title: Intrafollicular inflammatory cytokines but not steroid hormone concentrations are increased in naturally matured follicles of women with proven endometriosis.
abstract: OBJECTIVE
  The aim of this study was to assess whether the intrafollicular cytokine profile in naturally developed follicles is different in women with endometriosis, possibly explaining the lower reproductive outcome in endometriosis patients.
  
  
  METHODS
  A matched case-control study was conducted at a university-based infertility and endometriosis centre. The study population included 17 patients with laparoscopically and histologically confirmed endometriosis (rAFS stages II-IV), each undergoing one natural cycle IVF (NC-IVF) treatment cycle between 2013 and 2015, and 17 age-matched NC-IVF women without diagnosed endometriosis (control group). Follicular fluid and serum was collected at the time of follicle aspiration. The concentrations of inflammatory cytokines (IL-1β, IL-6, IL-8, IL-15, IL-18, TNF-α) and hormones (testosterone, estradiol, AMH) were determined in follicular fluid and serum by single or multiplexed immunoassay and compared between both groups.
  
  
  RESULTS
  In the follicular fluid, IL-1β and IL-6 showed significantly (P < 0.001 and 0.01, respectively) higher median concentrations in the endometriosis group than in the control group and a tendency towards endometriosis severity (rAFS stage) dependence. The levels of the interleukins detectable in follicular fluid were significantly higher than those in the serum (P < 0.01). Follicular estradiol concentration was lower in severe endometriosis patients than in the control group (P = 0.036). Follicular fluid IL-1β and IL-6 levels were not correlated with estradiol in the same compartment in neither patient group.
  
  
  CONCLUSIONS
  In women with moderate and severe endometrioses, some intrafollicular inflammatory cytokines are upregulated and not correlated with intrafollicular hormone concentrations. This might be due to the inflammatory microenvironment in endometriosis women, affecting follicular function and thereby possibly contributing to the reproductive dysfunction in endometriosis.
authors.affiliation: Division of Gynaecological Endocrinology and Reproductive Medicine, University Women's hospital, Effingerstrasse 102, 3010, Bern, Switzerland.|Reproductive Medical Centre, Renmin Hospital of Wuhan University, Wuhan, China.
authors.forename: Gengxiang
authors.initials: G
authors.lastname: Wu
authors.affiliation: Division of Gynaecological Endocrinology and Reproductive Medicine, University Women's hospital, Effingerstrasse 102, 3010, Bern, Switzerland.
authors.forename: N A
authors.initials: NA
authors.lastname: Bersinger
authors.affiliation: Division of Gynaecological Endocrinology and Reproductive Medicine, University Women's hospital, Effingerstrasse 102, 3010, Bern, Switzerland.
authors.forename: M D
authors.initials: MD
authors.lastname: Mueller
authors.affiliation: Division of Gynaecological Endocrinology and Reproductive Medicine, University Women's hospital, Effingerstrasse 102, 3010, Bern, Switzerland. Michael.vonWolff@insel.ch.
authors.forename: M
authors.initials: M
authors.lastname: von Wolff
mesh_terms: D000328:Adult; D016207:Cytokines / Q000097:blood*; D004715:Endometriosis / Q000097:blood* / Q000473:pathology; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000378:metabolism; D006728:Hormones / Q000097:blood*; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000473:pathology; D054315:Oocyte Retrieval / Q000379:methods; D006080:Ovarian Follicle / Q000254:growth & development / Q000378:metabolism*; D010062:Ovulation Induction / Q000379:methods; D027724:Reproductive Techniques, Assisted
chemical_list: D016207:Cytokines; D006728:Hormones
keywords: Endometriosis; Estradiol; Follicular fluid; Interleukin; Natural cycle IVF