Endometriosis Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(6):262-267
DOI 10.1590/S0100-72032013000600005
PURPOSE: To correlate preoperative serum cancer antigen 125 (Ca-125) levels and laparoscopic findings in women with pelvic pain symptoms suggestive of endometriosis. METHODS: A retrospective study was conducted including all women with pelvic pain symptoms suspected for endometriosis operated by laparoscopy from January 2010 to March 2013. Patients were divided into 2 groups according to preoperative Ca-125 level (<35 U/mL and >35 U/mL). Subsequently, patients with ovarian endometriomas were excluded and a further analysis was conducted again according to the preoperative Ca-125 level. The following parameters were compared between groups: presence of ovarian endometrioma, presence and number of deep infiltrating endometriosis (DIE) lesions and American Society for Reproductive Medicine score. The statistical analysis was performed with Statistica version 8.0, using the Fisher exact test, Student's t-test and Mann-Whitney test, when needed. A p value of <0.05 was considered to be statistically significant. RESULTS: During the study period, a total of 350 women were submitted to laparoscopic treatment of endometriosis. One hundred thirty patients (37.1%) had Ca-125>35 U/mL and 220 (62.9%) had Ca-12<35 U/mL. The presence of ovarian endometriomas (47.7 versus 15.9%), DIE lesions (99.6 versus 78.6%) and intestinal DIE lesions (60 versus 30.9%) was more frequent, and the AFSr score was higher (34 versus 6) in the former group. In the second analysis, excluding the patients with ovarian endometriomas (>35 U/mL=68 patients and <35 U/mL=185 patients), similar results were obtained. The presence of DIE lesions (91.2 versus 76.2%), intestinal DIE lesions (63.2 versus 25.4%), bladder DIE lesions (20.6 versus 4.8%) and ureteral DIE lesions (7.3 versus 1.6%) was more frequent, and the AFSr score was higher (10 versus 6) in the Ca-125 >35 U/mL group. CONCLUSIONS: Investigation for DIE is mandatory in women with pelvic pain symptoms suggestive of endometriosis with a preoperative Ca-125 level >35 U/mL, especially when an ovarian endometrioma is not present.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(6):262-267
DOI 10.1590/S0100-72032013000600005
PURPOSE: To correlate preoperative serum cancer antigen 125 (Ca-125) levels and laparoscopic findings in women with pelvic pain symptoms suggestive of endometriosis. METHODS: A retrospective study was conducted including all women with pelvic pain symptoms suspected for endometriosis operated by laparoscopy from January 2010 to March 2013. Patients were divided into 2 groups according to preoperative Ca-125 level (<35 U/mL and >35 U/mL). Subsequently, patients with ovarian endometriomas were excluded and a further analysis was conducted again according to the preoperative Ca-125 level. The following parameters were compared between groups: presence of ovarian endometrioma, presence and number of deep infiltrating endometriosis (DIE) lesions and American Society for Reproductive Medicine score. The statistical analysis was performed with Statistica version 8.0, using the Fisher exact test, Student's t-test and Mann-Whitney test, when needed. A p value of <0.05 was considered to be statistically significant. RESULTS: During the study period, a total of 350 women were submitted to laparoscopic treatment of endometriosis. One hundred thirty patients (37.1%) had Ca-125>35 U/mL and 220 (62.9%) had Ca-12<35 U/mL. The presence of ovarian endometriomas (47.7 versus 15.9%), DIE lesions (99.6 versus 78.6%) and intestinal DIE lesions (60 versus 30.9%) was more frequent, and the AFSr score was higher (34 versus 6) in the former group. In the second analysis, excluding the patients with ovarian endometriomas (>35 U/mL=68 patients and <35 U/mL=185 patients), similar results were obtained. The presence of DIE lesions (91.2 versus 76.2%), intestinal DIE lesions (63.2 versus 25.4%), bladder DIE lesions (20.6 versus 4.8%) and ureteral DIE lesions (7.3 versus 1.6%) was more frequent, and the AFSr score was higher (10 versus 6) in the Ca-125 >35 U/mL group. CONCLUSIONS: Investigation for DIE is mandatory in women with pelvic pain symptoms suggestive of endometriosis with a preoperative Ca-125 level >35 U/mL, especially when an ovarian endometrioma is not present.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(12):568-574
