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Hon JX, Wahab NA, Karim AKA, Mokhtar NM, Mokhtar MH. MicroRNAs in Endometriosis: Insights into Inflammation and Progesterone Resistance. Int J Mol Sci 2023; 24:15001. [PMID: 37834449 PMCID: PMC10573326 DOI: 10.3390/ijms241915001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
Endometriosis, a non-malignant gynecological disorder influenced by estrogen, involves the growth of endometrial tissue outside the uterus. Its development includes processes such as inflammation, progesterone resistance, angiogenesis, and cell proliferation. Epigenetic factors, particularly the dysregulation of microRNAs (miRNAs), have emerged as key factors in these mechanisms in endometriosis. This review aims to unveil the intricate molecular processes that control inflammation, progesterone resistance, and miRNA functions in endometriosis. In addition, it provides a comprehensive overview of the current understanding regarding the involvement of miRNAs in the inflammatory aspects of this condition. This synthesis encompasses research investigating the molecular underpinnings of inflammation, along with the biogenesis and roles of miRNAs in endometriosis. Furthermore, it examines human studies and functional analyses to establish the intricate connection between miRNAs, inflammation, and progesterone resistance in the context of endometriosis. The results highlight the significant impact of dysregulated miRNAs on the inflammatory pathways and hormonal imbalances characteristic of endometriosis. Consequently, miRNAs hold promise as potential non-invasive biomarkers and targeted therapeutic agents aimed at addressing inflammation and enhancing the response to progesterone treatment in individuals with endometriosis.
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Affiliation(s)
- Jing-Xian Hon
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Norhazlina Abdul Wahab
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
- GUT Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Abdul Kadir Abdul Karim
- Department of Obstetrics & Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Norfilza Mohd Mokhtar
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
- GUT Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Mohd Helmy Mokhtar
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
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Chou Y, Tzeng C. The impact of phthalate on reproductive function in women with endometriosis. Reprod Med Biol 2021; 20:159-168. [PMID: 33850448 PMCID: PMC8022091 DOI: 10.1002/rmb2.12364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Endometriosis is a common gynecological condition in which stromal or glandular epithelium is implanted in extrauterine locations. Endometriosis causes detrimental effects on the granulosa cells, and phthalate interferes with the biological and reproductive function of endometrial cells at a molecular level. METHODS This article retrospectively reviewed the studies on phthalate exposure and its relationship with endometriosis. A literature search was performed for scientific articles using the keywords "phthalate and endometriosis," "endometriosis and granulosa cells," "phthalate and granulosa cells," and "phthalates and endometrial cells." RESULTS Endometriosis can affect cytokine production, steroidogenesis, cell cycle progression, expression of estrogen receptor-α (ER-α)/progesterone receptor (PR), and cause endoplasmic reticulum stress, senescence, apoptosis, autophagy, and oxidative stress in the granulosa cells. Mono-n-butyl phthalate (MnBP) alters the expression of cytokines, cell cycle-associated genes, ovarian stimulation, steroidogenesis, and progesterone production. Several in vitro studies have demonstrated that phthalate caused inflammation, invasion, change in cytokines, increased oxidative stress, viability, resistance to hydrogen peroxide, and proliferation of endometrial cells. CONCLUSION This might provide new insights about the impact of phthalate on the pathogenesis of endometriosis and its consequences on the ovarian function.
