Evidence for local production of inhibin A and activin A in patients with ovarian endometriosis

Objective: To evaluate the expression of inhibin A and activin A in ovarian endometriosis. Design: Uncontrolled cross-sectional study and controlled prospective in vitro study. Setting: Academic health centers in Siena, Udine, Sassari, and Milan, Italy. Patient(s): A group of women (n = 19) who underwent laparoscopic excision of ovarian endometriotic cysts. Intervention(s): Specimens of serum. peritoneal fluid. and cystic fluid, ovarian tissue for immunohistochemistry, and endometriotic cells for primary culture: were collected. Cell cultures were also prepared from proliferative endometrium of women without endometriosis. Main Outcome Measures(s): Dimeric inhibin A and activin A concentrations in biological fluids; immunostaining of or and PA subunits in ovarian endometrioma; cu and PA gene expression in cultured endometriotic cells compared with normal endometrium. Result(s): Inhibin A and activin A concentrations in the cystic fluid were slightly higher than in peritoneal fluid and significantly higher than in serum (P<.05). Immunoreactive cu and PA subunits were strongly expressed both in the epithelial and stromal components of ovarian endometrioma. The relative abundance of <beta>A mRNA was significantly decreased in endometriotic cells compared with eutopic stromal cells. Conclusion(s): The results of the present study provide evidence for a local production and secretion of inhibin A and activin A in ovarian endometriotic cysts. (C)2001 by American Society for Reproductive Medicine.