DOI 10.1590/S0100-72032012001200007
PURPOSE: To evaluate the expression of neurotrophic (NGF, NPY and VIP) and pro-inflammatory (TNF-α) mediators in the rectum and sigmoid fragments compromised by endometriosis. METHODS: Twenty-four patients were selected to undergo surgical treatment of endometriosis of the rectum and sigmoid colon with a segmental resection technique, followed by end-to-end anastomosis with a circular stapler from January 2005 to December 2007. The study included premenopausal women who underwent surgical treatment for deep endometriosis infiltrating the rectum with involvement of the rectum and sigmoid, reaching the level of the muscle layer, submucosa or mucosa. Twenty-four rectum and sigmoid fragments with histologically confirmed endometriosis, one from each of the 24 selected patients, were used for the study group. For the control group, we used a fragment of the distal resection margin called anastomosis ring from each of the 24 patients enrolled in the study. Samples were grouped into Tissue Micro Array (TMA) blocks and subjected to immunohistochemistry to evaluate the expression of tumor necrosis factor alpha (TNF-α), nerve growth factor (NGF), neuropeptide Y (NPY) and P vasoactive intestinal peptide (VIP), followed by semiquantitative analysis of immunostaining by reading the relative optical density (OD). RESULTS: There was higher optical density relative to TNF-α immunostaining and NGF in the study group (samples with intestinal endometriosis), DO=0.01, for the two proteins, respectively (p<0.05), compared to controls without endometriosis. There was no statistically significant difference in the optical density of immunostaining of NPY and VIP. CONCLUSION: We identified increased immunostaining of TNF-α antibodies and fragments of NGF in the rectum and sigmoid compromised by endometriosis compared to disease-free controls. We did not identify any statistical difference in immunostaining of NPY and VIP proteins.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(12):568-574
DOI 10.1590/S0100-72032012001200007
PURPOSE: To evaluate the expression of neurotrophic (NGF, NPY and VIP) and pro-inflammatory (TNF-α) mediators in the rectum and sigmoid fragments compromised by endometriosis. METHODS: Twenty-four patients were selected to undergo surgical treatment of endometriosis of the rectum and sigmoid colon with a segmental resection technique, followed by end-to-end anastomosis with a circular stapler from January 2005 to December 2007. The study included premenopausal women who underwent surgical treatment for deep endometriosis infiltrating the rectum with involvement of the rectum and sigmoid, reaching the level of the muscle layer, submucosa or mucosa. Twenty-four rectum and sigmoid fragments with histologically confirmed endometriosis, one from each of the 24 selected patients, were used for the study group. For the control group, we used a fragment of the distal resection margin called anastomosis ring from each of the 24 patients enrolled in the study. Samples were grouped into Tissue Micro Array (TMA) blocks and subjected to immunohistochemistry to evaluate the expression of tumor necrosis factor alpha (TNF-α), nerve growth factor (NGF), neuropeptide Y (NPY) and P vasoactive intestinal peptide (VIP), followed by semiquantitative analysis of immunostaining by reading the relative optical density (OD). RESULTS: There was higher optical density relative to TNF-α immunostaining and NGF in the study group (samples with intestinal endometriosis), DO=0.01, for the two proteins, respectively (p<0.05), compared to controls without endometriosis. There was no statistically significant difference in the optical density of immunostaining of NPY and VIP. CONCLUSION: We identified increased immunostaining of TNF-α antibodies and fragments of NGF in the rectum and sigmoid compromised by endometriosis compared to disease-free controls. We did not identify any statistical difference in immunostaining of NPY and VIP proteins.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(9):420-424
DOI 10.1590/S0100-72032012000900006