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Affiliation(s)
- Ya‐Ching Chou
- Department of Biological Science and TechnologyCollege of Biological Science and TechnologyNational Chiao Tung UniversityHsinchuTaiwan
- Center for Intelligent Drug Systems and Smart Bio‐devices (IDSB)National Chiao Tung UniversityHsinchuTaiwan
| | - Chii‐Ruey Tzeng
- Department of Obstetrics and GynecologyTaipei Medical UniversityTaipeiTaiwan
- Taipei Fertility Center, TaipeiTaiwan
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Iwami N, Kawamata M, Ozawa N, Yamamoto T, Watanabe E, Mizuuchi M, Moriwaka O, Kamiya H. New treatment strategy for endometriosis using progestin-primed ovarian stimulation with dienogest: A prospective cohort study, comparison of dienogest versus dydrogesterone. Reprod Biol 2020; 21:100470. [PMID: 33333410 DOI: 10.1016/j.repbio.2020.100470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/11/2020] [Accepted: 11/29/2020] [Indexed: 10/22/2022]
Abstract
Dienogest (DNG) is an oral progestin effective for the treatment of symptomatic endometriosis, such as reduction of endometrial lesion and control of pain intensity. Progestin-primed ovarian stimulation (PPOS) is a new controlled ovarian hyperstimulation (COH) regimen, and several reports have shown that dydrogesterone (DYG) is an appropriate progestin for PPOS. The purpose of this study was to evaluate the efficacy of DNG in patients undergoing PPOS during COH in comparison with DYG. This was a prospective, cohort, parallel-group, non-inferiority trial of 150 women with endometriosis undergoing assisted reproductive technology between February 2018 and May 2020 at the single fertility center. The assignment to each protocol was based on the optimal treatment for each patient. Patients taking DNG 2 mg continuously were assigned in the DNG group(n = 73). The other patients were allocated in DYG group(n = 77). All viable embryos were cryopreserved for subsequent transfer. The main outcome measures were the mature oocyte and fertilization rates. During this study, no premature LH surge was detected. A smaller number of oocytes were retrieved in the DNG group than in the DYG group (6.18 ± 3.60 vs. 9.85 ± 5.77); however, the rate of mature oocytes was significantly higher in the DNG group than in the DYG group (89.1 % vs. 78.9 %). The fertilization rate was comparable between two groups. Therefore, patients taking DNG for PPOS can continue endometriosis treatment and obtain good-quality embryos during COH. Further prospective randomized-controlled trial should be performed to confirm of this novel strategy of DNG.
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Affiliation(s)
- Nanako Iwami
- Kamiya Ladies Clinic, 2-1, Nishi 2, Kita 3, Chuo-ku, Sapporo, Hokkaido, 060-0003, Japan.
| | - Miho Kawamata
- Kamiya Ladies Clinic, 2-1, Nishi 2, Kita 3, Chuo-ku, Sapporo, Hokkaido, 060-0003, Japan
| | - Naoko Ozawa
- Kamiya Ladies Clinic, 2-1, Nishi 2, Kita 3, Chuo-ku, Sapporo, Hokkaido, 060-0003, Japan
| | - Takahiro Yamamoto
- Kamiya Ladies Clinic, 2-1, Nishi 2, Kita 3, Chuo-ku, Sapporo, Hokkaido, 060-0003, Japan
| | - Eri Watanabe
- Kamiya Ladies Clinic, 2-1, Nishi 2, Kita 3, Chuo-ku, Sapporo, Hokkaido, 060-0003, Japan
| | - Masahito Mizuuchi
- Kamiya Ladies Clinic, 2-1, Nishi 2, Kita 3, Chuo-ku, Sapporo, Hokkaido, 060-0003, Japan
| | - Osamu Moriwaka
- Kamiya Ladies Clinic, 2-1, Nishi 2, Kita 3, Chuo-ku, Sapporo, Hokkaido, 060-0003, Japan
| | - Hirobumi Kamiya
- Kamiya Ladies Clinic, 2-1, Nishi 2, Kita 3, Chuo-ku, Sapporo, Hokkaido, 060-0003, Japan
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Bonetti TC, Haddad DC, Domingues TS, Alegretti JR, Motta ELA, Seeley K, Silva ID. Expressed proteins and activated pathways in conditioned embryo culture media from IVF patients are diverse according to infertility factors. JBRA Assist Reprod 2019; 23:352-360. [PMID: 31251011 PMCID: PMC6798601 DOI: 10.5935/1518-0557.20190039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Given that the embryo culture medium secretome reflects the embryo development, we hypothesize that protein profiles are affected according to infertility factors, which can be responsible for detrimental embryonic developmental competence. The aim of this study was to screen the protein profile of conditioned embryo culture media in patients presenting deep infiltrating endometriosis (ENDO) and polycystic ovarian syndrome (PCOS) undergoing IVF, by proteomics approaches. The control group was constituted by tubal factor patients. METHODS Patients underwent in vitro fertilization (IVF) treatment as routine and oocytes were fertilized by ICSI. The embryos were group cultured until day 3 of development, and after transfer the culture media were collected. For the proteomics analysis, two pools of samples were prepared for groups CONTROL and PCOS, and 4 pools of samples for group DIE. Samples were prepared to deplete high abundant proteins and followed evaluated by high throughput proteomics approach. RESULTS The embryonic organ and tissue development were physiological functions activated, based on proteins identified in the 3 study groups of samples. The samples coming from DIE patients presented a high calcium activity and on the other hand, embryos coming from PCOS patients showed a decreased calcium action. Other pathways as grow factors through the EGF signaling pathway overexpressed in ENDO culture medium and protein kinase A in PCOS were also observed. CONCLUSIONS Proteomic embryonic secretome will advance our knowledge of early embryogenesis and additionally could lead to improved selection of embryos for transfer warrants further investigation.
