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Increased Incidence and Recurrence of Recent Corpus Luteum Without Ovulation Stigma (Luteinized Unruptured Follicle Syndrome?) in Baboons With Endometriosis

Leuven University Fertility Center, Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, B-3000 Leuven, Belgium; Institute of Primate Research, Nairobi, Kenya; University Hospital Gasthuisberg, Belgium

Charanjit S. Bambra, PhD

Barbara M. Raeymaekers, MSc

Philippe R Koninckx, MD, PhD

Institute of Primate Research, Nairobi, Kenya; University Hospital Gasthuisberg, Belgium

Objective: To test the hypothesis that a recent corpus luteum (CL) without fresh ovulation stigma (OS) can be found with a higher incidence and recurrence in baboons with endometriosis and is associated with a reduced egg recovery rate after uterine flush.

Methods: One hundred thirty-eight laparoscopies were performed in the early luteal phase of 52 cycles in 32 female baboons with a normal pelvis (controls) and of 86 cycles in 21 animals with endometriosis. The incidence and recurrence of a recent CL without OS was studied during each laparoscopy and during the first three laparoscopies in 15 baboons (five controls, ten with endometriosis), respectively. The association between the presence of a recent CL without OS and the egg recovery rate was evaluated during 65 cycles in 21 baboons after uterine flush.

Results: When all 138 laparoscopies were analyzed, the incidence of a recent CL without OS was higher (P < 0.3) in animals with stage II-IV endometriosis (35%) than in those with stage I disease (19%) or controls (11%). Both the incidence (seven of ten) and recurrence (three of ten) of a recent CL without OS were higher in baboons with endometriosis than in controls (zero of five, P < .02) when studied during the first three laparoscopies. Laparoscopies in primates having a recent CL without OS were associated with a lower egg recovery rate (13%) than in animals with recent CL and OS (54%, P = .005).

Concluson: A recent CL without OS was associated with a reduced egg recovery rate and could be found with a higher incidence and recurrence in baboons with endometriosis than in control, suggesting that luteinized unruptured follicle syndrome exists and could contribute to endometriosis-associated subfertility.

Key Words: Luteinized unruptured follicle syndrome • LUF • endometriosis • baboon • embryo

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