Abstract
Aim
Leptin is proposed to participate in the reproductive system of women by acting on either ovaries or hypothalamic-pituitary axis. The objective of the present study is to investigate the leptin concentrations in peritoneal fluid and serum samples of women diagnosed with primary infertility.
Methods
A prospective study was carried out in women who underwent laparoscopy within the diagnostic process of primary infertility between January 2005 and January 2007. Leptin concentrations were determined in blood samples obtained before surgery and in peritoneal fluid samples collected during laparoscopy.
Results
Peritoneal fluid was obtained from 112 subjects; 21 with unexplained infertility 28 with polycystic ovary syndrome (PCOS), 30 with bilateral tubal occlusion, and 33 with endometriosis. Subjects with PCOS have significantly higher body weights, BMI values and plasma leptin levels when compared to other study groups. Peritoneal fluid levels of leptin were significantly higher in the endometriosis group compared to other three study groups. A positive correlation was found between peritoneal fluid leptin levels and the endometriosis stage (r = 0.51, P = 0.01). However, plasma leptin levels were unrelated to the disease extent.
Discussion
It might be hypothesized that leptin may be an active factor in the pathogenesis of PCOS and endometriosis, which are two major causes of primary infertility. A mild leptin deficiency in peritoneal environment may interrupt follicular development and ultimately lead to PCOS. Leptin has angiogenic and mitogenic properties, which trigger inflammatory cytokines and eventually result in the development of endometriosis implants. Significantly, higher levels of leptin in peritoneal environments of endometriosis subjects strongly imply the important role of this common pathology.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Fertility Society/American Society for Reproductive Medicine (1997) Revised American Society for Reproductive Medicine classification of endometriosis. Fertil Steril 67:817–821. doi:10.1016/S0015-0282(97)81391-X
Bedaiwy MA, Falcone T (2003) Peritoneal fluid environment in endometriosis: clinicopathologic implications. Minerva Ginecol 55:333–345
Bedaiwy MA, Falcone T, Goldberg JM, Sharma RK, Nelson DR, Agarwal A (2005) Peritoneal fluid leptin is associated with chronic pelvic pain but not infertility in endometriosis patients. Hum Reprod 21(3):788–791
Cao R, Brakenhielm E, Wahlestedt C, Thyberg J, Cao Y (2001) Leptin induces vascular permeability and synergistically stimulates angiogenesis with FGF-2 and VEGF. Proc Natl Acad Sci USA 98:6390–6395
Ciofi JA, van Blekorm J, Antczak M, Shafer A, Wittmer S (1997) The expression of leptin and its receptors in preovulatory human follicles. Mol Hum Reprod 3(6):467–472
De Placido G, Alviggi C, Caravetta C, Pisaturo ML, Sanna V, Wilding M, Lord GM, Matarese G (2001) The peritoneal fluid concentration of leptin is increased in women with peritoneal but not ovarian endometriosis. Hum Reprod 16:1251–1254
Finck BN, Johnson RW (2000) Tumor necrosis factor-alpha induces leptin production through the p55 TNF receptor. Am J Physiol Regul Integr Comp Physiol 278(2):537–543
Gogacz M, Polak G, Jakowicki J, Kotarski J (2001) Peritoneal fluid leptin concentration in infertile patients. J Reprod Immunol 51:159–165
Gonzalez RR, Caballero-Campo P, Jasper M, Mercader A, Devoto L, Pellicer A, Simon C (2000) Leptin and leptin receptor are expressed in the human endometrium and endometrial leptin secretion is regulated by the human blastocyst. J Clin Endocrinol Metab 85:4883–4888
Kitawaki J, Koshiba H, Ishihara H, Kusuki L, Tsukamoto K, Honjo H (2000) Expression of leptin receptor in human endometrium and fluctuation during the menstrual cycle. J Clin Endocrinol Metab 85:1946–1950
Mahutte NG, Matalliotakis IM, Goumenou AG, Vassiliadis S, Koumantakis GE, Arici A (2003) Inverse correlation between peritoneal fluid leptin concentrations and the extent of endometriosis. Hum Reprod 18:1205–1209
Mantzoros CS (2000) Role of leptin in reproduction. Ann NY Acad Sci 900:174–183
Matarese G, Alviggi C, Sanna V, Howard JK, Lord GM, Carravetta C, Fontana S, Lechler RI, Bloom SR, De Placido G (2000) Increased leptin levels in serum and peritoneal fluid of patients with pelvic endometriosis. J Clin Endocrinol Metab 85:2483–2487
Messinis LE, Papageorgiou I, Milingos S, Asprdini E, Kollios G, Seferiadis K (2001) Estradiol plus progesterone treatment increases serum leptin concentrations in normal women. Hum Reprod 16:1827–1832
Moschos S, Chan JL (2002) Leptin and reproduction: a review. Fertil Steril 77:433–444
Park HY, Kwon HM, Lim HJ, Hong BK, Lee JY, Park BE, Jang Y, Cho SY, Kim HS (2001) Potential role of leptin in angiogenesis: leptin induces endothelial cell proliferation and expression of matrix metalloproteinases in vivo and in vitro. Exp Mol Med 33:95–102
Sabogal JC, Munoz L (2001) Leptin in obstetrics and gynecology: a review. Obstet Gynecol Surv 56:225–230
Wu MH, Chuang PC, Chen HM, Lin CC, Tsai SJ (2002) Increased leptin expression in endometriosis cells is associated with endometrial stromal cell proliferation and leptin gene up-regulation. Mol Hum Reprod 8:456–464
Yamada M, Irahara M, Tezuka M, Murakami T, Shima K, Aono T (2000) Serum leptin profiles in the normal menstrual cycles and gonadotropin treatment cycles. Gynecol Obstet Invest 49:119–123
Zhang HH, Kumar S, Barnett AH, Eggo MC (2000) Tumor necrosis factor-alpha exerts dual effects on human adipose leptin synthesis and release. Mol Cell Endocrinol 159:79–88
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gungor, T., Kanat-Pektas, M., Karayalcin, R. et al. Peritoneal fluid and serum leptin concentrations in women with primary infertility. Arch Gynecol Obstet 279, 361–364 (2009). https://doi.org/10.1007/s00404-008-0744-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-008-0744-y