As infertility is intimately associated with endometriosis, the levels of myeloperoxidase (MPO), a leukocyte enzyme and an oxidative stress marker, were determined in a case-control prospective study of 68 women with and without endometriosis undergoing in vitro fertilization in the outpatient fertility center within a tertiary care academic medical center. Measured values included plasma and follicular fluid (FF) concentrations of MPO, plasma estradiol, as well as oocyte quality, fertilization, implantation, and pregnancy rates in these women. In FF (mean + standard error of mean [SEM]), the MPO concentrations (ng/ mL) for controls were 4.3 + 0.37, mild endometriosis (stages I-II) 3.9 + 0.17, and moderate/severe endometriosis (stages III-IV) 16.6 + 12.5 (P < 0.0143). In FF, among patients supplemented with vitamins E and C, the MPO levels decreased significantly only in moderate/severe endometriosis from 25.3 + 22.0 ng/mL to 4.9 + 1.61 ng/mL, respectively. Plasma levels of MPO between groups did not change. Outcome data revealed a trend toward decreased percentage of mature oocytes, implantation rate, and clinical pregnancy rate with severity of endometriosis and MPO levels. Myeloperoxidase may be a potential oxidative stress target for endometriosis-associated infertility.

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