PURPOSE: To evaluate the association between ovarian endometrioma and the presence of deep infiltrating endometriosis (DIE) lesions in a sample of women of the South of Brazil. METHODS: A retrospective study was conducted in all women undergoing surgical treatment of endometriosis from January 2010 to June 2012. Patients were divided into 2 groups according to the presence or not of ovarian endometrioma. Patients presenting an ovarian endometrioma were subsequently divided into 2 groups according to the diameter of the endometrioma (<40 and >40 mm). The following parameters were compared between the groups: cancer antigen (CA) 125 level, size of the endometrioma, presence and number of deep lesions. The statistical analysis was performed with Statistica version 8.0 using Fisher's exact test, Student's t-test and Mann-Whitney test, when needed. The p values of <0.05 were considered statistically significant. RESULTS: During the study period, a total of 201 women underwent laparoscopic surgical treatment of endometriosis. Fifty-five patients (27.9%) presented ovarian endometrioma and 180 patients (89.5%) presented DIE confirmed by pathologic examination. Women presenting an ovarian endometrioma had higher CA 125 levels (39.5 versus 24.1 U/mL; p<0.01) and stronger association with the presence of DIE lesions (98.2 versus 86.2%; p=0.01) and intestinal DIE (57.1 versus 37.9%; p=0.01). There was no difference between the groups with endometriomas <40 and >40 mm. CONCLUSIONS: Ovarian endometrioma is a marker for the presence of DIE lesions, including intestinal DIE.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(9):420-424
DOI 10.1590/S0100-72032012000900006
PURPOSE: To evaluate the association between ovarian endometrioma and the presence of deep infiltrating endometriosis (DIE) lesions in a sample of women of the South of Brazil. METHODS: A retrospective study was conducted in all women undergoing surgical treatment of endometriosis from January 2010 to June 2012. Patients were divided into 2 groups according to the presence or not of ovarian endometrioma. Patients presenting an ovarian endometrioma were subsequently divided into 2 groups according to the diameter of the endometrioma (<40 and >40 mm). The following parameters were compared between the groups: cancer antigen (CA) 125 level, size of the endometrioma, presence and number of deep lesions. The statistical analysis was performed with Statistica version 8.0 using Fisher's exact test, Student's t-test and Mann-Whitney test, when needed. The p values of <0.05 were considered statistically significant. RESULTS: During the study period, a total of 201 women underwent laparoscopic surgical treatment of endometriosis. Fifty-five patients (27.9%) presented ovarian endometrioma and 180 patients (89.5%) presented DIE confirmed by pathologic examination. Women presenting an ovarian endometrioma had higher CA 125 levels (39.5 versus 24.1 U/mL; p<0.01) and stronger association with the presence of DIE lesions (98.2 versus 86.2%; p=0.01) and intestinal DIE (57.1 versus 37.9%; p=0.01). There was no difference between the groups with endometriomas <40 and >40 mm. CONCLUSIONS: Ovarian endometrioma is a marker for the presence of DIE lesions, including intestinal DIE.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(6):278-284
DOI 10.1590/S0100-72032012000600007
PURPOSE: To evaluate the anatomical distribution of deep infiltrating endometriosis (DIE) lesions in a sample of women from the South of Brazil. METHODS: A prospective study was conducted on women undergoing surgical treatment for DIE from January 2010 to January 2012. The lesions were classified according to eight main locations, from least serious to worst: round ligament, anterior uterine serosa/vesicouterine peitoneal reflection, utero-sacral ligament, retrocervical area, vagina, bladder, intestine, ureter. The number and location of the DIE lesions were studied for each patient according to the above-mentioned criteria and also according to uni- or multifocality. The statistical analysis was performed using Statistica version 8.0. The values p<0.05 were considered statistically significant. RESULTS: During the study period, a total of 143 women presented 577 DIE lesions: uterosacral ligament (n=239; 41.4%), retrocervical (n=91; 15.7%), vagina (n=50; 8.7%), round ligament (n=50; 8,7%), vesico-uterine septum (n=41; 7.1%), bladder (n=12; 2.1%), and intestine (n=83; 14.4%), ureter (n=11; 1.9%). Multifocal disease was observed in the majority of patients (p<0.0001), and the mean number of DIE lesions per patient was 4. Ovarian endometrioma was present in 57 women (39.9%). Sixty-five patients (45.4%) presented intestinal infiltration on histological examination. A total of 83 DIE intestinal lesions were distributed as follows: appendix (n=7), cecum (n=1) and rectosigmoid (n=75). The mean number of intestinal lesions per patient was 1.3. CONCLUSIONS: DIE has a multifocal pattern of distribution, a fact of fundamental importance for the definition of the complete surgical treatment of the disease.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(6):278-284
