Steroids and protein markers in the follicular fluid as indicators of oocyte quality in patients with and without endometriosis

Purpose: To investigate the concentrations of steroid hormones (estradiol, progesterone), pregnancy–associated protein-A, IGF-binding protein-4 and leptin in the follicular fluid of infertile patients with and without endometriosis.

Follicular fluid of IVF patients with and without endometriosis was aspirated, centrifuged and stored to analyze the above mentioned hormones and to compare their concentrations between women with and without endometriosis.

Follicular fluid estradiol levels were significantly higher in controls than in affected women. The concentrations of the other markers did not differ between the two groups.

Since not only the follicular fluid concentration of estradiol, but also the oocyte quality is decreased in women with endometriosis, we suggest that estradiol can be considered as a marker not only of oocyte maturity but also of oocyte quality. Similar content being viewed by others

Lord GM, Matarese G, Howard JK, Baker RJ, Bloom SR, Lechler RI: Leptin modulates the T-cell immune response and reverses starvation-induced immunosuppression. Nature 1998;394:897–901 Sierra-Honigmann MR, Nath AK, Murakami C: Biological action of leptin as an angiogenic factor. Science 1998;281:1683–1686 Barash IA, Cheung CC, Weigle DS, Ren H, Kabigting EB, Kuijper JL, Clifton DK, Steiner RA: Leptin is a metabolic signal to the reproductive system. Endocrinology 1996;137:3144–3147 Matarese G, Alviggi C, Sanna V, Howard JK, Lord GM, Carravetta C, Fontana S, Lechler RI, Bloom SR, De Placido G: Increased leptin levels in serum and peritoneal fluid of patients with pelvic endometriosis. J Clin Endocrinol Metab 2000;85:2483–2487 Oxvig C, Sand O, Kristensen T, Kristensen L, Sottrup-Jensen L: Isolation and characterisation of circulating complex between human pregnancy-associated plasma protein-A and proform of eosinophil major basic protein. Biochim Biophys Acta. 1994;1201:415–423 Lawrence JB, Oxvig C, Overgaard MT, Sottrup-Jensen L, Gleich GJ, Hays LG, et al: The insulin-like growth factor (IGF)-dependent IGF binding protein-4 protease secreted by human fibroblasts is pregnancy-associated plasma protein-A. Proc Nat Acad Sci USA 1999;96:3149–3153 Conover CA, Faessen GF, Ilg KE, Chandrasekher YA, Christiansen M, Overgaard MT, Oxvig C, Giudice LC: Pregnancy-associated plasma protein-A is the insulin-like growth factor binding protein-4 protease secreted by human ovarian granulosa cells and is a marker of dominant follicle selection and the corpus luteum. Endocrinology 2001;142:2155–2158 Arici A, Matalliotakis I, Goumenou A, Koumantakis G, Fragouli Y, Mahutte NG: Increased pregnancy-associated plasma protein-4 (PAPP-A) concentrations in peritoneal fluid of women with endometriosis. Am J Reprod Immunol 2003;49:70–74 Adashi EY: Insulin-like growth factors as determinants of follicular fate. J Soc Gynecol Invest 1995;2:721–726 Mason HD, Cwyfan-Hughes S, Holly JM, Franks S: Potent inhibition of human ovarian steroidogenesis by insulin-like growth factor binding protein-4 (IGFBP-4). J Clin Endocrinol Metab 1998;83:284–287 Cahill DJ, Wardle PG, Harlow ChR, Hull MG: Effect of progesterone therapy on follicular development, related hormone concentrations and fertilization in vitro in unstimulated cycles and unexplained and endometriosis-associated infertility. Hum Reprod 1996;11:647–650 Simon C, Gutierrez A, Vidal A, De los Santos M, Tarìn JJ, Remohì J Pellicer A: Outcome of patients with endometriosis in assisted reproduction: Results from in vitro fertilization and oocyte donation. Hum Reprod 1994;9:725–729 Pellicer A, Oliveira N, Ruiz A, Remohì J, Simòn C: Exploring the mechanism(s) of endometriosis-related infertility: An analysis of embryo development and implantation in assisted reproduction. Hum Reprod 1995;10 (Suppl.2):91–97 Arici A, Oral E, Bukulmez O, Duleba A, Olive DL, Jones EE. The effects