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Peritoneal Fluid Prostaglandins in Endometriosis, Tubal Disorders, and Unexplained Infertility

From the Departments of Obstetrics and Gynecology, University of Helsinki, Finland, and Department of Clinical Chemistry, University of Oulu, Finland

Abstract

To elucidate the roles of prostaglandins in peritoneal fluid and sex steroids in patients with endometriosis (N=29), tubal disorders (N=15), and unexplained infertility (N=13), assays were performed using 6-keto-prostaglandin F₁ (6-keto-PGF₁) (a metabolite of prostacyclin), thromboxane B₂ (a metabolite of thromboxane A₂), estradiol, and progesterone. Women with normal pelvic anatomy (N=25) served as controls. Peritoneal fluid 6-keto-PGF₁ concentrations in patients with endometriosis (742 ± 104 pg/ml, mean ± SE), tubal disorders (987 ± 211 pg/ml), and unexplained infertility (1659 ± 770 pg/ml) were higher than those in the control women (515 ± 77 pg/ml). The thromboxane B₂ levels in the peritoneal fluid in endometriosis (554 ± 73 pg/ml), tubal disorders (614 ± 107 pg/ml), and unexplained infertility (668 ± 161 pg/ml) were higher than the levels in the control subjects (333 ± 23 pg/ml). There was no relationship between 6-keto-PGF₁/thromboxane B₂ in peritoneal fluid and day of menstrual cycle. The concentrations of estradiol and progesterone were normal in all patient groups and were not related to the 6-keto-PGF₁ and thromboxane B₂ levels. The authors suggest that these prostanoids, which may contribute to infertility, may originate mainly from the peritoneum as a result of irritation by endometriotic implants, tubal adhesions, and scarring.

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