Endometriosis may be associated with mitochondrial dysfunction in cumulus cells from subjects undergoing in vitro fertilization-intracytoplasmic sperm injection, as reflected by decreased adenosine triphosphate production

Fertil Steril. 2015 Feb;103(2):347-52.e1. doi: 10.1016/j.fertnstert.2014.11.002. Epub 2014 Dec 13.


Objective: To determine whether endometriosis is associated with mitochondrial dysfunction in cumulus (granulosa [GC]) cells of subjects undergoing IVF-intracytoplasmic sperm injection (ICSI).

Design: Prospective cohort study.

Setting: An IVF clinic in a tertiary academic care center.

Patient(s): Eleven women with endometriosis and 39 controls.

Intervention(s): None.

Main outcome measure(s): Cumulus cell adenosine triphosphate (ATP) levels, mitochondrial DNA (mtDNA), and genomic DNA (gDNA) number.

Result(s): Cumulus cell ATP content was 65% lower in subjects with surgically proven endometriosis (median 312.5 attomoles/ng total DNA, interquartile range = 116.0-667.8) compared with controls (median 892.4 attomoles/ng total DNA, interquartile range = 403.0-1,412.2). There was no significant difference in mtDNA:gDNA ratio. There were no significant differences in age, body mass index (BMI), basal serum FSH level, total oocyte number, metaphase II (M2) oocyte number, metaphase I oocyte number, percentage of M2 oocytes, fertilization rate, implantation rate, or pregnancy rate (PR). Multivariate regression analysis showed significant positive correlations between ATP and [1] M2 oocyte number (r = 0.307) and [2] pregnancy (r = 0.332). There were also trends toward positive correlations between ATP and [3] age (r = 0.283), [4] total number of oocytes (r = 0.271), [5] percentage of M2 oocytes (r = 0.249), and [6] implantation rate (r = 0.293). There were no statistically significant correlations between mtDNA:gDNA ratio and any demographic factors or clinical outcomes measured.

Conclusion(s): Surgically confirmed endometriosis may be associated with cumulus cell mitochondrial dysfunction in subjects undergoing IVF-ICSI for infertility, as reflected by decreased ATP production.

Keywords: Endometriosis; cumulus cells; infertility; mitochondria.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenosine Triphosphate / biosynthesis*
  • Adult
  • Cohort Studies
  • Cumulus Cells / metabolism*
  • DNA, Mitochondrial / metabolism
  • Endometriosis / diagnosis
  • Endometriosis / metabolism*
  • Female
  • Fertilization in Vitro / methods
  • Humans
  • Male
  • Mitochondria / metabolism*
  • Pregnancy
  • Pregnancy Rate / trends
  • Prospective Studies
  • Sperm Injections, Intracytoplasmic* / methods


  • DNA, Mitochondrial
  • Adenosine Triphosphate