Effect of Peritoneal Fluid with Endometriosis on Mouse Embryo Development in vitro

Jung, Byeong Jun; Yun, Yeon Jung; Chang, Hyun Jung; Lee, Sang Hoon; Bae, Do Whan; Hur, Min

Abstract

Endometriosis affects up to 5 million women in the united states. The number of cases observed at any time is 1 in 15(7%) women in the reproductive age range. Infertility occurs in as many as 30% to 40% of cases. Anatomical compromise with failure of oocyte capture and transport is an eviednt explanation for infertility in women suffering from advanced(stageIII/IV) endometriosis. In contrast, the pathophysiology in couples suffening from mild to moderate endometriosis as a sole infertility diagnosis is poorly understood. Research over the last decade indicates that women with endometriosis suffer from excessive activstion of immunocompetent cells within the pelvis. In experimental paradigms, adversd effects of a peritoneal fluid on the reproductive process of the endometriosis patients can be demonstrated and include:(1) Phagocytosis of sperm(2) Decreased sperm motility(3) Alteration of sperm-egg interactions(4) Failure of oocytes capture by the fimbria and(5) Impeded embryo development. These data raise the possibility that the intraperitoneal inflammatory process observed in women with endometriosis may be responsible for the associated infertility. The purpose of this study was to evaluate the effect of peritoneal fluid(PF) from patient with moderate endometriosis on mouse embryo development.PF was aspirated from the posterior cul-de-sac at laparoscopy and centrifuged, and the cell-free superantant was not heat-inactivated and not filtered. Fifty percent PF in human tubular fluid(HTF) media was prepared as a study group. The control group consisted of PF with a nonendometriosis and of 0.5% bovine serum albumin and HTF. The in vitro fertilization was performed with these culture media. We were observed distribution of embryo under the microscopy at 24 hours, 72 hours, 92 hours and 120 hours after insemination. The 2-cell embryonic stages in the study group(254 ovums) and those in the control group(247 ovums) at 24 hours were 50.4%, 70.4%, respectively. At 72 hours, the embryonic stages of both groups were reached the morula stage. At 72 hours, only 7.0% of the embryos in the study group reached the hatching, versus 55.7% in the control group. (p < 0.001). At the 120 hours, 100% of embryos in study group were degenerating, versus only 13.2% in the control group. As a result, the peritoneal fluid of the endometriosis patients exert an adverse influence on early reproductive performance, especially inhibiting embryo development. The peritoneal fluid may be as a mediator in the pathogenesis of endometriosis associated subfertility.