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Affiliation(s)
- Tatiana Cs Bonetti
- Disciplina de Ginecologia Endocrinológica, Departamento de Ginecologia, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP-EPM). Brasil
| | - Debora Cm Haddad
- Setor Integrado de Reprodução Humana, Departamento de Urologia, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP-EPM). Brasil
| | - Thais S Domingues
- Disciplina de Ginecologia Endocrinológica, Departamento de Ginecologia, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP-EPM). Brasil.,Huntington - Medicina Reprodutiva. Brasil
| | | | - Eduardo LA Motta
- Disciplina de Ginecologia Endocrinológica, Departamento de Ginecologia, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP-EPM). Brasil.,Huntington - Medicina Reprodutiva. Brasil
| | - Kent Seeley
- Proteomics and Mass Spectrometry Facility, Center for Drug Discovery and Innovation (CDDI), University of South Florida (USF). USA
| | - Ismael Dcg Silva
- Disciplina de Ginecologia Endocrinológica, Departamento de Ginecologia, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP-EPM). Brasil
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Abstract
The somatic component of follicular structure is a mixture of different cell types, represented by Granulosa cells (GCs) that are the paracrine regulators of the oocyte growth. GCs finely support this process by a continuous bidirectional talk with oocyte, which ensure oocyte quality and competence. Specific pathways are involved in the cross-talk and in both GCs and oocyte development. This review summarizes data from GCs gene expression analysis concerning both their physiological role and their interaction with oocyte. We also explore the CGs transcriptome modifications induced by controlled ovarian stimulation (COS) or pathological conditions and their impact in reproduction. The transcriptome analysis of GCs could be a powerful tool to improve our knowledge about the pathways involved in oocyte development. This approach, associated with new technologies as RNA-seq could allow the identifications of new noninvasive biological markers of oocyte quality to increase the efficiency of clinical IVF. Moreover, GCs expression analysis could be useful to shed light on new therapeutic targets by providing new options for the treatment of infertility.
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Affiliation(s)
- Marco D'Aurora
- a Department of Psychological , Health and Territorial Sciences, School of Medicine, "G. d'Annunzio" University Chieti-Pescara , Chieti , Italy
- b Center of excellence on Aging, CeSI-met, "G. d'Annunzio" University Chieti-Pescara , Chieti , Italy
| | - Samantha Sperduti
- b Center of excellence on Aging, CeSI-met, "G. d'Annunzio" University Chieti-Pescara , Chieti , Italy
- c Department of Medical , Oral and Biotechnological Sciences, School of Medicine, "G. d'Annunzio" University Chieti-Pescara , Italy
| | - Giovanna Di Emidio
- d Department of Health , Life and Environmental Sciences, University of L'Aquila , L'Aquila , Italy Coppito , and
| | - Liborio Stuppia
- a Department of Psychological , Health and Territorial Sciences, School of Medicine, "G. d'Annunzio" University Chieti-Pescara , Chieti , Italy
- b Center of excellence on Aging, CeSI-met, "G. d'Annunzio" University Chieti-Pescara , Chieti , Italy
| | - Paolo Giovanni Artini
- e Department of Experimental and Clinical Medicine , Division of Gynecology and Obstetrics, University of Pisa , Pisa , Italy
| | - Valentina Gatta
- a Department of Psychological , Health and Territorial Sciences, School of Medicine, "G. d'Annunzio" University Chieti-Pescara , Chieti , Italy
- b Center of excellence on Aging, CeSI-met, "G. d'Annunzio" University Chieti-Pescara , Chieti , Italy
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Sanchez AM, Somigliana E, Vercellini P, Pagliardini L, Candiani M, Vigano P. Endometriosis as a detrimental condition for granulosa cell steroidogenesis and development: From molecular alterations to clinical impact. J Steroid Biochem Mol Biol 2016; 155:35-46. [PMID: 26407755 DOI: 10.1016/j.jsbmb.2015.07.023] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 07/27/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
Endometriosis is an estrogen-dependent chronic inflammatory condition that affects women in their reproductive period. Alterations in ovarian follicle morphology and function have been documented in affected women. The local intrafollicular environment has been as well examined by various groups. In the present review, we aimed to summarize the molecular evidence supporting the idea that endometriosis can negatively influence growth, steroidogenesis and the function of the granulosa cells (GCs). Reduced P450 aromatase expression, increased intracellular ROS generation and altered WNT signaling characterize the GCs of women with endometriosis. Clear evidence for an increased level of GC apoptosis has been provided in association with the downregulation of pro-survival factors. Other potentially negative effects include decreased progesterone production, locally decreased AMH production and lower inflammatory cytokine expression, although these have been only partially clarified. The possibility that endometriosis per se may influence IVF clinical results as a consequence of the detrimental impact on the local intrafollicular environment is also discussed.
