title: L-carnitine supplementation reduces oocyte cytoskeleton damage and embryo apoptosis induced by incubation in peritoneal fluid from patients with endometriosis.
abstract: OBJECTIVE
  To investigate the protective effect of L-carnitine (LC) against deleterious substances present in the peritoneal fluid (PF) of patients with endometriosis, which may affect the oocyte cytoskeleton and embryogenesis.
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  Research embryology laboratory at an academic hospital.
  
  
  METHODS
  Frozen metaphase II mouse oocytes and embryos.
  
  
  METHODS
  One hundred metaphase II mouse oocytes were divided into five groups and incubated: PF from endometriosis patients; PF from endometriosis patients + LC; PF from tubal ligation patients (patient control); LC only; and human tubal fluid (HTF) alone. A total of 180 eight-cell mouse embryos were divided into: endometriosis only; tubal ligation only; endometriosis + LC; LC alone; and HTF alone.
  
  
  METHODS
  Protective effect of LC on oocytes and embryos.
  
  
  RESULTS
  Incubation of the oocytes and the embryos with PF from patients with endometriosis statistically significantly damaged the oocyte microtubules and chromosomes and increased embryo apoptosis compared with controls. Incubation with LC (0.6 mg/mL) statistically significantly improved microtubule and chromosome structure and decreased the level of embryo apoptosis.
  
  
  CONCLUSIONS
  We propose the use of LC as a supplement in patients with endometriosis, a novel approach that may help improve in vitro fertilization outcome in these patients.
authors.affiliation: Reproductive Research Center, Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Gihan
authors.initials: G
authors.lastname: Mansour
authors.forename: Hussein
authors.initials: H
authors.lastname: Abdelrazik
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Sharma
authors.forename: Emad
authors.initials: E
authors.lastname: Radwan
authors.forename: Tommaso
authors.initials: T
authors.lastname: Falcone
authors.forename: Ashok
authors.initials: A
authors.lastname: Agarwal
mesh_terms: D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D001202:Ascitic Fluid / Q000473:pathology*; D002331:Carnitine / Q000627:therapeutic use*; D004622:Embryo, Mammalian / Q000187:drug effects / Q000473:pathology / Q000502:physiology*; D004715:Endometriosis / Q000473:pathology*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D051379:Mice; D018613:Microscopy, Confocal; D008870:Microtubules / Q000187:drug effects / Q000502:physiology; D009865:Oocytes / Q000187:drug effects / Q000473:pathology*; D011247:Pregnancy; D013243:Sterilization Reversal
chemical_list: D002331:Carnitine