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Purpose: Endometriosis is considered to be an estrogen-related chronic inflammatory disease. The 17β-hydroxysteroid dehydrogenase 1 (HSD17B1) converts estrone to 17β estradiol. The role of HSD17B1 937 A>G (rs605059) single nucleotide polymorphism (SNP) in development of endometriosis is still disputable. This study evaluated the association of the HSD17B1 937 A>G (rs605059) SNP with infertile women affected by endometriosis from Polish Caucasian population., Methods: The genotyping of cases (n = 290) and fertile women (n = 410) was conducted by high-resolution melting curve analysis., Results: Statistical analysis demonstrated that the HSD17B1 937 A>G SNP is associated with endometriosis in stages I and II. The p trend and p allelic values calculated for the HSD17B1 937 A>G polymorphism were statistically significant and were equal to 0.001 and 0.0009, respectively. There was a significant association for the dominant model: (AG + GG vs AA) OR = 1.973 (95% CI = 1.178-3.304), p = 0.009, and for the recessive model: (GG vs AG + AA) OR = 1.806 (95% CI = 1.178-2.770), p = 0.006. However, we did not find statistical association of HSD17B1 937 A>G polymorphism with all infertile women with endometriosis or infertile women with endometriosis in stages III and IV., Conclusion: Our genetic study demonstrated HSD17B1 937 G variant as a risk factor for infertility in women with stage I and II endometriosis in Polish Caucasian patients.

Endometriosis is considered to be an epigenetic disease. It has previously been reported that the DNA methyltransferase 3-like (DNMT3L) rs8129776 single nucleotide polymorphism (SNP) contributes to endometrioma. In the present study, high‑resolution melting curve analysis was used to investigate the risks associated with the DNMT3L c.910‑635A/G (rs8129776), c.832C/T (rs7354779), c.812C/T (rs113593938) and c.344+62C/T (rs2276248) SNPs on stage I‑II endometriosis‑associated infertility. Included in the present study were patients presenting with stage I‑II endometriosis‑associated infertility (n=154) and a control cohort of healthy patients with confirmed fertility (n=383). No significant association between the above‑listed DNMT3L SNPs and the development of endometriosis‑associated infertility was identified. The lowest P‑values generated from trend analysis were observed in the DNMT3L c.832C/T (rs7354779) SNP (Ptrend=0.114). Furthermore, haplotype analyses of the DNMT3L SNPs failed to reveal any risk association between the development of endometriosis‑associated infertility and the above‑listed polymorphisms, even when the SNPs were present in combinations. Finally, a meta‑analysis was performed to examine the association between the DNMT3L rs8129776 SNP and the development of endometrioma, from which no association between the two was identified. On the basis of these results, the present study has demonstrated that variations in the DNMT3L gene do not contribute to stage I-II endometriosis-associated infertility.

It has recently been reported that vitamin D blood plasma levels are associated with reduced risk of endometriosis. The present study aimed to investigate whether the vitamin D binding protein (GC), vitamin D receptor (VDR), and retinoid X receptor (RXR) gene variants may be genetic risk factors for endometriosis‑associated infertility. The subjects consisted of 154 women with endometriosis‑associated infertility and 347 controls. Using polymerase chain reaction restriction fragment length polymorphism and high resolution melt techniques, the GC rs1155563, rs2298849 and rs7041; RXRA rs10881578, rs10776909 and rs749759; VDR BsmI rs1544410; and FokI rs2228570 single nucleotide polymorphisms (SNPs) were investigated in the patients with endometriosis and the healthy controls. The results indicated that no significant differences were observed between the genotype and allele frequencies of all experimental SNPs in the vitamin D signaling pathway genes in women with endometriosis-associated infertility and controls. However, a significant association was present between the A‑T haplotype, consisting of VDR rs1544410 and rs222857 minor alleles, and endometriosis-associated infertility [OR=1.659 (1.122‑2.453), P=0.011]. The results of the present study suggested that VDR gene variants act as genetic risk factors for endometriosis‑associated infertility.

