| The causes and factors involved in the.growth of ectopic endome-trium in pelvic endometriosis are still not clear. Therefore, it has been suggested that soluble components in peritoneal fluid may be involved in the growth of ectopic endometrium in pelvic endometriosis. Recently , the presence of IGF system was reported in human peritoneal fluid. The IGF peptides and their receptors have also demonstrated ' immunohistochemically/ in ectopic endometrial tissues. In addition, it has been demonstrated , that IGFs are mitogens to endometrial stro-mal cells in vitro and they can rescue endometrial cells from apopto-sis.However, so far only a few studies have compared IGF and IG-FBP levels in peritoneal fluid from patients with and without endometriosis, and their results have been controversial. Furthermore, the role of IGF system in women with endometriosis' infertility has not been reported. The purpose of this study was to evaluate whether IGF components may be involved in the growth of ectopic endometrium by determining and comparing the levels of IGF - I ,IGF - II in peritoneal fluid of patients with and without endometriosis.Materials and Methods1. 1 Experimental subjectsThirty - one patients who had endometriosis diagnosed by lapa-roscopy checking and operating for this study, ten additional patients undergoing laparoscopic tubal hgation, who did not have endometrio-sis, served as the control group. Patients with any other pathologic condition of the pelvis, such as myoma, were excluded. According to the revised American Fertility Society classification, 31 patients was nlassfied early - stage ( I , II ) and late - stage( III, IV). Peritoneal fluid was centrifuged at 2000 rpm for 10 minutes, supernatants were aliquoted and stored at - 80 until assayed.1. 2 Assay MethodsThe peritoneal fluid levels of IGF - I and IGF - II were measured by using enzyme linked immunosorbent assay.1.3 Statistical AnalysisData were expressed as means SE. Statistical significance was determined by using Student s t - test and analysis of variance on an IBM - compatible computer utilizing SPSS11.0. P <0.05 was considered significant.Results2.1 IGF - I and IGF - II levels in peritoneal fluid of patients with endometriosis and control patientsIn the current study, IGF - I levels in peritoneal fluid were higher in patients with endometriosis than in control groups ( p < 0. 01). There were no significant differences in IGF levels between the groups(p >0.05).2.2 IGF levels in peritoneal fluid of patients with early - stage endometriosis and late - stage endometriosisThe IGF - I levels in peritoneal fluid did not significant differ between early - stage endometriosis and late - stage endometriosis ( p> 0. 05 ). The IGF - H levels in peritoneal fluid did not significant differ between early - stage endometriosis and late - stage endometrio-sis (p>0.05).2. 3 IGF levels in peritoneal fluid in the fertile and infertile patients of endometriosisThe concentration of IGF - I in peritoneal fluid of infertile patients was significantly higher than that of fertile patients( p <0. 05). The concentration of IGF - II has no significant difference between fertile and infertile patients in the endometriosis group (p >0.05).Discussion3. 1 IGF - I promote cellular growth and differentiationIt has been reported that IGF - I has a mitogenic effect in vitro on culture endometrial cells obtained from patients without endometriosis. Functions on IGF - I have been studied in vitro on several cell lines and include mitogenic and metabolic effects on target tissues. IGF have also been implicated in survival and differentiation in all kind of cells. IGF - I on the target cells includes a stimulation of proliferative growth with an increased number of cells, mitotic figures, and replicated DNA synthesis. IGF show pleiotropic effects including stimulation of cell division and differentiation. Our results, in conjunction with these reports, further support the involv...
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