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Affiliation(s)
- Ana Maria Sanchez
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Edgardo Somigliana
- Department of Obstetrics, Gynecology and Neonatology, Fondazione Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Paolo Vercellini
- Department of Obstetrics, Gynecology and Neonatology, Fondazione Cà Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Luca Pagliardini
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Massimo Candiani
- Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milano, Italy
| | - Paola Vigano
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milano, Italy.
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Nie M, Yu S, Peng S, Fang Y, Wang H, Yang X. miR-23a and miR-27a Promote Human Granulosa Cell Apoptosis by Targeting SMAD51. Biol Reprod 2015; 93:98. [DOI: 10.1095/biolreprod.115.130690] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 09/04/2015] [Indexed: 12/17/2022] Open
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Endometriosis-Related Infertility: The Role of the Assisted Reproductive Technologies. BIOMED RESEARCH INTERNATIONAL 2015; 2015:482959. [PMID: 26240824 PMCID: PMC4512514 DOI: 10.1155/2015/482959] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 12/10/2014] [Indexed: 12/15/2022]
Abstract
The assisted reproductive technologies, particularly in vitro fertilization (IVF), represent the most efficient and successful means of overcoming infertility associated with endometriosis. Although older studies suggest that IVF outcomes are compromised in endometriosis patients, more contemporary reports show no differences compared to controls. The exception may be evidence of poorer outcomes and diminished ovarian response in women with advanced disease, particularly those with significant ovarian involvement or prior ovarian surgery. Prolonged pre-IVF cycle suppressive medical therapy, particularly gonadotropin releasing hormone agonists, appears to improve success rates in a subset of endometriosis patients. However, as of yet, there is no diagnostic marker to specifically identify those who would most benefit from this approach. Pre-IVF cycle surgical resection of nonovarian disease has not been consistently shown to improve outcomes with the possible exception of resection of deeply invasive disease, although the data is limited. Precycle resection of ovarian endometriomas does not have benefit and should only be performed for gynecologic indications. Indeed, there is a large body of evidence to suggest that this procedure may have a deleterious impact on ovarian reserve and response. A dearth of appropriately designed trials makes development of definitive treatment paradigms challenging.
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de Mattos CS, Trevisan CM, Peluso C, Adami F, Cordts EB, Christofolini DM, Barbosa CP, Bianco B. ESR1 and ESR2 gene polymorphisms are associated with human reproduction outcomes in Brazilian women. J Ovarian Res 2014; 7:114. [PMID: 25526766 PMCID: PMC4302593 DOI: 10.1186/s13048-014-0114-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 11/26/2014] [Indexed: 12/02/2022] Open
Abstract
Background Important candidate genes involved in the ovarian response to exogenous FSH are the estrogen receptor genes (ESRs), since the effects of estrogens on follicle growth, maturation and oocyte release. It is known that some markers of ovarian stimulation can help to personalize the treatment, adjusting the dose of exogenous rFSH, thus preventing excessive wear of the patient. Inspired on this information we aimed to analyze four different polymorphisms in the estrogen receptor genes ESR1: rs2234693/T-397C (PvuII) and rs9340799/A-351G (Xbal) and ESR2: rs4986938/G1082A (RsaI) and rs1256049/A + 1730G (AluI), and their association with assisted reproduction outcomes in Brazilian women that underwent in vitro fertilization (IVF). Methods A cross-sectional study was performed involving 136 infertile women less than 39 years of age with normal ovarian reserve. Patients were divided according to the same COH protocol for statistical analysis. The Taqman assay was used for PvuII and XbaI of ESR1, and RsaI and AluI of ESR2 genotyping. Serum estradiol and FSH were measured by Elisa assay. Results The PvuII (ESR1) TT and RsaI (ESR2) GG genotypes were associated with a longer induction period and higher doses of medication (p < 0.03). The XbaI (ESR1) AA genotype was associated with better COH results, including a larger number of follicles, mature oocytes, embryos, and good quality embryos (p < 0.05). The AluI GG genotype showed an association with the Ovarian Hyperstimulation Syndrome (OHSS) (p = 0.03). According to the haplotype analysis of ER1 (PvuII/XbaI), we demonstrated that the CA combination increases by 0.68 the number of good quality embryos while the TG decreases it by 0.71 (p = 0.04). Conclusion ER polymorphisms have an association with the assisted reproduction outcomes in Brazilian women.
