Endocrine and inflammatory factors and endometriosis-associated infertility in assisted reproduction techniques

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Endometriosis negatively impacts assisted reproduction outcomes, with higher follicular fluid PGE2 and lower granulosa cell aromatase observed in affected patients.

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This study evaluated how endometriosis affects folliculogenesis and ART outcomes by measuring inflammatory factors (IL1b, PGE2, PGF2α, and TGFβ2) and steroid hormones (E2, progesterone, FSH, and LH) in follicular fluid and assessing serum E2 and LH, alongside granulosa cell mRNA expression of IL1b, Ptgs2, aromatase, and PPARγ, in 65 ART patients. Patients with endometriosis had significantly lower oocyte retrieval, metaphase II rate, cleavage rate, effective embryo rate, and pregnancy rates than controls, and serum E2 was lower in the endometriosis group. In granulosa cells from patients with endometriosis, aromatase levels were lower, while follicular fluid PGE2 was higher; PGE2, PGF2α, TGFβ2, and IL1b were also significantly correlated with each other. The paper explicitly concludes that among the endocrine and inflammatory factors, PGE2 in follicular fluid impairs oocyte number and quality and notes these results in relation to serum E2, while the main caveat is that the study uses observational associations in measured samples rather than demonstrating causality. This paper is centrally about endometriosis — it links inflammatory and endocrine markers in follicular fluid to endometriosis-associated infertility and reduced ART outcomes.

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Abstract

PurposeOur research aimed to evaluate the effect of endometriosis on folliculogenesis and pregnancy, and to assess the involvement of inflammatory factors (IL1b, PGE2, PGF2α, and TGFβ2) in follicular fluid.MethodsA total of 65 follicular fluid aspirates were collected. Concentrations of inflammatory factors (IL1b, PGE2, PGF2α, and TGFβ2) and steroid hormones (E2, progesterone, FSH, and LH) within follicular fluid as well as serum E2 and LH concentrations were measured. The mRNA expression of IL1b, Ptgs2, aromatase, and PPARγ in granulosa cells was determined. The outcome of ART was monitored and recorded.ResultsThe oocyte retrieval, rate of metaphase II oocyte, cleavage rate, effective embryo rate, and pregnancy rates of patients with endometriosis were all significantly lower than those of the control patients. In those with endometriosis, serum E2 concentrations were lower than those observed in controls. Aromatase levels in the granulosa cells of the endometriosis group were lower while concentrations of PGE2 in follicular fluid were higher than in the control group. Concentrations of PGE2, PGF2α, TGFβ2, and IL1b were significantly correlated with each other.ConclusionsThese results suggest that the outcomes of ART, in relation to serum E2 concentration, were adversely affected by the presence of endometriosis. Furthermore, the results supported that, among the endocrine and inflammatory factors, PGE2 within the follicular fluid impairs the number and quality of oocytes.
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Abstract

Purpose Our research aimed to evaluate the effect of endometriosis on folliculogenesis and pregnancy, and to assess the involvement of inflammatory factors (IL1b, PGE2, PGF2α, and TGFβ2) in follicular fluid.

Methods

A total of 65 follicular fluid aspirates were collected. Concentrations of inflammatory factors (IL1b, PGE2, PGF2α, and TGFβ2) and steroid hormones (E2, progesterone, FSH, and LH) within follicular fluid as well as serum E2 and LH concentrations were measured. The mRNA expression of IL1b, Ptgs2, aromatase, and PPARγ in granulosa cells was determined. The outcome of ART was monitored and recorded.

Results

The oocyte retrieval, rate of metaphase II oocyte, cleavage rate, effective embryo rate, and pregnancy rates of patients with endometriosis were all significantly lower than those of the control patients. In those with endometriosis, serum E2 concentrations were lower than those observed in controls. Aromatase levels in the granulosa cells of the endometriosis group were lower while concentrations of PGE2 in follicular fluid were higher than in the control group. Concentrations of PGE2, PGF2α, TGFβ2, and IL1b were significantly correlated with each other.

Conclusions

These results suggest that the outcomes of ART, in relation to serum E2 concentration, were adversely affected by the presence of endometriosis. Furthermore, the results supported that, among the endocrine and inflammatory factors, PGE2 within the follicular fluid impairs the number and quality of oocytes. Similar content being viewed by others

References

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Conflict of interest We certify that this work is our original unpublished work and it has not been submitted elsewhere for publication, and we have full control of all primary date, all authors have approved the manuscript to submit to your journal. It is submitted with the full knowledge and approval of the institution or organization given as the affiliation of the authors. No conflict of interest exists with this research. Author information Authors and Affiliations Corresponding authors Rights and permissions About this article Cite this article Du, YB., Gao, MZ., Shi, Y. et al. Endocrine and inflammatory factors and endometriosis-associated infertility in assisted reproduction techniques. Arch Gynecol Obstet 287, 123–130 (2013). https://doi.org/10.1007/s00404-012-2567-0 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-012-2567-0

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Condition tags

endometriosisinfertility

MeSH descriptors

Cytokines Endometriosis Follicular Fluid Hormones Infertility, Female Reproductive Techniques, Assisted Adult Aromatase Aromatase Aromatase Cytokines Dinoprost Dinoprost Dinoprostone Dinoprostone Endometriosis Endometriosis Endometriosis Estradiol Estradiol

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