The follicular microenvironment of oocytes in women with endometriosis during ovulation stimulation in the IVF program

The follicular fluid content of gonadotropic and steroidal hormones and growth factor was measured in patients with external genital endometriosis. The study was conducted in 48 patients undergoing stimulated IVF cycles, of them 25 patients were diagnosed as having first-to-third degree external genital endometriosis and 23 had a regular two-phase menstrual cycle and tuboperitoneal infertility (a control group). The follicular fluid hormonal levels suggest the androgenic microenvironment and characterize the follicles obtained in women with external genital endometriosis as having atresia. The increased follicular fluid levels of soluble apoptotic markers may serve as indirect evidence for the activation of oocyte apoptosis in the atretic follicles. The findings allows one to identify some pathophysiological mechanisms leading to the functional incompetence of oospheres as one of the constituents of the pathogenesis of infertility in external genital endometriosis (impaired angiogenesis, activated follicular granular cell apoptosis, altered ratio of pro- to antiapoptotic factors, and follicular fluid cytokine accumulation). The above factors reduce the quality of embryos in women with endometriosis and worsen the outcomes of therapeutic cycles of assisted reproductive technologies.

external genital endometriosis, follicular microenvironment of oocytes, oocyte quality, in vitro fertilization outcomes