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Affiliation(s)
- Clarissa Santiago de Mattos
- Human Reproduction and Genetics Center - Division of Sexual and Reproductive Healthcare and Population Genetics - Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, Santo André, SP, 09060-650, Brazil.
| | - Camila Martins Trevisan
- Human Reproduction and Genetics Center - Division of Sexual and Reproductive Healthcare and Population Genetics - Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, Santo André, SP, 09060-650, Brazil.
| | - Carla Peluso
- Human Reproduction and Genetics Center - Division of Sexual and Reproductive Healthcare and Population Genetics - Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, Santo André, SP, 09060-650, Brazil.
| | - Fernando Adami
- Division of Epidemiology and Biostatistics, Department of Collective Health - Faculdade de Medicina do ABC, Santo André, SP, Brazil.
| | - Emerson Barchi Cordts
- Human Reproduction and Genetics Center - Division of Sexual and Reproductive Healthcare and Population Genetics - Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, Santo André, SP, 09060-650, Brazil.
| | - Denise Maria Christofolini
- Human Reproduction and Genetics Center - Division of Sexual and Reproductive Healthcare and Population Genetics - Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, Santo André, SP, 09060-650, Brazil.
| | - Caio Parente Barbosa
- Human Reproduction and Genetics Center - Division of Sexual and Reproductive Healthcare and Population Genetics - Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, Santo André, SP, 09060-650, Brazil.
| | - Bianca Bianco
- Human Reproduction and Genetics Center - Division of Sexual and Reproductive Healthcare and Population Genetics - Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821, Santo André, SP, 09060-650, Brazil.
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Analyzing the possible involvement of anti-Müllerian hormone and anti-Müllerian hormone receptor II single nucleotide polymorphism in infertility. J Assist Reprod Genet 2013; 31:163-8. [PMID: 24271023 DOI: 10.1007/s10815-013-0134-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 10/24/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE We performed TaqMan genotyping assays of anti-Mullerian hormone (AMH) and anti-Mullerian hormone receptor type II (AMHRII) single nucleotide polymorphisms (SNPs) in order to investigate how their frequency and distribution affect infertility treatment outcome. METHODS Eighty Japanese women (advanced age: n = 51, endometriosis: n = 18, male infertility as a control: n = 11) who undertook ART were included in the study, and all couples underwent a full infertility investigation protocol. In order to investigate the natural distribution of SNPs, a naturally pregnant group of 28 subjects was recruited from among women who conceived naturally and subsequently delivered in our department. Genomic DNA was extracted from peripheral blood and genotyping was conducted by TaqMan genotyping assay. The relationship of AMH and AMHRII SNPs and treatment outcome in infertile women. Comparison of allele and genotype frequencies of infertile patients with naturally pregnant women. RESULTS AMHRII -482 A>G homozygote mutation was complicated with ISV 5-6 C>T homozygote mutation and showed a significantly lower oocyte retrieval rate compared with a wild type. Two of 3 cases of AMHRII -482 A>G homozygote mutation were poor responders, and the distribution and frequency of each allele of naturally pregnant women showed no statistical difference compared with infertile women. CONCLUSIONS This study revealed the possible involvement of AMHRII -482 A>G polymorphism on the malfunction of follicular development in Japanese women.