DOI 10.1590/S0100-72032012000600007
PURPOSE: To evaluate the anatomical distribution of deep infiltrating endometriosis (DIE) lesions in a sample of women from the South of Brazil. METHODS: A prospective study was conducted on women undergoing surgical treatment for DIE from January 2010 to January 2012. The lesions were classified according to eight main locations, from least serious to worst: round ligament, anterior uterine serosa/vesicouterine peitoneal reflection, utero-sacral ligament, retrocervical area, vagina, bladder, intestine, ureter. The number and location of the DIE lesions were studied for each patient according to the above-mentioned criteria and also according to uni- or multifocality. The statistical analysis was performed using Statistica version 8.0. The values p<0.05 were considered statistically significant. RESULTS: During the study period, a total of 143 women presented 577 DIE lesions: uterosacral ligament (n=239; 41.4%), retrocervical (n=91; 15.7%), vagina (n=50; 8.7%), round ligament (n=50; 8,7%), vesico-uterine septum (n=41; 7.1%), bladder (n=12; 2.1%), and intestine (n=83; 14.4%), ureter (n=11; 1.9%). Multifocal disease was observed in the majority of patients (p<0.0001), and the mean number of DIE lesions per patient was 4. Ovarian endometrioma was present in 57 women (39.9%). Sixty-five patients (45.4%) presented intestinal infiltration on histological examination. A total of 83 DIE intestinal lesions were distributed as follows: appendix (n=7), cecum (n=1) and rectosigmoid (n=75). The mean number of intestinal lesions per patient was 1.3. CONCLUSIONS: DIE has a multifocal pattern of distribution, a fact of fundamental importance for the definition of the complete surgical treatment of the disease.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(5):203-208
DOI 10.1590/S0100-72032012000500003
PURPOSE: To evaluate the nuclear maturation stage and the presence of meiotic spindles of in vivo matured oocytes from infertile women undergoing stimulated cycles for intracytoplasmic sperm injection (ICSI) and compare intracytoplasmic sperm injection outcomes between oocytes in telophase I (TI) and metaphase II (MII), and the ones with and without visible meiotic spindle. METHODS: A prospective and controlled study with 106 infertile patients who underwent ovarian stimulation for intracytoplasmic sperm injection purposes. Patients aged 38 years or less, with basal follicle stimulating hormone (FSH) less than 10 mIU/mL and body mass index (BMI) less than 30 kg/m². Were included patients presenting any systemic diseases, any active infection, smokers or patients who had been using hormonal medications and hormonal and nonhormonal anti-inflammatory drugs for the past two months prior to the assisted reproduction procedure were excluded. The oocytes with the first polar body extruded (in vivo matured oocytes) were imaged by polarization microscopy immediately before intracytoplasmic sperm injection and characterized according to nuclear maturation stage (telophase I and metaphase II) and to the presence of a meiotic spindle. We analyzed the fertilization rates, cleavage, number of good quality embryos on the second day (D2) from oocytes on telophase I versus those in metaphase II, and metaphase II visible spindle versus non-visible ones. Data were analyzed comparatively by Fisher's exact test. The level of significance was set at 5% in all analyses (p<0.05). RESULTS: The meiotic spindles of 516 oocytes were imaged using polarization microscopy. From the 516 oocytes analyzed, seventeen were in telophase I (3.3%) and 499 (96.7%) in metaphase II. The oocytes injected in telophase I had significantly lower fertilization rates than those injected in metaphase II (53 and 78%, respectively) and produced no good quality embryos on day 2. When the oocytes with and without a visible meiotic spindle were compared, there was no significant difference in the intracytoplasmic sperm injection results. CONCLUSIONS: Oocytes injected in telophase I showed lower fertilization rates when compared to those in metaphase II. It is possible that the analysis of oocyte nuclear maturation by polarization microscopy can be used as a predictor of fertilization after intracytoplasmic sperm injection.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(5):203-208
