BMP-6 and SMAD4 gene expression is altered in cumulus cells from women with endometriosis-associated infertility

Introduction Oocyte competence and quality depend on communication between the oocyte and the cumulus and theca cells. In the preantral phase, the members of the transforming growth factor beta (TGF-beta) superfamily are responsible for this communication and play an important role in folliculogenesis. Members of the TGF-beta superfamily are related to endometriosis (overexpression in the ectopic endometrium); however, few studies have explored these proteins as influencing fertility in endometriosis. Considering endometriosis-related infertility and to better understand the role of the TGF-beta superfamily members in the antral phase in women with endometriosis, this research investigated the gene expression of the genes for ligandsAMH,BMP-6,GDF-9,INHA,INHBB, andTGF beta 3; receptorsAMHR2,BMPR2, andTGF beta R3; and intracellular signalling:SMAD3andSMAD4. Material and methods The gene expression ofAMH,BMP-6,GDF-9,INHA,INHBB,TGF beta 3,AMHR2,BMPR2,TGF beta R3,SMAD3, andSMAD4in cumulus cells was investigated through quantitative real-time PCR in a case-control study including infertile women with and without peritoneal endometriosis undergoing in vitro fertilization. Results Age and outcomes of assisted reproduction were similar between the groups (P > .05). However, women with endometriosis showed reduced expression ofBMP-6andSMAD4(P < .05) in cumulus cells compared with the control group, other genes did not present altered gene expression in women with endometriosis (P > .05). Conclusions The reduced expression ofBMP-6andSMAD4in women with peritoneal endometriosis compared with the control group indicates that granulosa (cumulus) cell function could be altered in these women.