Production of Prostaglandin F2alpha by the Different Forms of Endometriosis

It has been suggested that atypical, nonpigmented endometriotic lesions have an increased capacity to synthesize prostaglandin (PG)F2alpha compared with typical endometriosis, and could therefore represent the more active forms of the disease. We took biopsy specimens of various endometriotic lesions and of normal endometrium and peritoneum during operative laparoscopy in 12 infertile women. The specimens were transferred in flasks containing Krebs solution and placed in a shaking incubator for 1 hour at 37° C. The incubation solution was changed every 20 minutes and assayed by radioimmunoassay procedures for the concentration of PGF2alpha. Biopsy specimens from normal peritoneum and normal endometrium were also taken from five control patients with no evidence of endometriosis. The PGF2alpha concentration/milligram of tissue was not significantly less different between typical and atypical implants, and among the different atypical forms. Endometriotic cyst wall produced significantly less PGF2alpha than both typical and atypical peritoneal implants, and significantly more than normal peritoneum. There was no difference in production for normal tissue (endometrium or peritoneum) between patients with endometriosis and controls. We did not confirm evidence from the literature of a higher production of PGF2alpha in atypical versus typical endometriotic lesions. Our data do not support selective ablation of atypical forms, since typical endometriotic lesions could be similarly active in prostaglandin production.