Data suggests that dopamine receptor DRD2 gene variants may contribute to hyperprolactinemia and that they may be risk factors for endometriosis-related infertility. The purpose of the present study was to determine whether nucleotide variants of the DRD2 gene may be associated with infertility related to endometriosis. Five DRD2 SNPs, rs1800497, rs6277, rs2283265, rs4245146 and rs4648317, which are located in different blocks of linkage disequilibrium, were studied in 151 cases and 381 controls. No significant differences between DRD2 rs1800497, rs6277, rs2283265, rs4245146 and rs4648317 genotype, allele nor haplotype frequencies were observed in women with endometriosis-related infertility compared with the control group. The present results did not confirm DRD2 gene variants to be genetic risk factors for endometriosis-related infertility.

Objective: Recently, the FCRL3 -169T>C (rs7528684) single-nucleotide polymorphism (SNP) has been demonstrated to be a risk factor of endometriosis related infertility. We studied whether the FCRL -169T>C SNP can be associated with endometriosis-related infertility in a sample of the Polish population, Methods: Using PCR-RFLP analysis we genotyped 141 infertile women with endometriosis and 519 fertile women. FCRL3 transcript levels were determined by reverse transcription and real-time quantitative PCR analysis in CD19(+) B cells from women with endometriosis-associated infertility and fertile women, Results: We found a significantly increased frequency of the FCRL3 C/C genotype in women with endometriosis-associated infertility than controls [OR = 1.681 (95 % CI = 1.120-2.522, p = 0.0116, p corr = 0.0348)]. There was also a statistically increased frequency of the C/C and C/T genotypes in patients compared with controls [OR = 2.009 (95 % CI = 1.214-3.324, p = 0.0059, p corr = 0.0177)]. The p value of the χ (2) test for the trend observed for the FCRL3 -169T>C polymorphism was also statistically significant (p trend = 0.0012, p corr = 0.0036). We also found significantly increased FCRL3 transcript levels in carriers of the FCRL3 -169 CC vs TT and CT vs TT genotype both in women with endometriosis-related infertility (p = 0.012; p = 0.015) and fertile women (p = 0.017; p = 0.032) CONCLUSIONS: FCRL3 -169T>C polymorphism alters the expression of FCRL3 and can be a risk factor of endometriosis-related infertility.

Objective: Endometriosis is recognized as an estrogen-dependent disease. There are conflicting data demonstrating single nuclear polymorphisms (SNPs) of CYP17 and CYP19 steroidogenic genes as related to endometriosis risk. We assessed the CYP17 5'-untranslated region -34 A/G (rs743572) and CYP19 Ex10 + C1558T (rs10046) SNPs in stage I-II endometriosis., Design: Case-control study., Setting: Division of reproduction at a university department in Poland., Population: A total of 115 women with diagnosed stage I-II endometriosis according to the revised American Society for Reproductive Medicine (rASRM) classification and 197 fertile women as controls., Methods: The SNPs CYP17 -34 A/G and CYP19 Ex10 + C1558T were identified by high-resolution melting curve analysis., Main Outcome Measures: Genotype prevalence and odds ratio for recessive and dominant genetic model for CYP17 and CYP19 SNPs., Results: We observed a significantly increased CYP17 GG and GA genotype frequency in women diagnosed with rASRM stage I-II endometriosis compared with fertile women (OR = 2.4; 95% CI 1.4-4.2, p = 0.002). We also found a significantly increased CYP17 G allele frequency in cases compared with controls (OR = 1.6; 95% CI 1.2-2.2, p = 0.004). There were no significant differences in the distribution of the CYP17 GG genotype and CYP19 Ex10 + C1558T polymorphism between women diagnosed with rASRM stage I-II endometriosis and controls., Conclusion: The CYP17 -34 G variant, previously associated with increased 17β-estradiol production, displayed a contribution to stage I-II endometriosis in women from a Polish population. Increased 17β-estradiol concentration in carriers of the CYP17 -34 G variant might contribute to endometriosis and associated pathological processes., (© 2013 Nordic Federation of Societies of Obstetrics and Gynecology.)

