Malondialdehyde levels in uterine washing in fertile and infertile women throughout the menstrual cycle

152 Pages·1992·4.6 MB·English

by  Drabkin, Laura Michelle

YALE
MIDICAL LIBRARY

Digitized by the Internet Archive
in 2017 with funding from
Arcadia Fund
https://archive.org/details/malondialdehydelOOdrab
MALONDIALDEHYDE LEVELS IN UTERINE WASHINGS IN
FERTILE AND INFERTILE WOMEN THROUGHOUT THE
MENSTRUAL CYCLE
A Thesis Submitted to the Yale University School of Medicine
in Partial Fulfillment of the Requirements for the
Degree of Doctor of Medicine
by
Laura Michelle Drabkin
1992
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Malondialdehyde Levels In Uterine Washings Drabkin 2
TABLE OF CONTENTS
Section Page
Abstract 3
Introduction 5
Literature review 6
I. Free oxygen radicals 6
Lipid peroxidation 7
Measuring lipid peroxidation 9
Lipid peroxide-induced cellular damage 10
Antioxidants 15
II. The ischemic-reperfused myocardium as a model 18
Other examples of reperfusion injury 23
III. The endometrium 25
The menstmal cycle 25
Endometrial changes with menstruation 28
Dating the menstrual cycle by biopsy 32
IV. Implantation 33
V. Free radicals and reproduction 35
Materials and methods 40
Patient population 40
Experimental design 40
Method for collection 42
Assay 42
Analysis of results 44
Results 45
Demographics 45
MLD levels 45
Discussion 51
Role of lipid peroxidation in infertility - a hypothesis 51
Comments on study 54
Future research/possible treatment approaches 56
Acknowledgments 57
References 58

Malondialdehyde Levels In Uterine Washings Drabkin 3
ABSTRACT
MALONDIALDEHYDE LEVELS IN UTERINE WASHINGS IN
FERTILE AND INFERTILE WOMEN THROUGHOUT THE
MENSTRUAL CYCLE . Laura M. Drabkin, Ray Aten, Maria L
Carcangiu, Gad Lavy, Dept, of Obstetrics and Gynecology, Yale University
School of Medicine, New Haven, CT 06510.
Partially reduced reactive oxygen species are important mediators of
cell injury and cause lipid peroxidation. Malondialdehyde (MLD), a
product of lipid peroxidation, can be used to determine indirectly the
production of free oxygen radicals. This study was designed to examine
lipid peroxidation in uterine fluids throughout the menstrual cycle in
normal women and to establish a normogram to be used to evaluate the
potential significance of lipid peroxidation in infertility.
Fifty-seven ovulatory women and 18 infertile women comprised the
study population. Uterine washings were collected and MLD levels were
measured with a fluorimetric assay and normalized for protein content. A
pattern consistent with low levels of MLD during the late follicular phase
(LF=0.169+0.035) , a nadir in the early luteal phase (EL=0.093±0.Q37),
and high levels in the early follicular phase (EF=0.303±0.046) emerged in
normal ovulatory women (one way ANOVA, p=0.0475). The MLD levels
in the infertile group showed no discernible pattern.
Oxygen free radicals are present in both the endometrium of normal
cycling women and infertile women, and may significantly affect the
microenvironment of embryo implantation. This study indicates marked
differences in lipid peroxidation in the various phases of the normal