Metabolic endotoxaemia--a potential novel link between ovarian inflammation and impaired progesterone production

Gynecol Endocrinol. 2015 Apr;31(4):309-12. doi: 10.3109/09513590.2014.994602. Epub 2014 Dec 24.


Introduction: Medical conditions such as obesity and inflammatory bowel disease are associated with impaired luteal function, menstrual disturbance and infertility. It is proposed that the disturbance in gut wall integrity ("leaky gut") seen in these conditions may result in the passage of bacterial endotoxin (LPS) from the colonic lumen into the circulation that may initiate inflammation in the ovary and subsequently impair hormone production.

Methods: Quantify the association between systemic levels of LBP, a marker of endotoxin exposure, and levels of inflammation in the ovary (follicular fluid IL-6), plus steroid hormone production in 45 women undergoing IVF treatment.

Results: Endotoxaemia (LBP) were positively correlated with plasma CRP and inflammation within the ovary (follicular fluid IL-6). Furthermore, endotoxaemia was negatively correlated with progesterone production.

Conclusion: The observed correlations, together with previously published animal studies linking endotoxin exposure to impaired luteal function, suggest that the translocation of bacterial endotoxin from the gut lumen into the circulation has the potential to interfere with progesterone production and result in luteal deficiency.

Keywords: Endotoxaemia; IL-6; lipopolysaccharide; luteal; progesterone.

Publication types

  • Observational Study

MeSH terms

  • Acute-Phase Proteins
  • Adult
  • Biomarkers / blood
  • Carrier Proteins / blood
  • Cohort Studies
  • Endotoxemia / physiopathology*
  • Family Characteristics
  • Female
  • Fertilization in Vitro
  • Follicular Fluid / chemistry
  • Humans
  • Infertility, Female / blood
  • Infertility, Female / etiology*
  • Infertility, Female / metabolism
  • Infertility, Female / therapy
  • Infertility, Male
  • Interleukin-6 / analysis
  • Interleukin-6 / metabolism
  • Intestinal Mucosa / immunology*
  • Intestinal Mucosa / physiopathology
  • Male
  • Membrane Glycoproteins / blood
  • Oophoritis / etiology*
  • Oophoritis / physiopathology
  • Ovary / immunology*
  • Ovary / metabolism
  • Ovary / physiopathology
  • Pilot Projects
  • Progesterone / biosynthesis
  • Progesterone / blood
  • Progesterone / deficiency*


  • Acute-Phase Proteins
  • Biomarkers
  • Carrier Proteins
  • IL6 protein, human
  • Interleukin-6
  • Membrane Glycoproteins
  • lipopolysaccharide-binding protein
  • Progesterone