Enhanced follicular recruitment and atresia in cortex derived from ovaries with endometriomas
Open accessAbstract
Objective To evaluate the effects of endometriomas on the regulation of early follicular development. Design Histologic analysis of prospectively collected biopsy samples. Setting Research unit in a university hospital. Patient(s) Women <40 years of age who have ovarian endometriomas. Intervention(s) Biopsy of healthy cortex from ovaries affected by endometriomas (≤ 4 cm) and contralateral ovaries without cysts. Main outcome measure(s) Histomorphological staging of early follicles, measurement of follicle, oocyte, and oocyte nucleus diameters, immunohistochemistry of proliferating cell nuclear antigen, and caspase-3. Result(s) Thirteen cortical samples from ovaries with endometriomas and 13 samples from contralateral ovaries without endometriomas were evaluated. Cortex from ovaries with endometriomas contained significantly more morphologically atretic early follicles than cortex from contralateral ovaries without cysts. These follicles showed cleaved caspase-3 immunostaining. Diameters of primordial follicles and oocytes were decreased in cortex from ovaries with endometriomas, whereas early follicles with proliferating cell nuclear antigen-positive granulosa cells (GCs) were significantly increased in number. Conclusion(s) Ovaries with endometriomas, which may be more prone to local pelvic inflammation, showed activated follicular recruitment and atresia of early follicles. The potential contribution of inflammation to follicle "burnout" in case of endometriomas is discussed.
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In ovaries affected by endometriosis, a higher proportion of primordial follicles are recruited into the growing pool and a greater number of maturing follicles degenerate, resulting in quicker depletion of ovarian reserve.
“In ovaries affected by endometriosis, a higher proportion of primordial follicles are recruited into the growing pool and a greater number of maturing follicles degenerate, resulting in quicker depletion of ovarian reserve (Kitajima et al., 2014; Takeuchi et al., 2019).”
From Endometriosis and polycystic ovary syndrome are diametric disorders (2021) · cites this paper as Kitajima et al., 2014
The Discussion reports increased early-follicle recruitment and atresia in ovaries with endometriomas, which the authors say may result in focal exhaustion of the primordial-follicle reserve. The claim extends this finding to ovaries affected by endometriosis generally and states quicker reserve depletion as a definite result, whereas the study examined ovaries with 1–4 cm endometriomas and hedges that conclusion. (LLM, conf=0.86)
Experimental — accuracy not yet measuredLower testosterone in women with endometriosis contributes to a faster pace of follicular recruitment and death.
“Lower testosterone in women with endometriosis shows evidence of contributing to a faster pace of follicular recruitment and death, across several studies.”
From Endometriosis and polycystic ovary syndrome are diametric disorders (2021) · cites this paper as Kitajima et al., 2014
The Discussion reports increased follicular recruitment and atresia in ovaries with endometriomas compared with contralateral ovaries without cysts. The paper discusses local inflammation, fibrosis, and anti-Müllerian hormone as possible contributors, but the searched passages do not link lower testosterone to these changes. The findings also concern ovaries with endometriomas, rather than all women with endometriosis. (LLM, conf=0.88)
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References 24 · Cited by 229
Research works printed but not linked: 21
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- Authors
- Kitajima, M., Dolmans, M.-M., Donnez, O., Masuzaki, H., Soares, M., & Donnez, J.
- Affiliations
- Nagasaki University (JP)
- UCLouvain (BE)
- Corresponding author
- Dolmans, Marie-Madeleine
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2014-04
- Volume
- 101
- Issue
- 4
- Pages
- 1031-1037
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W1997742717
- Cited by
- 229
- References
- 24
- Citations by year
- 2026: 12 · 2025: 24 · 2024: 19 · 2023: 19 · 2022: 27 · 2021: 31 · 2020: 27 · 2019: 14 · 2018: 18 · 2017: 17 · 2016: 9 · 2015: 10 · 2014: 2
- FWCI
- 15.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Funders
- Fonds De La Recherche Scientifique - FNRS
- Japan Society for the Promotion of Science (24592475)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Keywords
- endometrioma, follicular atresia, follicle recruitment, primordial follicles, oocyte size, granulosa cells, proliferating cell nuclear antigen, caspase-3, ovarian inflammation, ovarian cortex
- MeSH terms
- Adult, Endometriosis, Female, Follicular Atresia, Ovarian Follicle, Humans, Young Adult
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