title: Altered circulating levels of matrix metalloproteinases 2 and 9 and their inhibitors and effect of progesterone supplementation in women with endometriosis undergoing in vitro fertilization.
abstract: OBJECTIVE
  To investigate differences in the activity of matrix metalloproteinases (MMPs) 2 and 9 and their respective tissue inhibitors (TIMPs) in follicular fluid of women with endometriosis, to correlate the findings with IVF outcome, and to examine the therapeutic potential of progesterone supplementation in restoring the fine balance between MMPs and TIMPs.
  
  
  METHODS
  Prospective case-control clinical study.
  
  
  METHODS
  Infertility clinic and reproductive health research unit.
  
  
  METHODS
  A total of 340 infertile women undergoing IVF.
  
  
  METHODS
  Natural micronized progesterone capsules were administered for luteal support.
  
  
  METHODS
  Association of MMPs 2 and 9 and TIMP-1 with oocyte maturity and embryo development.
  
  
  RESULTS
  An abnormal expression of MMP-2, MMP-9, and TIMP-1 with extensive MMP-9/TIMP-1 imbalance in women with endometriosis undergoing IVF was observed. Transforming growth factor β1 plays an important role in these women with possible involvement of Smad-2 and -3 proteins. Progesterone supplementation improves the imbalance in MMP-9/TIMP-1 ratio significantly in women with endometriosis who conceive after IVF.
  
  
  CONCLUSIONS
  Increase in MMP-2 and -9 and decrease in TIMP-1 expression was associated with poor oocyte and embryo development in women with endometriosis undergoing IVF. MMP-9/TIMP-1 balance was highly affected in these women, and progesterone supplementation appeared to restore this imbalance to a considerable degree.
authors.affiliation: School of Medical Science and Technology, Indian Institute of Technology, Kharagpur, West Bengal, India.
authors.forename: Abhay Kumar
authors.initials: AK
authors.lastname: Singh
authors.forename: Ratna
authors.initials: R
authors.lastname: Chattopadhyay
authors.forename: Baidyanath
authors.initials: B
authors.lastname: Chakravarty
authors.forename: Koel
authors.initials: K
authors.lastname: Chaudhury
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004715:Endometriosis / Q000097:blood* / Q000188:drug therapy; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D020778:Matrix Metalloproteinase 2 / Q000097:blood*; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D061965:Matrix Metalloproteinase Inhibitors / Q000097:blood; D011247:Pregnancy; D011374:Progesterone / Q000008:administration & dosage*; D011446:Prospective Studies; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood*
chemical_list: D015415:Biomarkers; D061965:Matrix Metalloproteinase Inhibitors; C560822:TIMP1 protein, human; D019715:Tissue Inhibitor of Metalloproteinase-1; D011374:Progesterone; C522361:MMP2 protein, human; D020778:Matrix Metalloproteinase 2; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9