European Journal of Obstetrics & Gynecology and Reproductive Biology
Total antioxidant status of peritoneal fluid in infertile women
Introduction
Changes in the peritoneal fluid (PF) environment, which has direct contact with gametes, may affect fertilisation as well as early embryonic development. PF obtained from women with endometriosis and unexplained infertility has been shown to have a negative effect on sperm function and motility [1], [2], [3]. Prough et al. [4] noted that PF from patients with unexplained infertility inhibited the growth of mouse embryos.
Free oxygen radicals have been implicated in the pathogenesis of various diseases, including some cases of male infertility. In 1977 Jones and Mann [5] reported that free radical-induced lipid peroxidation caused an immediate arrest of motility and the irreversible loss of respiratory and fructolytic functions of spermatozoa. Recent findings have confirmed that reactive oxygen species affect sperm morphology and function [6], [7]. The lower total antioxidant capacity of seminal plasma in infertile men compared to the fertile group has also been reported [8].
No difference in nitric oxide, lipid peroxides, reactive oxygen species concentrations and total antioxidant status was found in the PF of women with endometriosis compared to that of fertile patients [9], [10], [11]. Wang et al. [11] noted higher levels of reactive oxygen species in the PF of patients with idiopathic infertility than in fertile women. In a recent study we found higher concentrations of malonyldialdehyde in the PF of women with unexplained infertility compared to those of the fertile group [12]. A particularly interesting hypothesis seems to be that an imbalance between reactive oxygen species levels and the antioxidant defences in the peritoneal fluid environment may be one of the factors responsible for unexplained infertility.
The aim of this study was to assess the total antioxidant status (TAS) in PF of infertile and fertile women.
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Materials and methods
Sixty-six women were studied, including 18 infertile women with minimal or mild endometriosis, 23 patients with unexplained infertility, 12 women with tubal infertility and 13 fertile women with benign, non-inflammatory ovarian tumours (Table 1).
Endometriosis was staged according to the revised American Fertility Society classification [13]. Unexplained infertility was defined as failure of a couple to achieve pregnancy after 2 years of unprotected intercourse. These women had regular (25–31
Results
Total antioxidant status was significantly lower in PF from women with unexplained infertility (0.49±0.21 mmol/l) compared to both fertile patients (0.67±0.24 mmol/l, P=0.02) and women with tubal infertility (0.76±0.26 mmol/l, P=0.001). Peritoneal fluid total antioxidant status did not differ significantly between patients with endometriosis (0.61±0.2 mmol/l), tubal infertility and the fertile group (Fig. 1).
Discussion
Mammalian tissues are equipped with antioxidant defences to minimize the damage resulting from interactions between cells and reactive oxygen species. Individual components of the antioxidant defences interact to form an integrated system. Therefore we decided not to focus on the measurement of individual antioxidants but to evaluate the total antioxidant status of peritoneal fluid from infertile women.
In our study we found a significantly lower TAS in the PF of women with unexplained
Condensation
Total antioxidant status is lower in the peritoneal fluid of patients with unexplained infertility compared to fertile women. Impairment of the antioxidant defences in the peritoneal fluid environment may play a role in the pathogenesis of infertility.
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