Introduction: Claudin-4 (CLDN4) is a transmembrane protein, responsible for cellular contact and organization. A different expression of claudin 4 in the endometrium, depending on the menstrual cycle and with peak at the aim of the 'implantation window', has been observed. CLDN4 is believed to play an important role in embryo implantation., The Aim: The aim of the study was to compare the mRNA CLDN4 expression levels in two subgroups of infertile women (idiopathic infertility or minimal endometriosis) and compare them to fertile controls., Method: The study included 36 women with idiopathic infertility and 24 with minimal endometriosis. The control group comprised 26 women. Eutopic endometrium samples were collected with a Pipelle device during the implantation window. Firstly mRNA was extracted from the endometrium and reverse transcribed into cDNA. Real time PCR was used for the assessment of relative expression levels., Results: The observed transcription level of CLDN4 did not differ statistically between the studied groups, but was significantly higher when compared to controls., Conclusions: Exceedingly high levels of CLDN4 might negatively influence fertility rates.

Objective: Overexpression of DNA methyltransferase 3A (DNMT3A) and aberrant methylation of various genes in eutopic endometrium have been demonstrated in women with endometriosis. We aimed to study whether DNMT3A polymorphisms could be a genetic risk factor for endometriosis and endometriosis-related infertility., Study Design: We studied 5 SNPs (rs2289195, rs7590760, rs13401241, rs749131 and rs1550117) located in the DNMT3A gene in 357 women with endometriosis and 640 controls., Results: We did not observe significant differences between genotype and allele frequencies of rs2289195, rs7590760, rs13401241, rs749131 and rs1550117 SNPs in women with endometriosis, endometriosis-related infertility, and controls. The lowest p values of the trend test were observed for DNMT3A rs1550117 in endometriosis and endometriosis-related infertility (p(trend)=0.049 and p(trend)=0.055, respectively)., Conclusions: Our results did not supply evidence for the contribution of SNPs located in DNMT3A to either endometriosis or endometriosis-related infertility., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Endometriosis is defined by endometrial glands and stroma outside of the endometrial cavity Three types of endometriosis have been described: peritoneal endometriosis, ovarian endometriosis and deep infiltrating endometriosis. Endometriosis afflicts 6-15% of women population. It occurs mainly in the group of women in reproductive age, but also in the group of minors and approximately 3% of women after menopause. Within the group of women suffering from infertility the frequency of endometriosis increased to 35-50% of cases. Endometriosis is associated with pain symptoms which can bear the character of pain occurring periodically and altering into constant pain, dysmenorrhea, dyspareunia, dysuria and dyschezia. The correlation between the stage of endometriosis and intensity of pain symptoms not always has to be proportionate. Laparoscopy can be perceived as a standard procedure in endometriosis diagnostics as it allows simultaneous treatment. Profound interview as well as visual diagnostics (USG, MRI) should precede laparoscopy Treatment of endometriosis can be divided into pharmacological and surgical treatment, which can be invasive or non-invasive. The type of treatment depends on patient's age and her procreation plans, occurring ailments and endometriosis type. Important role is played by adjuvant treatment such as appropriate diet and lifestyle. Treatment of advanced endometriosis should be conducted in reference centres that are appointed with adequate equipment and have the possibility of interdisciplinary treatment. Presented standards can digest and outline the order of proceedings both in diagnostics and endometriosis treatment. The research group believes that the above compilation will facilitate undertaking appropriate decision in diagnosis and treatment of the disease, which will subsequently contribute to therapeutic success.

