Background:Endometriosis is one of the common causes of infertility with very diverse etiology. In modern lifestyle, humans are exposed to several endocrine-disrupting chemicals (EDCs) which may lead to reproductive disturbances. Diethyl hexyl phthalate (DEHP) is one of the common EDCs to which women are exposed by the use of cosmetics, perfumes, food packaging, medicine, and insecticides.Aim:The aim of this study was to measure the levels of DEHP in women diagnosed with endometriosis and healthy females and to compare these levels among different stages of endometriosis.Setting and Design:This descriptive study was conducted at a tertiary care hospital.Subjects and Methods:This study comprised of fifty women diagnosed with endometriosis, aged 20–40 years, and fifty age-matched healthy, fertile women without endometriosis. Females on any medication/comorbid conditions were excluded from the study. Serum DEHP concentrations were measured by high-performance liquid chromatography (HPLC). The results were expressed as means ± standard deviation (SD) (ng/ml of DEHP).Statistical Analysis:Data were analyzed using IBM-SPSS version 20. Two-sample Student's t-test and one-way ANOVA were applied for the analysis.Results:The mean ± SD value of DEHP in cases was 65.29 ± 21.69 ng/ml; however, the mean ± SD value of DEHP in controls was undetectable. Comparison of DEHP among stages of endometriosis revealed an increasing trend with advanced stages (III and IV). The values were not different between the two age groups of women with endometriosis (20–30 and 31–40 years).Conclusion:High levels of DEHP in women diagnosed with endometriosis suggest a role of phthalates in the etiology of endometriosis and permit careful use of such compounds.
Background: Endometriosis has a complex multifactorial pathophysiology and is a leading cause of female infertility. Emerging evidence suggests the role of endocrine disrupting chemicals and environmental factors such as Diethyl phthalate (DEP) in the pathophysiology of the disease. Aim: To investigate the serum DEP levels in females with infertility having endometriosis and normal healthy counter parts. Methods: Married females (n=50) age 20-40 years, diagnosed with endometriosis and having history of >1 year of infertility, were selected as cases. Age matched women (n=50) with proven fertility and screened negative for endometriosis were included as controls. Females on any medicine, having co morbid conditions were also excluded from the study. DEP concentration in serum was determined by using High performance liquid chromatography (HPLC). Results: Significantly higher levels (p=0.003) of DEP were seen in endometriosis females (3.76± 1.28 ng/ml) as compared to controls (2.61± 1.72 ng/ml). The comparison of DEP levels between different stages of endometriosis revealed an increasing, but no significant trend with advancement of the disease. Conclusion: High serum DEP levels in patients substantiate their role in disease pathophysiology. Therefore, it may be advisable to pay attention while using such compounds. There is an increased need to regulate the levels of such industrial compounds manufactured for daily use of human beings by efficient and judicious quality assurance plastics and by using the standards set by WHO and/or FDA. Keywords: Phthalate, Endometriosis, Diethyl phthalate, plasticizers, Infertility
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