Michio Kitajima1, Marie-Madeleine Dolmans2, Olivier Donnez3, Hideaki Masuzaki4, Michelle Soares3, Jacques Donnez5. 1. Université Catholique de Louvain, Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Brussels, Belgium; Department of Obstetrics and Gynecology, Nagasaki University School of Medicine, Nagasaki, Japan. 2. Université Catholique de Louvain, Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Brussels, Belgium. Electronic address: anne.lepage@uclouvain.be. 3. Université Catholique de Louvain, Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Brussels, Belgium. 4. Department of Obstetrics and Gynecology, Nagasaki University School of Medicine, Nagasaki, Japan. 5. Société de Recherche pour l'Infertilité (SRI), Brussels, Belgium.
Abstract
OBJECTIVE: To evaluate the effects of endometriomas on the regulation of early follicular development. DESIGN: Histologic analysis of prospectively collected biopsy samples. SETTING: Research unit in a university hospital. PATIENT(S): Women <40 years of age who have ovarian endometriomas. INTERVENTION(S): Biopsy of healthy cortex from ovaries affected by endometriomas (≤ 4 cm) and contralateral ovaries without cysts. MAIN OUTCOME MEASURE(S): Histomorphological staging of early follicles, measurement of follicle, oocyte, and oocyte nucleus diameters, immunohistochemistry of proliferating cell nuclear antigen, and caspase-3. RESULT(S): Thirteen cortical samples from ovaries with endometriomas and 13 samples from contralateral ovaries without endometriomas were evaluated. Cortex from ovaries with endometriomas contained significantly more morphologically atretic early follicles than cortex from contralateral ovaries without cysts. These follicles showed cleaved caspase-3 immunostaining. Diameters of primordial follicles and oocytes were decreased in cortex from ovaries with endometriomas, whereas early follicles with proliferating cell nuclear antigen-positive granulosa cells (GCs) were significantly increased in number. CONCLUSION(S): Ovaries with endometriomas, which may be more prone to local pelvic inflammation, showed activated follicular recruitment and atresia of early follicles. The potential contribution of inflammation to follicle "burnout" in case of endometriomas is discussed.
OBJECTIVE: To evaluate the effects of endometriomas on the regulation of early follicular development. DESIGN: Histologic analysis of prospectively collected biopsy samples. SETTING: Research unit in a university hospital. PATIENT(S): Women <40 years of age who have ovarian endometriomas. INTERVENTION(S): Biopsy of healthy cortex from ovaries affected by endometriomas (≤ 4 cm) and contralateral ovaries without cysts. MAIN OUTCOME MEASURE(S): Histomorphological staging of early follicles, measurement of follicle, oocyte, and oocyte nucleus diameters, immunohistochemistry of proliferating cell nuclear antigen, and caspase-3. RESULT(S): Thirteen cortical samples from ovaries with endometriomas and 13 samples from contralateral ovaries without endometriomas were evaluated. Cortex from ovaries with endometriomas contained significantly more morphologically atretic early follicles than cortex from contralateral ovaries without cysts. These follicles showed cleaved caspase-3 immunostaining. Diameters of primordial follicles and oocytes were decreased in cortex from ovaries with endometriomas, whereas early follicles with proliferating cell nuclear antigen-positive granulosa cells (GCs) were significantly increased in number. CONCLUSION(S): Ovaries with endometriomas, which may be more prone to local pelvic inflammation, showed activated follicular recruitment and atresia of early follicles. The potential contribution of inflammation to follicle "burnout" in case of endometriomas is discussed.
Authors: Kara N Goldman; Devon Chenette; Rezina Arju; Francesca E Duncan; David L Keefe; Jamie A Grifo; Robert J Schneider Journal: Proc Natl Acad Sci U S A Date: 2017-03-07 Impact factor: 11.205