Immunological factors in endometriosis-associated reproductive failure: studies in fertile and infertile women with and without endometriosis

Sergio Martínez‐Román, Martínez-Román S, S Martínez-Román, Balasch J, Juan Balasch, J Balasch, Montserrat Creus, M Creus, Creus M, F Fábregues, Fábregues F, Francisco Fábregues, F Carmona, Francisco Carmona, Vilella R, R. Vilella, Juan A. Vanrell, Vanrell JA, J A Vanrell
Human Reproduction · 1997 · vol. 12(8) , pp. 1794–1799 · doi:10.1093/humrep/12.8.1794 · PMID:9308814 · W1993053397
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This study investigated immunological factors in women with and without endometriosis and infertility, finding that peritoneal fluid abnormalities and higher sperm phagocytosis by macrophages are associated with endometriosis-related infertility, not just endometriosis itself.

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Abstract

Immunopathophysiological mechanisms in endometriosis-associated reproductive failure were studied in appropriate populations: infertile and fertile women with and without endometriosis. The incidence of sera positive for any of the autoantibodies tested among infertile women with endometriosis (n = 25) was similar to that observed in the three control groups [unexplained infertility patients (n = 25) and fertile women with (n = 10) and without (n = 25) endometriosis]. The mean volume of peritoneal fluid was significantly elevated in women with endometriosis (both fertile and infertile) as compared with patients without endometriosis (fertile or infertile). The concentration of peritoneal fluid leukocytes and the percentage of cells positive for macrophage markers were significantly increased and the percentage of T lymphocytes significantly decreased in infertile women with endometriosis but not in patients with unexplained infertility and fertile women with endometriosis, as compared with fertile controls without endometriosis. Macrophages from infertile patients with endometriosis had higher sperm phagocytosis than did those from infertile women without endometriosis or fertile subjects with or without endometriosis. Incidences of serum and peritoneal fluid samples embryotoxic to the in-vitro development of 2-cell mouse embryos were significantly higher in infertile patients with endometriosis than in unexplained infertility patients and fertile women with or without endometriosis. It is concluded that immunological mechanisms of endometriosis-associated infertility exist but that these peritoneal immunological factors in infertile women with endometriosis are related to their subfertility rather than to the presence of ectopic endometrial implants. This is supported by the lack of immunological abnormalities observed among fertile women with endometriosis. These immunological abnormalities are lacking in patients with unexplained infertility.

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Condition tags

endometriosisinfertility

MeSH descriptors

Ascitic Fluid Autoantibodies Endometriosis Infertility, Female Adult Animals Ascitic Fluid Autoantibodies Biological Assay Case-Control Studies Endometriosis Female Humans Infertility, Female Mice Prospective Studies

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