The follicular endocrine environment in stimulated cycles of women with endometriosis: steroid levels and embryo quality.
OBJECTIVE
To assess the endocrine milieu in follicles of stimulated cycles comparing women with and without endometriosis. Steroids were measured in follicular fluid (FF) and in in vitro culture of granulosa-luteal cells, and this status was related to the quality of the embryos obtained after IVF.


METHODS
Case-control study.


METHODS
IVF program at the Instituto Valenciano de Infertilidad.


METHODS
Twenty-four women with laparoscopically documented endometriosis and 26 controls undergoing IVF.


METHODS
Individual follicular aspiration, oocyte isolation, FF storage, and preparation of luteinized granulosa cells for culture; oocyte insemination and embryo cleavage in standard IVF.


METHODS
Serum (day of ovum pickup) and FF measurements of estradiol, progesterone, testosterone, and androstenedione. Secretion of progesterone was measured in the cell-conditioned medium. Results were compared between patients with endometriosis and controls, as well as between oocytes that yielded embryos of different quality.


RESULTS
Levels of progesterone in the FF increased with the severity of the disease, whereas testosterone accumulation in the FF decreased with the severity of the disease. An increase in progesterone accumulation in vitro was observed in basal and hCG-induced granulosa cell cultures. No difference was observed in terms of embryo quality, and no steroid marker was able to identify follicles with oocytes that displayed embryos of good or bad quality under the inverted microscope.


CONCLUSIONS
The data show differences in the steroidogenesis of follicles from stimulated women with and without endometriosis. These changes indicate good endocrine health but are not predictive of embryo quality.
Pellicer
A
A
Instituto Valenciano de Infertilidad and Department of Pediatrics, Valencia University School of Medicine, Spain. ivi@futurnet.es
Valbuena
D
D
Bauset
C
C
Albert
C
C
Bonilla-Musoles
F
F
Remohí
J
J
Simón
C
C
D000328:Adult; D016022:Case-Control Studies; D002478:Cells, Cultured; D004622:Embryo, Mammalian / Q000502:physiology*; D004715:Endometriosis / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000378:metabolism*; D006107:Granulosa Cells / Q000378:metabolism; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D011374:Progesterone / Q000378:metabolism; D012016:Reference Values
D006728:Hormones; D011374:Progesterone