Morcos, R. N., Gibbons, W. E., & Findley, W. E. (1985). Effect of peritoneal fluid on in vitro cleavage of 2-cell mouse embryos: possible role in infertility associated with endometriosis. Fertility and Sterility, 44(5), 678-683. https://doi.org/10.1016/s0015-0282(16)48987-9
Morcos RN, Gibbons WE, Findley WE. Effect of peritoneal fluid on in vitro cleavage of 2-cell mouse embryos: possible role in infertility associated with endometriosis. Fertil Steril. 1985;44(5):678-683. doi:10.1016/s0015-0282(16)48987-9
Morcos, Roy N., et al. "Effect of peritoneal fluid on in vitro cleavage of 2-cell mouse embryos: possible role in infertility associated with endometriosis." Fertility and Sterility, vol. 44, no. 5, 1985, pp. 678-683.
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Endometriosis peritoneal fluid slowed mouse embryo growth in vitro
Peritoneal fluid from infertile women with endometriosis was toxic to cultured mouse embryos in most samples. In this 1985 laboratory study, about 8 out of 10 endometriosis samples were toxic. Fluid from infertile women without endometriosis was toxic in 2 out of 10 samples.
Key Findings
Fourteen of 18 fluid samples from women with endometriosis were toxic to embryos, versus 2 of 10 samples from women without endometriosis (P < 0.01).
By 72 hours, 41% of embryos cultured in endometriosis fluid were degenerating versus 9% in the comparison group; 16.5% versus 50% had reached blastocyst stages.
Across 162 embryos in the endometriosis group and 100 in the comparison group, development was significantly further along without endometriosis at 24, 48, and 72 hours (P < 0.001).
Embryos exposed briefly to endometriosis fluid and then placed in fresh medium appeared not to return to the cleavage rate of control embryos.
Preliminary tests at a higher concentration (1 to 10) delayed embryo growth in both groups.
Interpretation
This laboratory experiment used peritoneal fluid from 28 infertile women at laparoscopy. Mouse embryos grew in the diluted fluid for 72 hours, and growth stages were scored every 24 hours. Most endometriosis samples were toxic, as were two of the 10 comparison samples. The authors suggest the effect could matter in infertility from endometriosis without obvious pelvic adhesions. They note that too few samples were available to link toxicity to disease severity.
RRM Context
Endometriosis can harm fertility through the pelvic environment, even without adhesions. The authors suggest inflammation around implants could supply the toxic factors. RRM treats infertility as a symptom of a cause, and looks for that cause.
Our editorial summary of this paper, not the article's abstract.
Abstract
The purpose of this study was to evaluate the effect of peritoneal fluid (PF) on in vitro cleavage of 2-cell mouse embryos. PF was aspirated from the posterior cul-de-sac at laparoscopy and centrifuged, and the cell-free supernatant was heat-inactivated at 56 degrees C for 30 minutes and filtered (0.22 micron). Five percent PF in Ham's F-10 media was prepared and eight to ten 2-cell mouse embryos cultured for 72 hours. There were two study groups, one consisting of 10 PF samples from infertile patients with no endometriosis (PF-NE) and 18 from infertile patients with endometriosis (PF-E). Each sample was assayed along with a control consisting of media only. At 72 hours, greater than 50% of the embryos in the control groups reached the blastocyst and hatching stages. Individual PF samples in both study groups were classified as toxic if less than 50% of the embryos reached the blastocyst and hatching stages at 72 hours. Eight of the 10 samples in the PF-NE group were nontoxic and 14 of the 18 samples in the PF-E group were toxic (P less than 0.01). For evaluation of the overall effect of PF, all results in the PF-E group were pooled (162 embryos) and compared by the Mann-Whitney U test to pooled results in the PF-NE group (100 embryos). The embryonic stages in the PF-NE group were significantly more advanced than those in the PF-E group (P less than 0.001) at 24, 48, and 72 hours.(ABSTRACT TRUNCATED AT 250 WORDS)
Endometriosis is a chronic inflammatory disease that drives pain, organ dysfunction, and infertility. How RRM-trained clinicians diagnose and treat it through excision surgery, cycle charting, and longitudinal care.