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Tanaka R, Murase M, Aizawa Y, Segino M, Ishidera Y, Kitagawa M, Katayama K, Takashima K, Yumura Y, Yoshida H, Sakakibara H, Hirahara F. A case of empty follicle syndrome who conceived after aspiration of an endometrial cyst. Reprod Med Biol 2013; 12:111-115. [PMID: 29699138 DOI: 10.1007/s12522-013-0146-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 03/25/2013] [Indexed: 11/27/2022] Open
Abstract
Empty follicle syndrome (EFS) has been defined as a condition where no oocytes can be retrieved for in vitro fertilization (IVF) even though ultrasound findings and estradiol (E2) levels suggest the presence of potential follicles. The EFS is a rare condition with an incidence of 0.5-7 % of women undergoing IVF treatments. Although there are many hypotheses as to the cause of EFS, including advanced ovarian age, drug-related problems, and dysfunctional folliculogenesis, its cause remains unknown. A 37-year-old woman with endometriosis and a 5-year history of primary infertility underwent IVF treatment for 4 cycles. No oocytes were retrieved in 2 cycles and no fertilized eggs were obtained in the other 2 cycles. We assumed that endometriosis adversely affected folliculogenesis and fertilization. Aspiration of an endometrial cyst in the right ovary and subsequent administration of oral contraceptives resulted in successful folliculogenesis and fertilization. Thereafter, she conceived and delivered a 2,662 g female infant at 38 weeks of gestation. Here, we report a case of EFS who conceived in the 5th IVF cycle after aspiration of an endometrial cyst. We assumed that endometriosis might have been involved in the dysfunction of folliculogenesis and EFS.
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Affiliation(s)
- Rieko Tanaka
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Mariko Murase
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Yoshino Aizawa
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Miwa Segino
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Yumi Ishidera
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Masakazu Kitagawa
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Kayo Katayama
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Kunitomo Takashima
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Yasushi Yumura
- Department of Urology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Hiroshi Yoshida
- Department of Obstetrics and Gynecology Yokohama City University Medical Center 4-57 Urafunecho, Minami Ward 232-0024 Yokohama Kanagawa Japan
| | - Hideya Sakakibara
- Department of Obstetrics and Gynecology Yokohama City University 3-9 Fukuura, Kanazawa Ward 236-0004 Yokohama Kanagawa Japan
| | - Fumiki Hirahara
- Department of Obstetrics and Gynecology Yokohama City University 3-9 Fukuura, Kanazawa Ward 236-0004 Yokohama Kanagawa Japan
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Yuguchi H, Tanabe A, Hayashi A, Tanaka Y, Okuda K, Yamashita Y, Terai Y, Ohmichi M. The expression status of G protein-coupled receptor GPR30 is associated with the clinical characteristics of endometriosis. Endocr Res 2013; 38:223-31. [PMID: 23458722 DOI: 10.3109/07435800.2013.774011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION GPR30 is a seven-transmembrane G protein-coupled estrogen receptor that regulates endometrial cellular responses to estrogen. GPR30 is often highly expressed in cancer cells from aggressive tumors. The aim of this study was to evaluate the expression patterns of GPR30 in endometriosis during medical treatment. PATIENTS A total of 38 females, 28 patients with endometriosis and 10 patients with leiomyoma who underwent laparoscopic surgery were included this study. INTERVENTION Eutopic endometrial tissue sampling from women without endometriosis and ectopic endometrial tissue sampling from women with endometriosis. MAIN OUTCOME MEASURE A quantitative real-time polymerase chain reaction analysis of the mRNA expression in eutopic and ectopic endometrial tissues with or without GnRH agonist treatment. The expression of GPR30 was confirmed by immunohistochemistry. RESULTS There was an increased level of GPR30 mRNA in eutopic endometrium during the proliferative phase, whereas higher expression was observed in the ectopic endometrium during the secretory phase. Increased GPR30 mRNA was observed in ectopic endometrium in comparison to eutopic endometrium. GnRH agonist treatment before laparoscopic surgery decreased GPR30 mRNA in ectopic endometrium. The immunohistochemical analysis also revealed that GPR30 was strongly expressed in epithelial cells in ectopic endometrium, whereas GnRH agonist treatment decreased the GPR30 expression. CONCLUSION High levels of GPR30 expression can play an important role in the progression of endometriosis.
