Does advanced-stage endometriosis affect the gene expression of estrogen and progesterone receptors in granulosa cells?

ObjectiveTo evaluate how endometriosis affects the expression of estrogen and progesterone receptors mRNA in granulosa cells.DesignProspective study.SettingIVF-ET program at Osaka Medical College.Patient(s)Eighteen patients with revised American Fertility Society stage IV endometriosis and 23 patients with tubal infertility without endometriosis.Intervention(s)Granulosa cells obtained from patients with endometriosis were examined for estrogen (ER-β, ER-α) and progesterone (PR-A, PR-B) receptor mRNA expression ratio against GAPDH.Main Outcome Measure(s)Hormonal environment and clinical outcome were investigated. Expression of ER and PR mRNA were evaluated by StepOne real-time polymerase chain reaction (PCR) analysis.Result(s)Total hMG/FSH levels were statistically higher in patients with endometriosis; however, high-quality embryo rates and pregnancy rates were lower in patients with endometriosis than in patients with tubal infertility. Expression of PR-A and ER-α in patients with endometriosis was statistically higher than in patients with tubal infertility. The expression of PRs and ERs in patients with tubal infertility showed a positive correlation; however, it was not identified in the endometriosis group.Conclusion(s)The higher PR-A and ER-α gene expression in granulosa cells in patients with endometriosis, compared with patients with tubal infertility, might be a leading cause of ovarian dysfunction due to endometriosis.