Demir Mustafa, Kalyoncu Senol, Ince Onur, Ozkan Bulent, Kelekci Sefa, Saglam Gulcan, Sutcu Recep, Yilmaz Bulent
Department of Obstetrics and Gynecology, Harran University Faculty of Medicine, Sanliurfa, Turkey.
Department of Obstetrics and Gynecology, Izmir Katip Celebi University Faculty of Medicine, Izmir, Turkey.
Geburtshilfe Frauenheilkd. 2019 May;79(5):517-523. doi: 10.1055/a-0829-3873. Epub 2019 May 21.
An important open question in the literature is whether endometrial receptivity marker levels are different in infertility related diseases than healthy women. The aim of the study is to compare the levels of interleukin two (IL-2) and tumor necrosis factor alpha (TNF-α) during the implantation window in the endometrial flushing fluid of polycystic ovary syndrome (PCOS), endometrioma, leiomyoma patients with healthy controls. In this case control study, after obtaining endometrial flushing fluids at mid-luteal phase of ovulatory women with PCOS (n = 20), endometrioma (n = 19), leiomyoma (n = 20) and healthy controls (n = 20), IL-2 and TNF-α levels were measured using ELISA kits in BioTek ELISA devices. Mean TNF-α levels (ng/mL) were similar for the PCOS (305.6, p = 0.220) and the leiomyoma group (246.3, p = 0.502) compared to healthy patients (261.1). However, the levels were higher in the endometrioma group (338.2, p = 0,004) than the control group (261.1) in a statistically significant way. Mean IL-2 levels (ng/mL) were significantly lower in the PCOS (290.9, p = 0.0005), the leiomyoma (282.9, p = 0.0002) and the endometrioma patients (229.5, p = 0.0009) than the control group (416.0). Relative to the control group, endometrial flushing fluid TNF-α levels were significantly higher in endometrioma patients and IL-2 levels were significantly lower in PCOS, leiomyoma and endometrioma patients. In benign gynecological diseases, endometrial markers related to infertility seem to show differences in endometrial flushing fluid. Future studies might identify the reference values for these markers, and endometrial markers can be used to diagnose gynecologic disorders causing infertility.
文献中一个重要的开放性问题是，与健康女性相比，不孕症相关疾病中子宫内膜容受性标志物水平是否存在差异。本研究的目的是比较多囊卵巢综合征（PCOS）、子宫内膜瘤、平滑肌瘤患者与健康对照者在着床窗期间子宫内膜冲洗液中白细胞介素-2（IL-2）和肿瘤坏死因子-α（TNF-α）的水平。在这项病例对照研究中，在排卵性PCOS女性（n = 20）、子宫内膜瘤女性（n = 19）、平滑肌瘤女性（n = 20）和健康对照者（n = 20）的黄体中期获取子宫内膜冲洗液后，使用BioTek酶联免疫吸附测定（ELISA）设备中的ELISA试剂盒测量IL-2和TNF-α水平。与健康患者（261.1）相比，PCOS组（305.6，p = 0.220）和平滑肌瘤组（246.3，p = 0.502）的平均TNF-α水平（ng/mL）相似。然而，子宫内膜瘤组（338.2，p = 0.004）的水平显著高于对照组（261.1）。PCOS组（290.9，p = 0.0005）、平滑肌瘤组（282.9，p = 0.0002）和子宫内膜瘤患者组（229.5，p = 0.0009）的平均IL-2水平（ng/mL）显著低于对照组（416.0）。相对于对照组，子宫内膜瘤患者的子宫内膜冲洗液TNF-α水平显著更高，而PCOS、平滑肌瘤和子宫内膜瘤患者的IL-2水平显著更低。在良性妇科疾病中，与不孕症相关的子宫内膜标志物在子宫内膜冲洗液中似乎存在差异。未来的研究可能会确定这些标志物的参考值，并且子宫内膜标志物可用于诊断导致不孕症的妇科疾病。
