Ovarian fecundity in patients with endometriosis can be estimated by the incidence of apoptotic bodies

OBJECTIVE: To investigate the incidence of apoptotic bodies in membrana granulosa in patients with endometriosis. DESIGN: Retrospective analysis. SETTING: Yamagata University Hospital. PATIENT(S): Fifty-eight normoovulatory women with endometriosis and 45 patients with male factor infertility underwent ovulation induction for IVF-ET with GnRH analogues and gonadotropins. INTERVENTION(S): Patients underwent follicle aspiration after the administration of hCG. MAIN OUTCOME MEASURE(S): Recovered granulosa cells (GCs) were examined by fluorescence microscopy, and the incidence of apoptotic bodies was tabulated. These data and the other parameters associated with IVF results were analyzed on the basis of both the revised American Fertility Society (AFS) classification of endometriosis and the existence of chocolate cysts. RESULT(S): The incidence of apoptotic bodies in membrana granulosa of patients with endometriosis was significantly higher than that of the control (male factor infertility) group and increased as the stage of the revised AFS classification advanced. The incidence of apoptotic bodies in membrana granulosa was significantly higher in patients with chocolate cysts than in those without chocolate cysts. The patients with endometriosis had smaller numbers of developed follicles (> or = 15 mm), harvested oocytes, and mature oocytes than the male factor infertility patients. The existence of chocolate cysts corresponded with a reduced number of both harvested oocytes and mature oocytes. CONCLUSION(S): Through the apoptosis of GCs, the existence of endometriosis may have negatively affected the follicle development and oocyte quality.