Endometriosis and human infertility: a new investigation into the role of eutopic endometrium

Authors: Minici, Francesca; Tiberi, Federica; Tropea, Anna; Orlando, Mariateresa; Gangale, Maria Francesca; Romani, Federica; Campo, Sebastiano; Bompiani, Adriano; Lanzone, Antonio; Apa, Rosanna

Source: Human Reproduction, Volume 23, Number 3, 9 March 2008 , pp. 530-537(8)

Publisher: Oxford University Press

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Abstract:

BACKGROUND

Endometriosis is related to infertility even in the absence of mechanical alterations of the reproductive tract. Even though the pathogenesis of this phenomenon is still unclear, an impaired endometrial receptivity has been recently suggested. The aim of the present study was to investigate if endometriotic peritoneal fluids (EPF) could interfere with endometrial stromal cell (ESC) decidualization and if tumor necrosis factor (TNF)- could be involved in the EPF effect.

METHODS

Eutopic ESC were isolated from patients with or without endometriosis. ESC were treated with 17-estradiol 10⁸ M and 6-methyl-17-hydroxyprogesteroneacetate 210⁷ M for 16 days. In vitro decidualization was morphologically and biochemically assessed. We analysed whether ESC decidualization could be affected by EPF or peritoneal fluids from control patients (CPF), with or without soluble TNF- receptor 1 (sTNFR-1).

RESULTS

Compared with ESC from control patients, eutopic ESC from patients with endometriosis showed an impaired decidualization. Decidualization of normal ESC was morphologically normal but biochemically abnormal in the presence of EPF, which was able to decrease the secretion of decidualization markers. sTNFR-1 was able to partially counteract this effect.

CONCLUSIONS

In endometriosis, the milieu surrounding the uterine cavity may be involved in impaired eutopic ESC decidualization, partially due to increased peritoneal levels of TNF-.

Keywords: endometriosis; endometrial receptivity; decidualization

Document Type: Research article

DOI: http://dx.doi.org/10.1093/humrep/dem399

Publication date: 2008-03-09

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Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.

Endometriosis and human infertility: a new investigation into the role of eutopic endometrium

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