Analysis of follicular fluid and serum markers of oxidative stress in women with infertility related to endometriosis

Objective: To study the levels of four markers of oxidative stress in follicular fluid (FF) and plasma of patients with infertility related to endometriosis and controls. Design: Experimental study. Setting: University-affiliated hospital and infertility center. Patient(s): Ninety-one infertile women were included in the study (23 infertile women with endometriosis and 68 controls including infertile women due to tubal factor, male factor, or healthy egg donors). Intervention(s): Blood was obtained at the time of egg retrieval, and FF from the mature follicles of each ovary was centrifuged and frozen until analysis. Main Outcome Measure(s): Vitamin C and E, malondialdehyde, and superoxide dismutase concentrations in plasma and follicular fluid. Result(s): Women with endometriosis showed a lower vitamin C concentration in FF (12.7 +/- 5.9 vs. 9.7 +/- 6.9 mu g/mL) and lower superoxide dismutase concentration in plasma (0.9 +/- 1.4 vs. 0.5 +/- 0.7 U/mL) compared with controls. Vitamin E plasma levels were significantly higher in women with endometriosis (8.1 +/- 3.8 vs. 5.2 +/- 3.2 mu g/mL). A nonsignificant trend toward a lower plasma concentration of malondialdehyde was found in women with endometriosis. Conclusion(s): These findings suggest a lower antioxidant capacity in infertile women with endometriosis. Although a certain level of reactive oxygen species is required under physiological conditions, an altered balance between pro-oxidant and antioxidant activities may have an impact on folliculogenesis and adequate embryo development. (Fertil Steril (R) 2012. (C) 2012 by American Society for Reproductive Medicine.)