of endometriosis on implantation: Results from the Yale University in vitro fertilization and embryo transfer program. Fertil Steril 1996;65:603–607 Harlow ChR, Cahill DJ, Maile LA, Talbot WM, Mears J, Wardle PG, et al: Reduced preovulatory granulosa cell steroidogenesis in women with endometriosis. J Clin Endocrinol Metab 1996;81:426–429 Tesarik J, Sousa M: Key elements of highly efficient intracytoplasmatic sperm injection technique: Ca+ fluxes and oocyte cytoplasmic dislocation. Fertil Steril 1995;64:770–776 Bersinger NA, Zakher A, Huber U, Pescia G, Schneider H: A sensitive immunoassay for pregnancy-associated plasma protein A (PAPP-A): A possible first trimester method of screening for Down syndrome and other trisomies. Arch Gynecol Obstet 1995;256:185–192 Malek A, Willi A, Muller J, Sager R, Bersinger NA: Capacity for hormone production of cultured trophoblast cells obtained from placentae at term and in early pregnancy. J Assist Reprod Genet 2001;18:299–303 Pellicer A, Valbuena D, Bauset C, Albert C, Bonilla-Musoles F, Remohì J, Simòn C: The follicular endocrine environment in stimulated cycles of women with endometriosis: Steroid levels and embryo quality. Fertil Steril 1998;69:1135–1141 Botero-Ruiz W, Laufer N, De Cherney AH, Polan ML, Haseltine FP, Behrman HR: The relationship between follicular fluid steroid concentrations and successful fertilization of human oocytes. Fertil Steril 1984;41:820–826 De Placido G, Alviggi C, Carravetta C, Pisaturo ML, Sanna V, Wilding M, Lord GM, Matarese G: The peritoneal fluid concentration of leptin is increased in women with peritoneal but not ovarian endometriosis. Hum Reprod. 200;16:1251–1254 Hardie L, Trayhurn P, Abramovich D, Fowler P: Circulating leptin in women: A longitudinal study in the menstrual cycle and during pregnancy. Clin Endocrinol (Oxf) 1997;47:101–106 Kitawaki J, Kusuki I, Koshiba H, Tsukamoto K, Honjo H: Leptin directly stimulates aromatase activity in human luteinized granulosa cells. Mol Hum Reprod 1999;5:708–713 Agarwal SK, Vogel K, Weitsman SR, Magoffin DA: Leptin antagonizes the insulin-like growth factor I augmentation of steroidogenesis in granulosa cells of the human ovary. J Clin Endocrinol Metab 1999;84:1072–1076 Ghizzoni L, Barreca A, Mastorakos G, Furlini M, Vottero A, Ferrari B, Chrousos GP, Bernasconi S: Leptin inhibits steroid biosynthesis by human granulosa-lutein cells. Horm Metab Res 2001;33:323–328 Tsai EM, Yang CH, Chen SC, Lin YH, Chen HS, Hsu SC, Lee JN: Leptin affects pregnancy outcome of in vitro fertilization and steroidogenensis of human granulosa cells. J Ass Reprod Genet 2002;19:169–176 Dorn C, Reinsberg J, Kupka M, van der Ven H, Schild RL: Leptin, VEGF, IGF-1, and IGFBP-3 concentrations in serum and follicular fluid of women undergoing in vitro fertilisation. Arch Gynecol Obstet 2003;268:187–193 Dmowski WP, Radwanska E: Current concepts on pathology, histogenesis and etiology of endometriosis. Acta Obstet Gynecol Scand (Suppl) 1984;123:29–33 McCann SE, Freudenheim JL, Darrow SL, Batt RE, Zielezny MA: Endometriosis and body fat distribution. Obstet Gynecol 1993;82:545–549 Hourvitz A, Widger AE, Filho FL, Chang RJ, Adashi EY, Erickson GF: Pregnancy-associated plasma protein-A gene expression in human ovaries is restricted to healthy follicles and corpora lutea. J Clin Endocrinol Metab 2000;85:4916–4919 Garcia-Velasco JA, Mahutte NG, Corona J, Zuniga V, Giles J, Arici A, Pellicer A: Removal of endometriomas before in vitro fertilization does not improve fertility outcomes: a matched, case-control study. Fertil Steril 2004;81:1194–1197 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Wunder, D.M., Mueller, M.D., Birkhäuser, M.H. et al. Steroids and protein markers in the follicular fluid as indicators of oocyte quality in patients with and without endometriosis. J Assist Reprod Genet 22, 257–264 (2005). https://doi.org/10.1007/s10815-005-5149-2 Received: Accepted: Issue date: DOI: https://doi.org/10.1007/s10815-005-5149-2