RESEARCH QUESTION What is the association between endometrioma-affected ovaries, their follicular fluid inflammatory microenvironment, and ovary-specific oocyte and embryo yield and quality? DESIGN Exposure-matched prospective cohort study conducted at a university-affiliated infertility clinic. Thirty-four women presenting for oocyte retrieval were enrolled between 2012 and 2013: women with unilateral endometrioma and no other observed peritoneal or deep lesions (n = 10) and women with no signs or symptoms of endometriosis (n = 24). Follicular fluid was aspirated at the time of oocyte retrieval. Samples from each ovary were analysed using a 27-plex immunoassay panel. The associations were evaluated by ovary-specific endometrioma exposure status (affected, unaffected, unexposed) with cytokine levels, oocyte yield and embryo quality. RESULTS Levels of interleukin (IL)-8 and monocyte chemoattractant protein-1 were higher in fluid obtained from endometrioma-affected ovaries compared with the unexposed ovaries from women without endometriosis, with intermediate levels observed in the contralateral unaffected ovaries. More modest differences were observed for IL-1β and IL-6. The affected ovaries of women with endometriosis yielded fewer oocytes (mean ± SD = 4.6 ± 2.3) compared with both the unaffected (6.0 ± 3.8) and unexposed (7.9 ± 5.6) ovaries. After adjusting for potential confounders and variables generated in a cytokine principal components analysis, oocyte yield remained slightly lower for the endometrioma-affected ovaries compared with unexposed ovaries. No informative differences among ovary groups for embryo quality parameters were observed. CONCLUSIONS The results suggest that the inflammatory milieu of ovarian endometriosis is strongly localized and has a more modestly systemic effect. The effect of endometriomas on infertility, however, cannot be entirely explained by increased inflammation.

中文翻译：

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子宫内膜瘤，卵泡液炎症网络及其与卵母细胞和胚胎特征的关系。

研究问题受子宫内膜瘤影响的卵巢，其卵泡液炎性微环境和卵巢特异性卵母细胞与胚胎产量和质量之间的关系是什么？设计在大学附属的不育诊所进行的与暴露匹配的前瞻性队列研究。在2012年至2013年之间招募了34例进行卵母细胞取出的妇女：患有单侧子宫内膜瘤且未观察到其他腹膜或深部病变的妇女（n = 10）和没有子宫内膜异位症的症状或症状的妇女（n = 24）。卵母细胞取出时抽吸卵泡液。使用27重免疫分析板对每个卵巢的样品进行分析。通过卵巢特异性子宫内膜瘤的暴露状态（受影响，未受影响，未暴露）与细胞因子水平，卵母细胞产量和胚胎质量进行评估。结果与未子宫内膜异位症的女性未暴露的卵巢相比，子宫内膜瘤影响的卵巢中获得的液体中白细胞介素（IL）-8和单核细胞趋化蛋白1的水平更高，在对侧未受影响的卵巢中观察到中等水平。对于IL-1β和IL-6观察到更适度的差异。与未受影响（6.0±3.8）和未暴露（7.9±5.6）的卵巢相比，患有子宫内膜异位症的妇女的卵巢产生的卵母细胞较少（平均±SD = 4.6±2.3）。调整了可能的混杂因素和在细胞因子主成分分析中产生的变量后，受子宫内膜瘤影响的卵巢的卵母细胞产量与未暴露的卵巢相比仍略低。卵巢组之间没有观察到胚胎质量参数的信息差异。结论结果表明，卵巢子宫内膜异位症的炎症环境很强地局部化，具有较适度的全身作用。但是，子宫内膜瘤对不孕症的影响不能完全由炎症增加来完全解释。