Background: A decrease in HOXA11 expression in eutopic mid-secretory endometrium has been found in women with endometriosis-associated infertility., Methods: Using Real-time quantitative PCR (RQ-PCR) and western blotting analysis we studied the HOXA11 transcript and protein levels in mid-luteal eutopic endometrium from eighteen infertile women with minimal endometriosis, sixteen healthy fertile women and sixteen infertile women with fallopian tubal occlusion from the Polish population. We also evaluated transcript levels of DNA methyltransferases DNMT1, DNMT3A and DNMT3B in these groups of women., Results: There were significantly lower levels of HOXA11 transcripts (p = 0.003, p = 0.041) and protein (p = 0.004, p = 0.001) in women with endometriosis as compared to fertile women and infertile women with tubal occlusion. Moreover, we found significantly higher methylation levels of the CpG region in the first exon of HOXA11 in infertile women with endometriosis compared with fertile women (p < 0.001) and infertile women with tubal occlusion (p < 0.001). We also observed significantly increased levels of DNMT3A transcript in women with endometriosis than fertile women (p = 0.044) and infertile women with tubal occlusion (p = 0.047). However, we did not observe significant differences in DNMT1 and DNMT3B transcript levels between these investigated groups of women., Conclusions: We confirmed that reduced HOXA11 expression may contribute to endometriosis-associated infertility. Moreover, we found that DNA hypermethylation can be one of the possible molecular mechanisms causing a decrease in HOXA11 expression in the eutopic mid-secretory endometrium in infertile women with endometriosis.

Objective: Endometriosis has been considered an epigenetic disease. Single nucleotide polymorphisms (SNPs) located in genes encoding enzymes of the folate and choline metabolism may affect DNA methyltransferase activity., Study Design: We studied 16 SNPs in 12 folate and choline metabolism genes, including BHMT (rs7356530 and rs3733890), BHMT2 (rs625879), CBS (844ins68), CHDH (rs893363 and rs2289205), CHKA (rs7928739), MTHFD1 (rs2236225), MTHFR (rs1801133), MTR (rs1805087), MTRR (rs1801394), PCYT1A (rs712012 and rs7639752), PEMT (rs4244593 and rs4646406) and TCN (rs1801198) in one hundred and sixty-three infertile women with minimal endometriosis and one hundred and fifty fertile women., Results: There were no significant differences between genotype and allele frequencies of these gene variants in infertile women with endometriosis (n=163) and controls (n=150). The lowest, but not statistically significant, p values of the trend test were observed for the CBS 844ins68 and MTR rs1805087 (ptrend=0.0527 and ptrend=0.0771, respectively) polymorphisms. However, the exhaustive multifactor dimensionality reduction analysis revealed an epistatic interaction between rs1801133 of MTHFR and rs4244593 of PEMT in endometriosis-associated infertility (p=0.0240)., Conclusions: Our results showed moderate evidence for the contribution of SNPs located in genes encoding folate and choline metabolism enzymes to infertility in women with endometriosis., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Recent human and animal studies have suggested that reduced HOXA10 expression in the implantation window of eutopic endometrium may contribute to infertility in women with endometriosis. Therefore, we examined the HOXA10 transcript, protein and HOXA10 promoter methylation levels in midluteal eutopic endometrium from 17 infertile women with minimal endometriosis and 15 healthy fertile women from a Polish cohort. Real-time quantitative PCR (RQ-PCR) and western blotting analysis revealed significantly lower levels of HOXA10 transcript (P=0.019) and protein (P=0.048) levels in eutopic endometrium from infertile women with endometriosis as compared to healthy fertile women. Moreover, sodium bisulfite sequencing of three HOXA10 CpG islands showed significantly higher methylation levels of genomic DNA from midluteal eutopic endometrium from infertile women with endometriosis as compared to healthy fertile women (P=0.006). We confirmed that DNA hypermethylation can be one of the potential molecular mechanisms silencing HOXA10 expression in the midluteal endometrium associated with infertility in women with endometriosis., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

Objective: Proprotein convertase 6 (PC6) is known to be the key enzyme involved in the transformation of many hormones, cytokines and their receptors into their active forms. Experimental in vitro studies have also proven that lack of PC6 in the endometrium prevents decidualisation. Therefore in our study we have aimed at determining whether infertility in some patients might be attributable to decreased expression of PC6., Material and Methods: With the use of RealTime PCR we have studied the expression level of PC6 in receptive phase endometria from 36 idiopathic infertile patients, 26 infertile patients with minimal grade endometriosis and compared those results with fertile, age-matched controls. The endometria were collected 7-9 days after ovulation., Results: There were no statistically significant differences regarding the expression of PC6 in endometria from patients with idiopathic infertility, infertile patients with endometriosis and controls., Conclusions: Since there is no detectable difference in PC6 expression, the decreased expression of PC6 is unlikely to cause infertility.

