To study follicular microenvironment in terms of free radical dynamics, oocyte quality, and assisted reproductive technology (ART) outcomes among women with (group A) and without (group B) endometriosis.
Design
Prospective cohort study.
Setting
University ART center.
Patient(s)
Women with and without endometriosis undergoing ART (n = 28).
Intervention(s)
Follicular fluid (FF), granulosa cells (GCs), immature oocytes (IOs), and ART data on sibling cohort oocytes in groups A and B were compared.
Main Outcome Measure(s)
ART live birth outcomes, maturation, and aging among in vitro matured (IVM) oocytes, nitrate levels in FF, and nitrotyrosine (NT) footprints and apoptosis in the GCs.
Result(s)
Clinical characteristics and ART live birth outcomes were no different between groups A and B. Women from group A had significantly lower peak serum E2 (2,068.8 ± 244.6 pg/mL vs. 2,756.2 ± 205.0 pg/mL) and higher apoptosis (80.0% vs. 22.2%) and NT staining (70.0% vs. 22.2%) in GCs compared with group B. Fewer IOs underwent IVM to MII (0.6 ± 0.3) in group A compared with group B (1.4 ± 0.2). IVM oocytes had significantly higher incidence of cortical granule loss (83.3% vs. 24.0%) and spindle disruption (66.7% vs. 16.0%) and higher zona pellucida dissolution timing (133.8 ± 9.4 s vs. 90.5 ± 5.8 s) in group A compared with group B. FF nitrate levels were significantly higher in women who failed to conceive in group A (478.2 ± 43.1 nmol/L) compared with those that did conceive (173.3 ± 19.0 nmol/L).
Conclusion(s)
Increased protein nitration, GC apoptosis, resistance to IVM, and oocyte aging indicate the involvement of oxidative dysregulation of NO in the pathophysiology of altered follicular milieu and poor oocyte quality in women with endometriosis.
Key Words
Endometriosis
oocyte aging
oocyte quality
nitric oxide
superoxide
peroxynitrite
Cited by (0)
P.T.G. has nothing to disclose. A.P.G. has nothing to disclose. N.J. has nothing to disclose. E.P. is a board member of the American Institute of Ultrasound in Medicine (AIUM) and the Society for Reproductive Endocrinology and Infertility, is a medicolegal consultant for insurance, has a grant from the National Aeronautics and Space Administration, and has received payment for lectures and development of educational activities and had travel/accommodation expenses paid by the American Society for Reproductive Medicine (ASRM) and AIUM. M.P.D. is a director of and has received personal fees from Advanced Reproductive Care, has received personal fees from Auxogyn, and has a grant from AbbVie. H.M.A.-S. has nothing to disclose.
Supported by Ortho-ASRM Women's Health Grant (to P.T.G.).
