HYALURONAN, TNF-α AND ESTRADIOL CONCENTRATIONS IN INFERTILE WOMEN WITH ENDOMETRIOSIS

Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induces a chronic inflammatory reaction.  The association between endometriosis and infertility has not yet been clarified but one of the suspected factors is the abnormality of oocyte development. The higher concentration of hyaluronan has been identified as crucial factor for abnormality of oocyte maturation. Estradiol has been correlated with oocyte development. The purpose of this study was to clarify the concentrations of hyaluronan, TNF-alpha and estradiol in infertile women with endometriosis. Using a cross sectional study, peritoneal and follicular fluid were aspirated laparospically from 38 infertile women in mid cycle and divided into 3 groups non endometriosis, mild and severe endometriosis in tertiary fertility clinic. Elisa laboratory technique was performed to all samples to detect peritoneal fluid TNF-alpha, estradiol and follicular fluid hyaluronan concentrations. In control, mild and severe endometriosis groups, the concentrations of hyaluronan were as follows 954.14 ± 294.87; 1499.29 ± 131.49 and 1786.77 ± 44.64 pg/ml , TNF-alpha 124.09 ± 99.28; 244.03 ± 106.51 and 409.08 ± 231 pg/ml , estradiol 298.13 ± 131.37; 567.98 ± 368.82 and 750.50 ± 181 pg/ml, respectively. There were significant difference concentrations of hyaluronan, TNF-alpha and estradiol between 3 groups (p<0.05).  The correlations were found among TNF-alpha, estradiol and hyaluronan, but the significant correlation was only found between estradiol and hyaluronan (p<0.05). In conclusion, the increase concentration of hyaluronan in endometriosis might be correlated with the abnormality of oocyte maturation. The inflammatory and hormonal milieu play a role in the abnormality of oocyte maturation in infertile women with endometriosis, but more study is needed.