title: Enhanced follicular recruitment and atresia in cortex derived from ovaries with endometriomas.
abstract: OBJECTIVE
  To evaluate the effects of endometriomas on the regulation of early follicular development.
  
  
  METHODS
  Histologic analysis of prospectively collected biopsy samples.
  
  
  METHODS
  Research unit in a university hospital.
  
  
  METHODS
  Women <40 years of age who have ovarian endometriomas.
  
  
  METHODS
  Biopsy of healthy cortex from ovaries affected by endometriomas (≤ 4 cm) and contralateral ovaries without cysts.
  
  
  METHODS
  Histomorphological staging of early follicles, measurement of follicle, oocyte, and oocyte nucleus diameters, immunohistochemistry of proliferating cell nuclear antigen, and caspase-3.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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: 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.
authors: Michio
authors: M
authors: Kitajima
authors: Université Catholique de Louvain, Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Brussels, Belgium. Electronic address: anne.lepage@uclouvain.be.
authors: Marie-Madeleine
authors: MM
authors: Dolmans
authors: Université Catholique de Louvain, Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Brussels, Belgium.
authors: Olivier
authors: O
authors: Donnez
authors: Department of Obstetrics and Gynecology, Nagasaki University School of Medicine, Nagasaki, Japan.
authors: Hideaki
authors: H
authors: Masuzaki
authors: Université Catholique de Louvain, Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Brussels, Belgium.
authors: Michelle
authors: M
authors: Soares
authors: Société de Recherche pour l'Infertilité (SRI), Brussels, Belgium.
authors: Jacques
authors: J
authors: Donnez
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000473:pathology*; D005260:Female; D005496:Follicular Atresia; D006801:Humans; D006080:Ovarian Follicle / Q000473:pathology*; D055815:Young Adult
keywords: Endometrioma; follicular atresia; follicular development; follicular recruitment; histomorphometric analysis