title: Metabolic endotoxaemia--a potential novel link between ovarian inflammation and impaired progesterone production.
abstract: BACKGROUND
  Medical conditions such as obesity and inflammatory bowel disease are associated with impaired luteal function, menstrual disturbance and infertility. It is proposed that the disturbance in gut wall integrity ("leaky gut") seen in these conditions may result in the passage of bacterial endotoxin (LPS) from the colonic lumen into the circulation that may initiate inflammation in the ovary and subsequently impair hormone production.
  
  
  METHODS
  Quantify the association between systemic levels of LBP, a marker of endotoxin exposure, and levels of inflammation in the ovary (follicular fluid IL-6), plus steroid hormone production in 45 women undergoing IVF treatment.
  
  
  RESULTS
  Endotoxaemia (LBP) were positively correlated with plasma CRP and inflammation within the ovary (follicular fluid IL-6). Furthermore, endotoxaemia was negatively correlated with progesterone production.
  
  
  CONCLUSIONS
  The observed correlations, together with previously published animal studies linking endotoxin exposure to impaired luteal function, suggest that the translocation of bacterial endotoxin from the gut lumen into the circulation has the potential to interfere with progesterone production and result in luteal deficiency.
authors.affiliation: Repromed, Dulwich , South Australia , and.
authors.forename: Kelton
authors.initials: K
authors.lastname: Tremellen
authors.forename: Naeema
authors.initials: N
authors.lastname: Syedi
authors.forename: Sze
authors.initials: S
authors.lastname: Tan
authors.forename: Karma
authors.initials: K
authors.lastname: Pearce
mesh_terms: D000209:Acute-Phase Proteins; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002352:Carrier Proteins / Q000097:blood; D015331:Cohort Studies; D019446:Endotoxemia / Q000503:physiopathology*; D005191:Family Characteristics; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000737:chemistry; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D007248:Infertility, Male; D015850:Interleukin-6 / Q000032:analysis / Q000378:metabolism; D007413:Intestinal Mucosa / Q000276:immunology* / Q000503:physiopathology; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood; D009869:Oophoritis / Q000209:etiology* / Q000503:physiopathology; D010053:Ovary / Q000276:immunology* / Q000378:metabolism / Q000503:physiopathology; D010865:Pilot Projects; D011374:Progesterone / Q000096:biosynthesis / Q000097:blood / Q000172:deficiency*; D000099231:Lipopolysaccharide-Binding Protein
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D002352:Carrier Proteins; D015850:Interleukin-6; D008562:Membrane Glycoproteins; D011374:Progesterone; D000099231:Lipopolysaccharide-Binding Protein; C508600:IL6 protein, human
keywords: Endotoxaemia; IL-6; lipopolysaccharide; luteal; progesterone