Endometrioma, the follicular fluid inflammatory network and its association with oocyte and embryo characteristics

Jennifer J. Yland, Jennifer Yland, Carvalho LFP, Luiz Fernando Pina Carvalho, Michael Beste, Beste M, Michael T. Beste, Amelia P. Bailey, Amelia Bailey, C. H. Thomas, Cassandra Thomas, Thomas C, Abrão MS, Mauricio S Abrão, Maurício Simões Abrão, Racowsky C, Catherine Racowsky, Linda Griffith, Linda G. Griffith, Missmer SA, Stacey A Missmer
Reproductive biomedicine online · 2019 · vol. 40(3) , pp. 399–408 · doi:10.1016/j.rbmo.2019.12.005 · PMID:32057676 · W2998156087
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This paper investigated the inflammatory network within the follicular fluid of endometriomas and its correlation with oocyte and embryo quality.

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Abstract

Research questionWhat is the association between endometrioma-affected ovaries, their follicular fluid inflammatory microenvironment, and ovary-specific oocyte and embryo yield and quality?DesignExposure-matched prospective cohort study conducted at a university-affiliated infertility clinic. Thirty-four women presenting for oocyte retrieval were enrolled between 2012 and 2013: women with unilateral endometrioma and no other observed peritoneal or deep lesions (n = 10) and women with no signs or symptoms of endometriosis (n = 24). Follicular fluid was aspirated at the time of oocyte retrieval. Samples from each ovary were analysed using a 27-plex immunoassay panel. The associations were evaluated by ovary-specific endometrioma exposure status (affected, unaffected, unexposed) with cytokine levels, oocyte yield and embryo quality.ResultsLevels of interleukin (IL)-8 and monocyte chemoattractant protein-1 were higher in fluid obtained from endometrioma-affected ovaries compared with the unexposed ovaries from women without endometriosis, with intermediate levels observed in the contralateral unaffected ovaries. More modest differences were observed for IL-1β and IL-6. The affected ovaries of women with endometriosis yielded fewer oocytes (mean ± SD = 4.6 ± 2.3) compared with both the unaffected (6.0 ± 3.8) and unexposed (7.9 ± 5.6) ovaries. After adjusting for potential confounders and variables generated in a cytokine principal components analysis, oocyte yield remained slightly lower for the endometrioma-affected ovaries compared with unexposed ovaries. No informative differences among ovary groups for embryo quality parameters were observed.ConclusionsThe results suggest that the inflammatory milieu of ovarian endometriosis is strongly localized and has a more modestly systemic effect. The effect of endometriomas on infertility, however, cannot be entirely explained by increased inflammation.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Follicular Fluid Oocytes Ovarian Diseases Chemokine CCL2 Chemokine CCL2 Endometriosis Female Fertilization in Vitro Follicular Fluid Humans Inflammation Inflammation Interleukin-8 Interleukin-8 Oocyte Retrieval Oocytes Ovarian Diseases Ovary Ovary

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