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Affiliation(s)
- Hiroko Yuguchi
- Department of Obstetrics and Gynecology, Osaka Medical College , Takatsuki, Osaka , Japan
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Hayashi A, Tanabe A, Kawabe S, Hayashi M, Yuguchi H, Yamashita Y, Okuda K, Ohmichi M. Dienogest increases the progesterone receptor isoform B/A ratio in patients with ovarian endometriosis. J Ovarian Res 2012; 5:31. [PMID: 23113924 PMCID: PMC3541078 DOI: 10.1186/1757-2215-5-31] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 10/29/2012] [Indexed: 11/10/2022] Open
Abstract
UNLABELLED BACKGROUND The resistance of endometriotic tissue to progesterone can be explained by alterations in the distribution of progesterone receptor (PR) and estrogen receptor (ER) isoforms. The aims of this study were to examine the expressions of PR-A, PR-B, ERα and ERβ in endometrioma and assess whether these expressions are affected by dienogest or leuprolide acetate (LA) treatment. METHODS We enrolled 60 females, including 43 patients with endometriosis (14 who received no medical treatment, 13 who received dienogest and 16 who received LA before undergoing laparoscopic surgery) and 17 patients with leiomyoma. The expression levels of PR and ER isoforms in eutopic and ectopic endometrium were assayed with quantitative real-time PCR, and confirmed with immunohistochemistry. RESULTS A decreased PR-B/PR-A ratio and an increased ERβ/ERα ratio were demonstrated in ectopic endometrium derived from females with endometriosis compared with the ratios observed in eutopic endometrium obtained from females without endometriosis. Although LA treatment did not affect the PR-B/PR-A and ERβ/ERα ratios, dienogest treatment increased the PR-B/PR-A ratio and decreased the ERβ/ERα ratio in patients with endometriomas. CONCLUSIONS Dienogest may improve progesterone resistance in endometriotic tissue by increasing the relative expressions of PR-B and PR-A, and decreasing the relative expressions of ERβ and ERα.
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Affiliation(s)
- Atsushi Hayashi
- Department of Obstetrics and Gynecology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki city, Osaka, 569-8686, Japan.
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Burns KA, Korach KS. Estrogen receptors and human disease: an update. Arch Toxicol 2012; 86:1491-504. [PMID: 22648069 DOI: 10.1007/s00204-012-0868-5] [Citation(s) in RCA: 191] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 05/14/2012] [Indexed: 02/06/2023]
Abstract
A myriad of physiological processes in mammals are influenced by estrogens and the estrogen receptors (ERs), ERα and ERβ. As we reviewed previously, given the widespread role for estrogen in normal human physiology, it is not surprising that estrogen is implicated in the development or progression of a number of diseases. In this review, we are giving a 5-year update of the literature regarding the influence of estrogens on a number of human cancers (breast, ovarian, colorectal, prostate, and endometrial), endometriosis, fibroids, and cardiovascular disease. A large number of sophisticated experimental studies have provided insights into human disease, but for this review, the literature citations were limited to articles published after our previous review (Deroo and Korach in J Clin Invest 116(3):561-570, 2006) and will focus in most cases on human data and clinical trials. We will describe the influence in which estrogen's action, through one of or both of the ERs, mediates the aforementioned human disease states.
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Affiliation(s)
- Katherine A Burns
- Receptor Biology Section, Laboratory of Reproductive and Developmental Toxicology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC 27709, USA
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Heublein S, Lenhard M, Vrekoussis T, Schoepfer J, Kuhn C, Friese K, Makrigiannakis A, Mayr D, Jeschke U. The G-protein-coupled estrogen receptor (GPER) is expressed in normal human ovaries and is upregulated in ovarian endometriosis and pelvic inflammatory disease involving the ovary. Reprod Sci 2012; 19:1197-204. [PMID: 22573494 DOI: 10.1177/1933719112446085] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Estrogens play a crucial role in maintaining ovarian function. Deregulation of estrogen signals is associated with fertility-impairing disorders. The aim of this study was to investigate whether the G-protein-coupled estrogen receptor (GPER) is present in the human ovary. Additionally, we analyzed the folliculogenesis and ovarian endometriosis in GPER expression. Seventy-nine patients (ovarian endometriosis, n = 26; ovarian pelvic inflammatory disease [PID], n = 10; normal ovaries/endometrium, n = 30/13) were analyzed by immunohistochemistry. Normal ovaries were also assessed by real-time polymerase chain reaction and double immunofluorescence. The most intense expression of GPER was noted in the ovarian surface epithelium. Theca cells and oocytes were also significantly positive. Expression of GPER was more frequent in mature follicles/oocytes than in primordial ones, implying that GPER could be a selector during folliculogenesis. Moreover, GPER was upregulated in ovarian endometriosis and PID. Overexpression of GPER in both inflammation and endometriosis affecting the ovary may prove useful in explaining/predicting the main endometriosis-related symptoms.