DOI 10.1590/S0100-72032012000500003
PURPOSE: To evaluate the nuclear maturation stage and the presence of meiotic spindles of in vivo matured oocytes from infertile women undergoing stimulated cycles for intracytoplasmic sperm injection (ICSI) and compare intracytoplasmic sperm injection outcomes between oocytes in telophase I (TI) and metaphase II (MII), and the ones with and without visible meiotic spindle. METHODS: A prospective and controlled study with 106 infertile patients who underwent ovarian stimulation for intracytoplasmic sperm injection purposes. Patients aged 38 years or less, with basal follicle stimulating hormone (FSH) less than 10 mIU/mL and body mass index (BMI) less than 30 kg/m². Were included patients presenting any systemic diseases, any active infection, smokers or patients who had been using hormonal medications and hormonal and nonhormonal anti-inflammatory drugs for the past two months prior to the assisted reproduction procedure were excluded. The oocytes with the first polar body extruded (in vivo matured oocytes) were imaged by polarization microscopy immediately before intracytoplasmic sperm injection and characterized according to nuclear maturation stage (telophase I and metaphase II) and to the presence of a meiotic spindle. We analyzed the fertilization rates, cleavage, number of good quality embryos on the second day (D2) from oocytes on telophase I versus those in metaphase II, and metaphase II visible spindle versus non-visible ones. Data were analyzed comparatively by Fisher's exact test. The level of significance was set at 5% in all analyses (p<0.05). RESULTS: The meiotic spindles of 516 oocytes were imaged using polarization microscopy. From the 516 oocytes analyzed, seventeen were in telophase I (3.3%) and 499 (96.7%) in metaphase II. The oocytes injected in telophase I had significantly lower fertilization rates than those injected in metaphase II (53 and 78%, respectively) and produced no good quality embryos on day 2. When the oocytes with and without a visible meiotic spindle were compared, there was no significant difference in the intracytoplasmic sperm injection results. CONCLUSIONS: Oocytes injected in telophase I showed lower fertilization rates when compared to those in metaphase II. It is possible that the analysis of oocyte nuclear maturation by polarization microscopy can be used as a predictor of fertilization after intracytoplasmic sperm injection.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(1):11-15
DOI 10.1590/S0100-72032012000100003
PURPOSE: The present study examined the relationship between some clinical variables and quality of life in a group of patients with endometriosis. METHODS: A total of 130 women seen at a multidisciplinary center specializing in gynecology endometriosis in 2008 participated in the study. This was a cross-sectional study conducted with a convenience sample. The diagnosis of endometriosis was performed by biopsy according to the criteria of the American Society for Reproductive Medicine. The clinical and demographic data were collected from the patients' records. Pain intensity was assessed by a visual numerical scale (0-10), and data on the quality of life were collected using the SF-36. Data analysis consisted of descriptive and inferential statistical tests, Spearman correlation coefficient and Kruskal-Wallis test to compare scores between groups. Nonparametric tests were used for analysis because data were not normally distributed. RESULTS: The patients were 21 to 54 years of age [