Unlabelled: One of the problems associated with endometriosis is its high recurrence rate. The aim of the study was to assess the risk factors which might contribute to the recurrence of endometrial cysts after their surgical removal., Material and Method: The study included 49 patients admitted to Division of Reproduction, between January 2000 and June 2004, due to endometrial cysts. Patients with more than a two-year follow-up after the initial surgery were retrospectively analyzed. The surgery constituted either an enucleation or an excision of the cyst after prior mobilization of the ovary from surrounding adhesions via laparoscopy or laparotomy. Ten independent factors which might have an impact on the endometriosis recurrence have been the subject of our investigation and analysis., Results: The overall rate of recurrence was 18% (9/49). The age of the patient (28.8 +/- 5.4 years for recurrent endometriosis vs. 33.1 +/- 5.2 years without endometriosis recurrence OR 0.789 95% CI = 0.609-1.020, p < 0.05) proved to be an essential factor responsible for a more frequent endometriosis recurrence. Contrarily, hand removal of cysts via laparoscopy (66.7% vs. 90% of laparoscopies in patients with and without recurrence, respectively, OR = 0.018, 95% CI = 0.0003-0.982, p = 0.049) and pregnancy after surgical treatment (47.5% in patients without recurrence vs. 22% in patients with recurrence, OR = 0.046, 95% CI = 0.0144-0.152, p = 0.031) was associated with significantly less frequent recurrence of endometriosis. CONCLUSISONS: (1) Young age of patients at the time of the first operation predisposes them to repeated appearance of endometrial cysts. (2) Laparoscopic removal of endometrial cysts and pregnancy after surgery decreases the risk of recurrence.

Background: Exact aetiology of infertility in stage I/II endometriosis patients is not known. Interleukin 11 (IL-11) and leukaemia-inhibitory factor (LIF) are factors associated with implantation window in human eutopic endometrium. We decided to test whether there is an altered secretion of these factors, which could explain receptivity defect in patients with minimal endometriosis., Methods: Uterine flushing and endometrial samples were collected 7-9 days after ovulation (implantation window) from infertile patients with stage I/II endometriosis (n = 14) and fertile, endometriosis-free controls (n = 21). IL-11 and LIF were assessed in uterine flushings in eutopic endometria in all patients by enzyme-linked immunosorbent assay (ELISA). In eutopic endometrium, semiquantitative RT-PCR was performed for LIF and IL-11 mRNA expressions., Results: No statistically significant differences were found in uterine flushing in women with and without endometriosis with regard to IL-11 levels (0.0 pg/ml versus 0.0 pg/ml) and LIF (25.53 pg/ml versus 36.26 pg/ml). These results were confirmed by the results of RT-PCR, where there were also no differences between studied groups., Conclusions: There is no receptivity defect with regard to LIF and IL-11 secretions by eutopic endometrium in infertile women with endometriosis.

Objective: To evaluate cytokine levels (IL-1beta, TNF-alpha, IL-6, IL-8), soluble intercellular adhesion molecule-1 (sICAM-1) and number of macrophages in peritoneal fluid (PF) of women with no minimal endometriosis and associated (or not) infertility in order to discriminate between infertility and/or endometriosis., Study Design: Cytokines and sICAM-1 were measured by using quantitative enzyme-linked immunosorbent assay (ELISA) while the macrophages were identified by May-Grunwald-Giemsa and non-specific esterase staining and presented as medians. The measurements were performed in 78 women belonging to four selected subgroups according to their endometriosis and/or infertility status. Statistical analysis was performed using Kruskal-Wallis non-parametric ANOVA test. Additionally, discriminant function analyses were performed., Results: We have found the most elevated macrophage numbers in the groups of women with endometriosis. IL-1beta did not present any statistically significant values differentiating the analysed subgroups. IL-6 (110.0 pg/ml) and TNF-alpha exhibited the highest concentrations (statistically significant) in a group of fertile women with endometriosis. IL-8 clearly differentiated between the subgroups with infertility and sICAM-1 was statistically significantly elevated in the subgroups of infertile women. In the forward discriminant analysis, when subdividing the studied population according to its infertility status (we considered macrophages, IL-8 and IL-6 in order of probability values), we have found striking probability value of 92% for the correct classification into an infertile population., Conclusion: Out of the range of the analysed factors we have found only the sICAM-1 to be singled out between the standard discriminant analysis and the forward one. However, this important flagging molecule might be of considerable value for discrimination between different types of pathology at the level of immune effector function. The increased levels of TNF-alpha and IL-6 signified a group of fertile women with endometriosis; however only IL-6 presented a discriminating value in multifunctional analysis of examined subgroups. The analysed range of factors had a greater tendency to discriminate between infertility status rather than endometriosis.