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Affiliation(s)
- Sabine Heublein
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University of Munich, Munich, Germany
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Sadeu J, Doedée A, Neal M, Hughes E, Foster W. Neurotrophins (BDNF and NGF) in follicular fluid of women with different infertility diagnoses. Reprod Biomed Online 2012; 24:174-9. [DOI: 10.1016/j.rbmo.2011.11.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 11/11/2011] [Accepted: 11/16/2011] [Indexed: 11/16/2022]
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Management of Infertile Women with Endometriosis. What's the Result of Leaving Ovarian Endometrioma during IVF-ET Cycles? ACTA ACUST UNITED AC 2011. [DOI: 10.5301/je.2011.8912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose The awareness of possible risk of damage to ovarian reserves after surgical treatment of ovarian endometriomas supports a more conservative approach in infertile women with ovarian endometrioma. A growing number of patients with ovarian endometrioma undergo In Vitro Fertilization and Embryo Transfer (IVF-ET) prior to surgery. The aim of this study was to assess the effect of ovarian endometrioma on IVF-ET cycles. Methods In a retrospective cohort pilot study, IVF-ET cycles performed by our group during the period 2000–2004 were assessed. One hundred and forty-four women with a history of surgery for endometriosis or endometriosis at the time of the cycle were included in the ‘study group'. Seventy infertile patients because of tubal factor constituted the ‘control group'. IVF-ET outcome was assessed. Results Patients with endometriosis required a higher total dosage of FSH/hMG and attained lower peak E2 levels, and fewer follicles and oocytes were obtained. Clinical pregnancy rate per patient was lower in the endometriosis group (24/144, 16.7%) when compared with tubal factor (20/70, 28.6%), clinical pregnancy rate per embryo transfer was similar (24/117, 20.5% and 20/61, 32.8% respectively). When stratifying results in the endometriosis group, patients with a history of prior surgery for ovarian endometrioma required a higher dosage of FSH/ hMG and attained a lower peak of estradiol. A trend with a consistent reduction in pregnancy rate in women with a history of prior surgery for ovarian endometrioma (5/37, 13% in patients with previous cystectomy and no recurrence; 2/17, 11.8% in patients with prior surgery and recurrence of endometrioma at pick-up; 2/10, 20% in women never operated with endometrioma at pick-up; 15/53, 28.3% in the minimal-mild endometriosis group; 20/61, 32.8% for tubal factor) was observed. Conclusions Both surgery for ovarian endometrioma and the existence of endometrioma during pickup appear to affect IVF-ET outcome. Patients with prior surgery and endometrioma recurrence at the time of pick-up revealed a further decrease in pregnancy rate.
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Coccia ME, Rizzello F, Mariani G, Bulletti C, Palagiano A, Scarselli G. Ovarian surgery for bilateral endometriomas influences age at menopause. Hum Reprod 2011; 26:3000-7. [PMID: 21868401 DOI: 10.1093/humrep/der286] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Questions remain as to whether surgical excision of ovarian endometriomas might cause damage to ovarian function. To test the hypothesis that ovarian surgery for endometrioma compromises ovarian function and accelerates ovarian failure. METHODS In a tertiary university Clinic, longitudinal prospective cohort study. Patients who underwent laparoscopy for endometriosis between March 1993 and November 2007 were assessed for inclusion in the study. A prospective follow-up at 3, 6 and 12 months then yearly was conducted. Evolution of menstrual pattern, symptoms and reproductive outcomes were investigated. RESULTS From over the 14-year period, 302 patients were included in the study. The mean age (±SD) of patients was 32.6 ± 5.6 years; the median duration of follow-up was 8.5 years (range 2-17 years). Menopause was documented in 43 women (14.3%) at a mean age of 45.3 ± 4.3 years (range 32-52 years). Women previously submitted to bilateral cystectomy were younger at menopause than those with monolateral endometrioma (42.1 ± 5.1 years versus 47.1 ± 3.5 years, P = 0.003). Premature ovarian failure (POF) was observed in 7 of 43 (16.3%) menopausal patients; the majority (4, 57.1%) after bilateral cystectomy. The relationship between the preoperative ovarian endometriomas total diameter and menopausal age was significant in case of surgery for bilateral endometriomas (R(2) = 0.754, P = 0.002). CONCLUSIONS Patients who had been operated on for bilateral endometriomas have an increased risk of POF. Ovarian parenchyma loss at the time of surgery seems related to cyst diameter. In the case of unilateral ovarian endometrioma, the contralateral intact ovary might adequately compensate.
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Affiliation(s)
- Maria Elisabetta Coccia
- Department of Science for the Health of Woman and Child, University of Florence, Via Ippolito Nievo 2, 50129 Florence, Italy.
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Kokcu A. Relationship between endometriosis and cancer from current perspective. Arch Gynecol Obstet 2011; 284:1473-9. [DOI: 10.1007/s00404-011-2047-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Accepted: 08/01/2011] [Indexed: 12/30/2022]
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