or = 34, standard diversion (SD)=6.56], 87% had a university degree, and 75% were married. Seventeen percent reported cases of endometriosis in the family. The average time of onset of symptoms was 4.5 years (SD=6.6), 63% of patients were in stage 3 or 4 of endometriosis 36% of patients had severe or disabling dysmenorrhea and the average intensity of pain according to a visual numerical scale was of 5.6 (SD=3.5). Results suggest that the staging of the disease did not determine the intensity of pain. The time of onset of symptoms also showed no relationship to pain intensity and SF-36 scores. On the other hand, the intensity of pain was associated with lower scores on some scales of the SF-36. CONCLUSION: Patients with endometriosis had lower scores of quality of life than the general population and lower than those of some other diseases.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(1):11-15
DOI 10.1590/S0100-72032012000100003
PURPOSE: The present study examined the relationship between some clinical variables and quality of life in a group of patients with endometriosis. METHODS: A total of 130 women seen at a multidisciplinary center specializing in gynecology endometriosis in 2008 participated in the study. This was a cross-sectional study conducted with a convenience sample. The diagnosis of endometriosis was performed by biopsy according to the criteria of the American Society for Reproductive Medicine. The clinical and demographic data were collected from the patients' records. Pain intensity was assessed by a visual numerical scale (0-10), and data on the quality of life were collected using the SF-36. Data analysis consisted of descriptive and inferential statistical tests, Spearman correlation coefficient and Kruskal-Wallis test to compare scores between groups. Nonparametric tests were used for analysis because data were not normally distributed. RESULTS: The patients were 21 to 54 years of age [ or = 34, standard diversion (SD)=6.56], 87% had a university degree, and 75% were married. Seventeen percent reported cases of endometriosis in the family. The average time of onset of symptoms was 4.5 years (SD=6.6), 63% of patients were in stage 3 or 4 of endometriosis 36% of patients had severe or disabling dysmenorrhea and the average intensity of pain according to a visual numerical scale was of 5.6 (SD=3.5). Results suggest that the staging of the disease did not determine the intensity of pain. The time of onset of symptoms also showed no relationship to pain intensity and SF-36 scores. On the other hand, the intensity of pain was associated with lower scores on some scales of the SF-36. CONCLUSION: Patients with endometriosis had lower scores of quality of life than the general population and lower than those of some other diseases.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(3):123-127
DOI 10.1590/S0100-72032011000300004
PURPOSE: to evaluate the frequency and clinical picture of patients with incisional endometriosis. METHODS: retrospective descriptive study performed from the medical records of patients that underwent nodules resection in the surgical scar at Faculdade de Medicina do ABC, from November 1990 to September 2003. The age, parity, number of cesarean sections, symptoms, tumor location, initial diagnosis, treatment, and recurrences were surveyed and analyzed. The results were reported as percentage, mean, and standard deviation. RESULTS: we found 42 patients that were diagnosed with scar endometriosis. From these 42 cases, 37 were of endometriosis on cesarean section scar; 3 cases of episiotomies and 2 cases on bladder in scar of hysterography. The mean age of the patients was 32.4 years old, standard deviation of ±6.2 years. All of them had previous obstetric surgery, and the main complaint was nodulation with perimenstrual pain in 40% of the cases. In 57% of the patients, the clinical evaluation was confirmed by pelvic or transvaginal ultrasonography. Patients were treated with total resection, and recurrence occurred in only two cases. CONCLUSION: scar surgical endometriosis is uncommon; however, the clinical diagnosis is easy when the signs and symptoms are known. The effective treatment is surgical resection.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(3):123-127
DOI 10.1590/S0100-72032011000300004