Objective: To assess the total antioxidant potential of women with endometriosis-associated infertility, women with idiopathic infertility, and fertile controls., Design: Retrospective study., Setting: University medical hospital., Patient(s): Sixty-five women admitted for diagnostic laparoscopy., Main Outcome Measures: Peritoneal fluid samples were analyzed for superoxide dismutase activity and total antioxidant status on spectrophotometry, glutathione peroxidase activity on enzyme-linked immunosorbent assay, and lipid peroxides levels on colorimetry., Result(s): Mean activity of superoxide dismutase, glutathione peroxidase, and total antioxidant status was lowest and lipid peroxide level was highest among infertile patients with endometriosis. Women with idiopathic infertility, in contrast, had the highest superoxide dismutase, glutathione peroxidase, and total antioxidant status activity and the lowest lipid peroxide level., Conclusion(s): High antioxidant potential is not a contributing factor in women with idiopathic infertility. Low total antioxidant status and low activity of antioxidant enzymes in the peritoneal fluid of infertile women with endometriosis probably do not influence fertility in these women, but these factors may play a role in the development of the disease.

Objectives: The only possibility to diagnose peritoneal endometriosis is laparoscopy or laparotomy with tissue sampling for histology. Women with impalpable endometriosis not visible on ultrasound suffering from infertility or teenagers with pelvic pain, where endometriosis may also be expected, would greatly benefit from an inoperative diagnostic method. A sure and comfortable method of assessing the effectiveness of endometriosis treatment does not exist. The aim of the study was description of the alpha 3 beta 1, alpha 4 beta 1 integrins and beta 1 chain expression in endometrial biopsies in women suffering from endometriosis., Material and Methods: Laparoscopy and hysteroscopy was performed in 32 patients because of infertility (n = 23) and/or pelvic pain (n = 11). For histochemical stainings of endometrial biopsy primary and secondary mouse antibodies to human integrins alpha 3 beta 1, alpha 4 beta 1 and beta 1 chain were used (DAKO)., Results: In 17 women peritoneal endometriosis was diagnosed by biopsy at the time of laparoscopy. An alpha 3 beta 1 integrin was more common in the glandular epithelium of women with endometriosis and beta 1 subunit was less frequently observed in the stroma of the endometriosis group than in women without endometriosis. The differences were statistically significant., Conclusion: The selected integrins do not yet allow finding a pattern characteristic for endometriosis.

Objectives: Endometriosis is characterised as a presence of proliferating endometrial fragments growing outside uterus. Despite many investigations we still do not understand why in some women sheded endometrium implants itself into peritoneum and grows, and in the others does not. It is possible that apoptotic status of endometrial fragments implanted into peritoneum is responsible for endometriosis growth as well as the treatment results. Cellular apoptosis is characterised morphologically by cell shrinkage, nuclear pyknosis, chromatin condensation, and blebbing of the plasma membrane., Material and Methods: The study was performed on 28 mature Wistar rats. We studied endometria of rats after induction of endometriosis in peritoneal cavity., Results: The only difference was found in endometrial glands. In animals with successful endometriosis implantation apoptosis indices in endometrial glands obtained during second laparotomy were lower than in the endometriosis free animals (p < 0.05).

