Analysis of follicular fluid and serum markers of oxidative stress in women with infertility related to endometriosis

Infertile women with endometriosis have an altered balance between pro-oxidant and antioxidant activities that may have an impact on folliculogenesis and adequate embryo development.

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Laura Prieto, M.D., Juan F. Quesada, M.D., Olivia Cambero, M.D., Alberto Pacheco, Ph.D., Antonio Pellicer, M.D., Rosa Codoceo, M.D., Juan A. Garcia-Velasco, M.D.

Vol 98, Issue 1 , Pages 126-130



To study the levels of four markers of oxidative stress in follicular fluid (FF) and plasma of patients with infertility related to endometriosis and controls.


Experimental study.


University-affiliated hospital and infertility center.


Ninety-one infertile women were included in the study (23 infertile women with endometriosis and 68 controls including infertile women due to tubal factor, male factor, or healthy egg donors).


Blood was obtained at the time of egg retrieval, and FF from the mature follicles of each ovary was centrifuged and frozen until analysis.

Main Outcome Measure(s):

Vitamin C and E, malondialdehyde, and superoxide dismutase concentrations in plasma and follicular fluid.


Women with endometriosis showed a lower vitamin C concentration in FF (12.7 ± 5.9 vs. 9.7 ± 6.9 μg/mL) and lower superoxide dismutase concentration in plasma (0.9 ± 1.4 vs. 0.5 ± 0.7 U/mL) compared with controls. Vitamin E plasma levels were significantly higher in women with endometriosis (8.1 ± 3.8 vs. 5.2 ± 3.2 μg/mL). A nonsignificant trend toward a lower plasma concentration of malondialdehyde was found in women with endometriosis.


These findings suggest a lower antioxidant capacity in infertile women with endometriosis. Although a certain level of reactive oxygen species is required under physiological conditions, an altered balance between pro-oxidant and antioxidant activities may have an impact on folliculogenesis and adequate embryo development.

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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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