PURPOSE: to evaluate the frequency and clinical picture of patients with incisional endometriosis. METHODS: retrospective descriptive study performed from the medical records of patients that underwent nodules resection in the surgical scar at Faculdade de Medicina do ABC, from November 1990 to September 2003. The age, parity, number of cesarean sections, symptoms, tumor location, initial diagnosis, treatment, and recurrences were surveyed and analyzed. The results were reported as percentage, mean, and standard deviation. RESULTS: we found 42 patients that were diagnosed with scar endometriosis. From these 42 cases, 37 were of endometriosis on cesarean section scar; 3 cases of episiotomies and 2 cases on bladder in scar of hysterography. The mean age of the patients was 32.4 years old, standard deviation of ±6.2 years. All of them had previous obstetric surgery, and the main complaint was nodulation with perimenstrual pain in 40% of the cases. In 57% of the patients, the clinical evaluation was confirmed by pelvic or transvaginal ultrasonography. Patients were treated with total resection, and recurrence occurred in only two cases. CONCLUSION: scar surgical endometriosis is uncommon; however, the clinical diagnosis is easy when the signs and symptoms are known. The effective treatment is surgical resection.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(2):65-69
DOI 10.1590/S0100-72032011000200002
PURPOSE: to evaluate the frequency of VDR gene polymorphism Fok1 in infertile women with endometriosis and Control and its relation to the disease. METHODS: a case-control study that included 147 infertile women with endometriosis and 154 fertile women without endometriosis as Control. Fok1 polymorphism (rs10735810, T2C), which promotes a T/C exchange in exon 2 of the VDR gene, was identified by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), that involves the combination of amplification by PCR and digestion with restriction endonuclease. The χ2 test was used to compare allele and genotype frequencies between groups. All p-values were two-tailed and a p-value < 0.05 was considered statistically significant. RESULTS: the TT, TC and CC genotype frequencies of VDR Fok1 polymorphism were 44.2%, 46.9% and 8.9% in infertile women with endometriosis and 41.6%, 50% and 8.4% in the Control Group. No significant difference was found (p=0.8), even when the patients were subdivided according to the stage of endometriosis (p=0.3 for minimal and mild endometriosis and p=0.2 for moderate and severe endometriosis). Alleles T and C were present, respectively, in 67.6% and 32.3% of infertile women with endometriosis (p=0.8), in 63.5% and 36.5% of women with minimal/mild endometriosis (p=0.5), in 72.5% and 27.5% of women with moderate/severe endometriosis (p=0.2), and in 66.6% and 33.4% of the Control Group. No statistically significant difference was found among any groups and the Control. CONCLUSION: the results suggest that VDR gene polymorphism Fok1 does not confer genetic susceptibility to endometriosis-associated infertility in the Brazilian population.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(2):65-69
DOI 10.1590/S0100-72032011000200002
PURPOSE: to evaluate the frequency of VDR gene polymorphism Fok1 in infertile women with endometriosis and Control and its relation to the disease. METHODS: a case-control study that included 147 infertile women with endometriosis and 154 fertile women without endometriosis as Control. Fok1 polymorphism (rs10735810, T2C), which promotes a T/C exchange in exon 2 of the VDR gene, was identified by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), that involves the combination of amplification by PCR and digestion with restriction endonuclease. The χ2 test was used to compare allele and genotype frequencies between groups. All p-values were two-tailed and a p-value < 0.05 was considered statistically significant. RESULTS: the TT, TC and CC genotype frequencies of VDR Fok1 polymorphism were 44.2%, 46.9% and 8.9% in infertile women with endometriosis and 41.6%, 50% and 8.4% in the Control Group. No significant difference was found (p=0.8), even when the patients were subdivided according to the stage of endometriosis (p=0.3 for minimal and mild endometriosis and p=0.2 for moderate and severe endometriosis). Alleles T and C were present, respectively, in 67.6% and 32.3% of infertile women with endometriosis (p=0.8), in 63.5% and 36.5% of women with minimal/mild endometriosis (p=0.5), in 72.5% and 27.5% of women with moderate/severe endometriosis (p=0.2), and in 66.6% and 33.4% of the Control Group. No statistically significant difference was found among any groups and the Control. CONCLUSION: the results suggest that VDR gene polymorphism Fok1 does not confer genetic susceptibility to endometriosis-associated infertility in the Brazilian population.