We studied levels of IL-12 in peritoneal fluid and serum in patients with minimal, advanced and recurrent endometriosis compared to women without endometriotic lesions in pelvis minor. The aim of the study was to determine whether level of IL-12 detected in peritoneal fluid or serum changes with grading of severity of endometriosis. To assess IL-12 levels immunosorbent ELISA was used. There were no statistically significant differences in IL-12 levels in peritoneal fluid nor in serum in any of studied groups. There was higher concentration (without statistical significance) of IL-12 in peritoneal fluid of healthy women compared to women with endometriosis.

Objective: To measure the levels of antigamete antibodies in serum and peritoneal fluid of women with endometriosis and/or infertility., Design: Antibody activity against human sperm and porcine oocytes was analyzed in selected subgroups of women., Setting: Clinic of reproduction., Patient(s): Women with endometriosis and/or infertility., Intervention(s): No treatment was implemented before peritoneal fluid and blood sample collection., Main Outcome Measure(s): Quantitative ELISA., Result(s): Four groups of women (n = 98) were analyzed for the presence of antizona and antisperm antibodies: infertile with endometriosis (n = 30), idiopathic infertility (n = 28), fertile with endometriosis (n = 20), and healthy fertile controls (n = 20). Antibodies were analyzed simultaneously in serum and peritoneal fluid. No statistically significant differences in antibody levels were detected in serum samples among the analyzed groups. The median values for antizona and antisperm antibodies in peritoneal fluid were significantly higher in women with idiopathic infertility than in the control group. In women with unexplained infertility, a high degree of correlation (Spearman) was found between the presence of antizona antibodies in peritoneal fluid and serum (r = 0.579). A positive predictive value of 80% was calculated for the presence of antizona antibodies (>5 ng/oocyte) in the peritoneal fluid of patients with infertility., Conclusion(s): Antizona antibodies locally produced in the peritoneal fluid have diagnostic value for infertility status; however, they cannot be treated as a marker or prognostic factor for minimal endometriosis and/or its treatment.

The aim of the study was evaluation of presence of the antibodies against theca of the oocyte in peritoneal effusion and in serum in fertile and infertile women with minimal endometriosis in luteal phase of the menstrual cycle. Antibodies were measured by means of ELISA method. Median of the antibodies against theca was three-fold higher in peritoneal effusion in infertile women. No differences were stated in serum.

Authors have presented and assessment of estradiol and progesterone levels in peritoneal fluid and blood serum in women with endometriosis. Peritoneal fluid was collected during laparoscopy performed in luteal phase of the cycle. In this cycle ovulation was controlled in all women. An ovulation was confirmed ultrasonographically and laparoscopically in 45% of women with endometriosis and in 80% of that without the illness. Progesterone concentration in peritoneal fluid in women with endometriosis was significantly lower to the control (p < 0.01).

An analysis of the peritoneal fluid in women with endometriosis was undertaken. Peritoneal fluid was collected during laparoscopy from the Douglas pouch. The quantity, color of the fluid as well as macrophages number, concentration and activity were assessed. Conclusion is that no one of the listed parameters of peritoneal fluid could be considered as an endometriosis marker.

The aim of the study was to see the function of follicular cells collected from ovaries of women suffering from endometriosis. The material was granulosa cells taken from 11 patients operated on 3rd and 4th degree of endometriosis. Antral granulosa cells were harvested from 34 medium-size (5-10 mm in diameter) follicles located on the cysts' walls or in the cysts' vicinity. Using the culture method, morphology and steroid secretion was estimated. Morphological properties of the cells in the culture did not differ significantly from that of healthy ones. All cells formed a monolayer and achieved different degrees of luteinization. Steroidogenesis of these granulosa cells was defected, particularly in the production of progesterone and testosterone.

Clinical study in 98 women with genital endometriosis was performed. In 33 patient endometriosis was treated by operative laparoscopy-electrocauterization of foci in 20 women, ovarian cyst resection in 9 and cyst extrication in 4. In 10 cases laparoscopy was followed by laparotomy. Very high correlation between endometriosis and infertility was found (71.4%). Very few patients conceived till now (28.57%). Searching in the time of laparoscopy very subtle foci of endometriosis was stressed.