Samples and sampling techniques
All mothers suffer Polycystic Ovary in the Tresna Maternity Hospital, Mataram City, from January to June 2020, there were 26 people who were used as the population and sample. Sampling technique using total sampling where the sampling technique uses the total population.

Instrument
The tool used in collecting research data is a questionnaire in which there are questions that are well structured, mature, where the respondent only has to give answers or by giving certain signs. The type of questionnaire used was a closed questionnaire (Closed Ended) is a form of question that makes it easier for respondents to provide answers, and is also easy to process (tabulate). The question form used is Dischotomous Choice where the respondent is only provided with two answers/alternatives, and only chooses one of them.

Intervention
First, respondents who agreed to be the research sample were asked to fill out a consent form to become respondents, namely informed consent. Then, in the second stage, respondents were asked to fill out a questionnaire to find out the respondent's data and the lifestyle they lived.

Analysis Data
This study conducted research with data collection methods by observation, identification, interviews and filling out questionnaires. The collected data were analyzed through the SPSS program and continued with analysis using descriptive analysis using tabulations of the frequency distribution of the studied variables which were then interpreted in the form of narratives and tables. The data that has been 21 In te rna tio na l Jour na l of N urs in g a nd M id w if er y S ci en ce (I JNMS ) ,Volume 7, Issue 1, April 2023 processed can be used as a basis for discussing problem statements which can then be presented in tabular form and conclusions can be drawn.

Ethical considerations
In conducting research, it is necessary to obtain recommendations from the institution or other parties by submitting an application for permission to the institution or institution where the research is conducted. When conducting research, researchers need to pay attention to several ethical considerations or aspects, including: anonymity, confidentiality, autonomy, justice and beneficence. The researcher asked the respondent's consent to participate (informed consent) before the research was conducted. Source: Primary Data, 2020 Based on table 1 above shows that the age of the patient's mother Polycystic Ovary, most have 20-35 years of age by 18 respondents (69.2%) and not found at the age of <20 years.

Mother's age in sufferers polycystic ovary
Based on the results of research conducted by researchers on 26 respondents, it can be seen that the majority of respondents were aged 20-35 years, 18 respondents (69.2%) and were not found at age <20 years. Age is one of the factors that influence female infertility. At the reproductive age of 20-35 years the reproductive organs are ready to be fertilized, fertility at this age can decrease because there are many influencing factors such as body weight that is not ideal (too fat or too thin), stress, lack of exercise and disease in the reproductive organs. In this study, all respondents aged 20-35 years did not exercise regularly. This research is in accordance with research conducted by Gita Hafas in 2010 with the title Effect of Age on Female Fertility, found that the reproductive age of 20-34 years was 22% (Gita Hafas, 2010).
From the results of the research above, based on the provisions of the BKKBN, this age is included in the healthy reproductive age, namely the age of 20-35 years which is related to physical and psychological health, free from disability and related to the reproductive system, its functions and processes (Kemenpppa, 2016in Arlyana, 2021. Based on the results of the study, it was also found that the outcomes of pregnant women at risk of having a baby born with asphyxia (63%) due to impaired uterine blood flow, preeclampsia and eclampsia (Wahyuni & Riyanti, 2018).

Lifestyle of polycystic ovary sufferers
Based on the results of research conducted by researchers on 26 respondents, it can be seen that the majority of respondents have a healthy lifestyle of 22 respondents (84.6%) and a small proportion of respondents have an unhealthy lifestyle of 4 respondents (15.4%).
Lifestyle is a lifestyle by paying attention to certain factors that affect daily life (Soekidjo, 2012). Factors that affect a healthy lifestyle, namely behavior patterns including skipping breakfast, not moving enough, eating high-calorie snacks and lifestyle changes including lack of exercise, drinks containing caffeine and consuming less vegetables and fruit.
In this study, it was found that 22 respondents experienced a healthy life but still suffered Polycystic Ovary because 18 respondents with PCO are career women or workers. This makes the mother often feel tired due to her workload and the average number of hours worked> 10 hours a day so that mothers are vulnerable to stress which can affect ovulation. In addition, it was found that 4 respondents were housewives, who spend more time at home, but in their lifestyle mothers often consume foods that should be limited but are consumed in excess, such as carbohydrates and do not carry out physical movements such as sports. And from research on 26 respondents, both those whose life categories were healthy or unhealthy, most of them rarely did sports and were prone to stress. This research is in accordance with research conducted by Nervian in 2013 with the title Effect of Lifestyle on Infertility, it was found that infertile women are due to an unhealthy lifestyle.

CONCLUSIONS
Based on data processing and analysis regarding the study "Lifestyle of Polycystic Ovary Sufferers at Tresna Maternity Hospital in 2015" most of the mothers who suffer from Polycystic Ovary are aged 20-35 years as many as 18 samples (69.2%) and most of the mothers who have a lifestyle healthy as many as 22 samples (84.6%). In conclusion, mothers who suffer from Polycystic Ovary already live a healthy lifestyle, so it is hoped that mothers will pay more attention to their lifestyle such as exercise and food consumed so that their lifestyle will be better.