Eri Nakamura

Dioxins in ascites and serum of women with endometriosis: a pilot study

BACKGROUND Animal studies and laboratory experiments have demonstrated that exposure to dioxins may be involved in the pathophysiology of endometriosis. However, recent epidemiological investigations have shown conflicting results. Although peritoneal fluid is a specific microenvironment playing a pivotal role in the development of endometriosis, to our knowledge, there is no published study evaluating the concentrations of dioxins in serum and peritoneal fluid simultaneously. The present study explores the possible correlation between the local peritoneal fluid levels of dioxins and concurrent endometriosis. METHODS There were 17 infertile women enrolled in the present study. After the diagnostic laparoscopic examination, the women were divided into two groups: endometriosis (n = 10) and controls (n = 7). We measured 29 dioxins simultaneously in serum and peritoneal fluid samples: 7 polychlorinated dibenzo-p-dioxins (PCDDs), 10 polychlorinated dibenzofurans (PCDFs), and 12 polychlorinated biphenyls (dioxin-like PCBs). A dioxin toxic equivalency (TEQ) system was utilized to calculate the dioxin concentration in each sample. RESULTS Serum concentrations of itemized components of 29 dioxins were similar in the endometriosis patients compared with the controls. Higher concentrations of PCDFs and dioxin-like PCBs were observed in peritoneal fluid than in serum, whereas the reverse was shown for PCDDs. Statistical analysis showed that higher levels of dioxin TEQ (PCDDs and PCDFs) in peritoneal fluid were significantly associated with an increased risk of endometriosis (OR: 2.5; 95% CI: 1.17-5.34; P = 0.035). CONCLUSIONS This is the first report suggesting that higher concentrations of dioxins (PCDDs and PCDFs) in peritoneal fluid are linked to endometriosis. More detail and epidemiological research is warranted to further explore this link.

Future for Elective Single Embryo Transfer: Review on Prognostic Aspect of Multiple Pregnancy

Abstract On the other side of the worldwide advance in assisted reproductive technology (ART), there is increasing concern about the maternal, fetal and post-natal risks of ART. To avoid multiple pregnancies, use of elective single embryo transfer (eSET) has been suggested in north European countries. In this review, we attempted to present an evidence-based discussion of the risks/benefits of ART and eSET. While many perinatal risks might be worse in ART than with natural conception in singleton pregnancies, the case is different in twin pregnancies and mainly depends on their monochorionic nature. Especially for early detection of intrauterine growth restriction, it is important to pay special attention to the location of umbilical cord insertion in the placenta. To evaluate the effectiveness of eSET, more studies are necessary with randomized controls.