Mulheres inférteis com endometriose pélvica mínima e leve submetidas à estimulação ovariana apresentam menor expressão do gene CYP19A1 em células do cumulus
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Infertile women with minimal to mild endometriosis showed significantly lower CYP19A1 gene expression in cumulus cells compared to infertile controls.
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Abstract
Menores taxas de gestação em portadoras de endometriose submetidas a técnicas de reprodução assistida podem estar relacionadas à piora da qualidade oocitária. A análise da expressão gênica em células do cumulus (CC) pode fornecer biomarcadores passíveis de predizer a qualidade gamética. O objetivo deste estudo foi comparar os níveis da expressão do gene CYP19A1 em CC de mulheres inférteis com endometriose mínima/leve (I/II) e controles inférteis. Foram selecionadas pacientes com infertilidade por endometriose pélvica inicial e por fator masculino e/ou tubário (grupo controle), submetidas à estimulação ovariana controlada para injeção intracitoplasmática de espermatozoide (ICSI). Imediatamente após a captação oocitária, CC foram isoladas e armazenadas. Foi realizada a quantificação da expressão do gene CYP19A1 nas CC por meio de PCR-Real Time. Foram isoladas CC de 23 mulheres inférteis com endometriose I/II e de 41 controles. Observou-se expressão significativamente menor do gene CYP19A1 em CC de mulheres inférteis com endometriose I/II (0,56 ± 0,17) quando comparadas às controles (0,15 ± 0,04) (p = 0,043). A menor expressão do gene CYP19A1 em CC de mulheres inférteis com endometriose pélvica em estágios iniciais pode mediar a piora da qualidade oocitária, abrindo novas perspectivas no entendimento da etiopatogênese da infertilidade relacionada à doença. Lower pregnancy rate in women with endometriosis submitted to assisted reproductive techniques might be related to poor oocyte quality. The analysis of the expression of the genes in cumulus cells (CC) might provide biomarkers that can predict gamete quality. The main objective of the present study was to compare the levels of the expression of the gene CYP19A1 in CC of infertile women with minimal and mild (I/II) endometriosis and infertile controls. There were selected patients with infertility caused by initial pelvic endometriosis and by male/tubal factor (control group), submitted to controlled ovarian stimulation to ICSI. Immediately after the oocyte retrieval, CC were isolated and stored. Quantification of the expression of the gene CYP19A1 in CC was performed using PCR-real time. CC were isolated from 23 infertile women with endometriosis I/II and 41 from control. Significant lower expression of the gene CYP19A1 in CC was observed in infertile women with endometriosis I/II (0.56 ± 0.17) when compared to control (0.15 ± 0.04) (p = 0,043). The lower expression of the gene CYP19A1 in CC of infertile women with pelvic endometriosis in initial stages might mediate the poor oocyte quality, opening new perspectives on the understanding of the etiopathogenesis of infertility related to the disease.
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