RESUMO
Los cambios fisiológicos con la edad, son consecuencia de cambios sistémicos generales producidos por el envejecimiento, entre los que se destacan cambios a nivel de los mecanismos de defensa relacionados con las especies reactivas del oxígeno (ROS) y alteraciones de la microcirculación. Los cambios evolutivos ováricos con la edad, se deben esencialmente a una depleción de la población folicular, la cual al disminuir por debajo de 1000 folículos, hace perder la capacidad del ovario de ciclar en forma normal, con la consiguiente disminución en los niveles de esteroides circulantes y sus efectos secundarios en los órganos efectores. Asociado a la disminución de la población folicular, se producen cambios en la calidad ovocitaria, los cuales determinan la disminución progresiva de la fertilidad en mujeres mayores de 35 años. Entre los cambios más frecuentes se observan aumento de aneuploidias, disfunciones mitocondriales, cambios de la microcirculación y disminución de la capacidad defensiva sobrelas ROS, entre otros.
The physiological changes with age are the consequence of systemic general changes produced by aging, where changes of the defense mechanisms related to ROS and microcirculation alterations are highlighted. The evolutive changes produced by age in the ovary are related to the follicular depletion. When the ovarian follicle population decrease below 1000 follicles, the ovary loses its capacityto cycle normally. As a consequence, the levels of circulating steroids diminished, producing negatives effects on secondary steroidal organs. In association with the follicular depletion, there are changes in oocyte quality, which determine the progressive diminution of fertility in women older than 35 years. The most frequent changes observed are an increase of the aneuploidies, mitochondrial dysfunction, microcirculation changes and a diminution of the defense capacity to ROS among others.
Assuntos
Humanos , Feminino , Envelhecimento/fisiologia , Ovário/fisiologia , Fenômenos Reprodutivos Fisiológicos , Fatores Etários , Fertilidade , Folículo Ovariano/fisiologia , Ovário/embriologia , Espécies Reativas de OxigênioRESUMO
Background: Endometriosis, a common gynecologic disorder characterized by endometrial glands and stroma outside the uterus, is diagnosed by direct visualization of peritoneal and ovarian implants during laparoscopy. Aim: To study the estrogenic microenvironment in eutopic endometria of women with and without endometriosis. Patients and methods: Eutopic endometria, obtained during laparoscopy from 23 women with endometriosis and 20 fertile cyclic women undergoing tubal sterilization, was studied. P450Arom mRNA expression (RT-PCR) was measured. Also, P450Arom activity was assessed measuring testosterone conversion to estradiol and the concentration of this last hormone in cultured endometrial explants. Results: Age and body mass index was similar in both groups studied. Seventy nine percent of endometria from women with endometriosis and in 29.4 percent from control group expressed P450Arom mRNA (p <0.01). The intensity of the band was higher in secretory endometria from women with endometriosis when compared to controls (p <0.01), but it was similar during the proliferative phase. Estradiol secretion to the culture media by proliferative endometria explants from women with endometriosis was 3-fold higher than secretory endometria (p <0.01) and endometria from control women in both phases. P450Arom activity, in the presence of testosterone, was 7-fold higher in endometrial cultures from women with endometriosis, when compare with the basal culture (p <0.01). However, in endometrial explant cultures from control women, this activity was not statistical different. Conclusions: These results indicate that in women with endometriosis, the microenvironment in the endometria is estrogenic as a consequence of an increased expression and activity of the P450 Arom.