Sanchez Ana Maria, Vanni Valeria Stella, Bartiromo Ludovica, Papaleo Enrico, Zilberberg Eran, Candiani Massimo, Orvieto Raoul, Viganò Paola
Division of Genetics and Cell Biology, IRCCS Ospedale San Raffaele, Milan, Italy.
Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
J Ovarian Res. 2017 Jul 12;10(1):43. doi: 10.1186/s13048-017-0341-4.
Endometriosis is an estrogen-dependent chronic inflammatory condition that affects women in their reproductive period causing infertility and pelvic pain. The disease, especially at the ovarian site has been shown to have a detrimental impact on ovarian physiology. Indeed, sonographic and histologic data tend to support the idea that ovarian follicles of endometriosis patients are decreased in number and more atretic. Moreover, the local intrafollicular environment of patients affected is characterized by alterations of the granulosa cell compartment including reduced P450 aromatase expression and increased intracellular reactive oxygen species generation. However, no comprehensive evaluation of the literature addressing the effect of endometriosis on oocyte quality from both a clinical and a biological perspective has so far been conducted. Based on this systematic review of the literature, oocytes retrieved from women affected by endometriosis are more likely to fail in vitro maturation and to show altered morphology and lower cytoplasmic mitochondrial content compared to women with other causes of infertility. Results from meta-analyses addressing IVF outcomes in women affected would indicate that a reduction in the number of mature oocytes retrieved is associated with endometriosis while a reduction in fertilization rates is more likely to be associated with minimal/mild rather than with moderate/severe disease. However, evidence in this field is still far to be conclusive, especially with regards to the effects of different stages of the disease and to the impact of patients' previous medical/surgical treatment(s).
子宫内膜异位症是一种雌激素依赖的慢性炎症性疾病，影响育龄期女性，导致不孕和盆腔疼痛。该疾病，尤其是在卵巢部位，已被证明对卵巢生理有不利影响。事实上，超声和组织学数据倾向于支持这样一种观点，即子宫内膜异位症患者的卵巢卵泡数量减少且闭锁的更多。此外，受影响患者的卵泡内局部环境的特征是颗粒细胞区室发生改变，包括P450芳香化酶表达降低和细胞内活性氧生成增加。然而，迄今为止，尚未从临床和生物学角度对有关子宫内膜异位症对卵母细胞质量影响的文献进行全面评估。基于对文献的系统综述，与其他不孕原因的女性相比，从患有子宫内膜异位症的女性中获取的卵母细胞更有可能在体外成熟失败，并表现出形态改变和较低的细胞质线粒体含量。针对受影响女性体外受精结果的荟萃分析结果表明，获取的成熟卵母细胞数量减少与子宫内膜异位症有关，而受精率降低更可能与轻微/轻度疾病而非中度/重度疾病有关。然而，该领域的证据仍远未确凿，尤其是关于疾病不同阶段的影响以及患者先前的药物/手术治疗的影响。
