Vascular endothelial growth factor and interleukin-6 in peritoneal fluid of women with endometriosis

Objective(s): To determine [1] vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) levels in peritoneal fluid from women with endometriosis and compare them with those from oral contraceptive (OC) users and normal cycling women and [2] any correlation between VEGF and IL-6 concentrations. Design: Controlled clinical study. Setting: University medical center. Patient(s): Patients undergoing laparoscopy for infertility or other benign gynecologic conditions. Intervention(s): Peritoneal fluid samples were collected. Main Outcome Measure(s): Levels of VEGF and IL-6 in peritoneal fluid were determined. Result(s): Compared with normal controls or women with less severe endometriosis (implant scores of 5 or less), women with more advanced endometriosis (implant scores of 6 or more) have elevated VEGF and IL-6 levels in peritoneal fluid. Compared with normal controls, markedly suppressed IL-6 but similar VEGF levels were found in peritoneal fluid from OC users. Neither VEGF nor IL-B varied cyclically in normal women or those with endometriosis. There was no correlation between levels of VEGF and IL-6 in peritoneal fluid. There was no correlation between implant scores and VEGF or IL-6 levels. Conclusion: The inflammation associated with endometriosis, through increased levels of peritoneal fluid VEGF, may promote angiogenesis for the progressive growth of endometriosis. Effective treatment of endometriosis by combination estrogen-progestin pills may involve the suppression of such inflammatory responses. (Fertil Steril((R)) 2000;73:166-70. (C) 1999 by American Society for Reproductive Medicine.)