| Endometriosis is characterized by the presence and proliferation of endometrial tissue outside the uterine cavity. Prevalence of endometriosis was high in infertility women. Endometriosis is associated with infertility even among affected women who ovulate and have anatomically patent fallopian tubes. The exact mechanism by which endometriosis interferes with fertility is not known.In advanced cases of endometriosis, with distorted pelvic anatomy, the mechanism of infertility is more easily explained. Many etiologies of infertility in early-stage endometriosis have been proposed. These include endocrine dysfunction; alterations in the local pelvic environment have been the subject of multiple basic science investigations. These alterations may have adverse effects on the oocytes, sperm, embryo or fallopian tube function, because the ovaries and fallopian tubes arebathed in peritoneal fluid. Some studies showed that PF embryo toxicity was increased in women with endometriosis. Unfortunately, there is no satisfactory hypothesis that unequivocally explains the association of early-stage endometriosis with infertility. The study on NO level in peritoneal fluid have been become a new subject.Nitric oxide (NO) is a multifunctional gaseous free radical. The lifespan of NO is relatively short; it is converted within seconds to nitrate and nitrite in an oxygenated environment. . NO mediate a large number of biological functions including vascular tone, platelet aggregation and regulation of synaptic transmission. Nitric oxide (NO) is now recognized as an important mediator of functions in a variety of physiological systems including the reproductive system.NO is synthesized via the oxidation of L-arginine to NO plus L-citrulline by one of three isoforms of NO synthase(NOS), including neural(NOS III),inducible(NOS II),and endothelial(NOS I ) .Although NO has emerged as a key participant in the reproductive function, little is known about NO levels in peritoneal fluid of women with endometriosis-related infertility.The present study will investigate oxide (NO), estrogen (E2) and Progesterone (P) levels in sera and peritoneal fluid of women with endometriosis-associated infertility and further discuss the mechanism of endometriosis-associated infertility and choose a cure method Material and MethodsThis was a prospective randomized study undertaken in Women's HospitalSchool of Medicine Zhejiang University. Forty patients with infertility of endometriosis diagnosed by laparoscopic surgery were divided into groups :24 patients in early EMS group( I II)and 16 patients in advanced EMS group(III IV).20 patients with infertility of tubal factor diagnosed by laparoscopic surgery and 20 patients underwent tubal anastomosis were used as tubal group and control group, NO, E2 and P were determined by fluorescence, RIA.A retrospective analysis of 362 IVF cycles from patients with the only diagnosis of endometriosis, or tubal factor were performed:55 patients with early stage endometriosis-associated infertility,57 patients with advanced stage endometriosis-associated infertility,251 patients with tubal infertility. All patients had a laparoscopy before IVF producedure. The outcome included numbers of oocytes retrieved, peak estrogen and progesterone concentration on the day of HCG administration, numbers of gonadotrophin ampoules used per cycle, fertilization and so on.NO level in peritoneal fluid of early endometriosis group was higher than that of other three groups (P<0.05) and NO level in peritoneal fluid of advanced endometriosis group was lower than that in other group (P<0.05). There was no significant difference in the serum NO concentration between four groups studied (P>0.05). The concentration of E2 and P in peritoneal fluid was higher than tat in serum (P<0.05). The E2 and P level of the four groups in proliferative phase in peritoneal fluid and serum were not different (P>0.05). In the secretary phase the concentration of E2 in peritoneal fluid and in serum of endometriosis groups were hi...
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