Akademik Veri Yönetim Sistemi
TSRM 2023, 11. Üreme Sağlığı ve İnfertilite Kongresi, Antalya, Türkiye, 16 - 19 Kasım 2023, cilt.47, ss.19-20
Objectives
Growth differentiation factor 9(GDF-9) and bone morphogenetic factor 15 (BMP-15) are oocyte derived paracrine regulators of follicular growth. A correlation between follicular fluid(FF) GDF-9 and BMP-15 levels with the number and quality of oocytes in IVF has been previously reported but no studies have searched this association for infertile women with endometriosis. We aimed to find whether levels of GDF-9 and BMP-15 in blood serum and follicle fluid are predictors for IVF success of women with ovarian endometriosis.Materials and methods
This prospective cohort study included 116 infertile patients. 47 of them had bilateral endometriomas and follicular fluids obtained from the ovaries with endometriomas (Group 1), 30 had unilateral endometriomas and follicular fluids obtained from ovaries without endometrioma (Group2) and 30 had no endometrioma (male factor infertility) (Group 3). Blood and follicle samples were taken on the day of oocyte pick up (OPU). Serum and FF GDF-9 and BMP-15 were analyzed by ELISA.Results
Serum GDF-9 and BMP-15 levels were not statistically different between the groups. Follicular fluid GDF-9 were also comparable among groups. However, FF BMP-15 levels in patients with both bilateral and unilateral endometrioma groups were statistically higher than control group(p=0,004). Serum and FF GDF-9 and BMP-15 levels were also compared between combined groups 1 and 2 versus control group and only FF BMP-15 level was found to be higher in the combined groups than the controls (p=0,001). Clinical pregnancy or abortus rates were similar between the three groups. A subgroup correlation test was performed between GDF-9 and BMP-15 follicular levels and BMİ, AMH, AFC, and oocyte count after OPU. In group 3 there was a positive correlation between FF GDF-9 level and oocyte number (p=0.024).Conclusions
High FF BMP-15 in endometrioma suggest its beneficial role in intraovarian interactions in endometrioma. Higher FF BMP-15 levels in contralateral normal ovaries without endometrioma suggest that factors other than paracrine mechanism may play role in pathogenesis. It is difficult to determine whether high intrafollicular BMP-15 protect granulosa cells from the negative effects of other cytokines and paracrine regulators associated with endometriosis or it is a result of a pathological paracrine process. Our study and previous literature suggest that follicular development and oocyte and embryo quality may not be adversely affected by endometriosis. Our clinical findings support the assumption that high BMP-15 levels in FF of endometriosis patients during the IVF process do not have a negative effect on the intraovarian micro-environment created by endometriosis.