Evaluation of the Phthalate Esters in South Indian Women with Endometriosis

Roya Rozati, Baludu G. Simha, Netaji Bendi, C. Chandra Sekhar, Chandra Sekhar
In: International Journal of Fertility and Sterility, Vol 1, Iss 4, Pp 165-170 (2008) · 2008 · doi:10.22074/ijfs.2007.46210 · W2290923876
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This study found significantly higher concentrations of five phthalate esters in South Indian women with endometriosis compared to controls, suggesting a potential role in the disease's etiology.

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This prospective case-control study evaluated an association between phthalate esters and endometriosis in South Indian women undergoing infertility treatment, enrolling 99 infertile women with endometriosis and 135 age-matched infertility controls without endometriosis (confirmed by laparoscopy at the time of sterilization, with other gynecologic disorders excluded). Phthalate ester concentrations were measured in blood using high-performance liquid chromatography, and women with endometriosis had significantly higher levels of multiple phthalate esters (including DMP, DEP, DnBP, BBP, and BEHP) than controls; the paper also reports that 38% of endometriosis cases versus 21% of controls had elevated levels. Correlations between phthalate ester concentrations and endometriosis severity were strong and statistically significant for all tested compounds (with reported correlation coefficients and p-values). The paper’s main caveat is that it assesses association in a case-control design rather than demonstrating causation. This paper is centrally about endometriosis — it evaluates whether phthalate esters are associated with the occurrence and severity of endometriosis in South Indian women.

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Abstract

Background To evaluate the possible association between phthalate esters (PEs) and the occurrence of endometriosis. Blood samples were collected from 99 infertile women with endometriosis (study group); 135 age-matched women without endometriosis (control group) but with infertility related to tubal defects, fibroids, polycystic ovaries, idiopathic infertility and pelvic inflammatory diseases diagnosed by laparoscopy with no evidence of endometriosis or other gynecological disorders during laparoscopic sterilization. Materials and methods This is a prospective case-control study, which recruited women undergoing infertility treatment at three collaborating centers (BMMHRC: Bhagwan Mahavir Medical Hospital and Research Centre, MHRT: Maternal Health and Research Trust, and Owaisi Hospital and Research Center) of Reproductive Medicine Hyderabad, which receives cases from all over the region of Andhra Pradesh, India. The concentrations of Phthalate Esters were measured by using the High Performance Liquid Chromatography (HPLC). Evaluation of Phthalate Esters concentrations in women with endometriosis compared with women who are free from the disease. Results Women with endometriosis showed significantly higher concentrations of Phthalate esters (Dimethyl phthalate (DMP), Diethyl phthalate (DEP), Di-n-butyl phthalate (DnBP), Butyl benzyl phthalate (BBP) and Bis (2-ethylhexyl) phthalate (BEHP)) compared with control group. We found that (38%) of the cases with endometriosis and (21%) of the control group. The correlation between the concentrations of Phthalate esters and different severity of endometriosis was strong and statistically significant at p<0.05 for all five compounds (DMP): r=+0.57, p<0.0001; DnBP r=+0.39, p<0.0001; BBP: r=+0.89, p<0.0001; DnOP: r=+0.66, p<0.0001 and BEHP: r=+0.33, p<0.0014. Conclusion This study for the first time from Indian subcontinent demonstrates that possibly Phthalate Esters might have a role in etiology of endometriosis.
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International Journal of Fertility and Sterility (Feb 2008) Evaluation of the Phthalate Esters in South Indian Women with Endometriosis Abstract Background To evaluate the possible association between phthalate esters (PEs) and the occurrence of endometriosis. Blood samples were collected from 99 infertile women with endometriosis (study group); 135 age-matched women without endometriosis (control group) but with infertility related to tubal defects, fibroids, polycystic ovaries, idiopathic infertility and pelvic inflammatory diseases diagnosed by laparoscopy with no evidence of endometriosis or other gynecological disorders during laparoscopic sterilization. Materials and methods This is a prospective case-control study, which recruited women undergoing infertility treatment at three collaborating centers (BMMHRC: Bhagwan Mahavir Medical Hospital and Research Centre, MHRT: Maternal Health and Research Trust, and Owaisi Hospital and Research Center) of Reproductive Medicine Hyderabad, which receives cases from all over the region of Andhra Pradesh, India. The concentrations of Phthalate Esters were measured by using the High Performance Liquid Chromatography (HPLC). Evaluation of Phthalate Esters concentrations in women with endometriosis compared with women who are free from the disease. Results Women with endometriosis showed significantly higher concentrations of Phthalate esters (Dimethyl phthalate (DMP), Diethyl phthalate (DEP), Di-n-butyl phthalate (DnBP), Butyl benzyl phthalate (BBP) and Bis (2-ethylhexyl) phthalate (BEHP)) compared with control group. We found that (38%) of the cases with endometriosis and (21%) of the control group. The correlation between the concentrations of Phthalate esters and different severity of endometriosis was strong and statistically significant at p<0.05 for all five compounds (DMP): r=+0.57, p<0.0001; DnBP r=+0.39, p<0.0001; BBP: r=+0.89, p<0.0001; DnOP: r=+0.66, p<0.0001 and BEHP: r=+0.33, p<0.0014. Conclusion This study for the first time from Indian subcontinent demonstrates that possibly Phthalate Esters might have a role in etiology of endometriosis. Keywords

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