Changes in Volume, Total Protein and Ovarian Steroid Concentrations of Peritoneal Fluid Throughout the Human Menstrual Cycle

Abstract

Peritoneal fluid was aspirated during laparoscopy from normal women at various stages of the menstrual cycle. The volume of the fluid was found to be influenced by the stage of the cycle, rising from an early proliferative mean value of 0\m=.\8ml to a mean volume of 18\m=.\7ml after ovulation and decreasing again to a mean volume of 5\m=.\4ml in the late secretory phase. The mean volume of peritoneal fluid obtained from women using the contraceptive pill was 0\m=.\8ml, whereas only negligible amounts of fluid were aspirated at laparotomy from the peritoneal cavity of men.Despite marked changes in volume, the total protein content of the peritoneal fluid ( \ m=+-\ 60% of the concentration measured in plasma) remained fairly constant throughout the cycle, although a slightly, but significantly, lower value was found in the late proliferative phase. After ovulation the concentration of oestradiol and progesterone in the peritoneal fluid was higher than in plasma in the majority of cases, suggesting that some follicular fluid had drained into the peritoneal cavity at that time. Progesterone, in contrast to oestradiol, was also found in higher concentrations in peritoneal fluid than in plasma before ovulation.These results suggest that the volume and ovarian steroid concentration of peritoneal fluid are influenced by cyclic ovarian activity. At least two mechanisms may account for these observations: changes possibly effected by oestradiol in vascular permeability leading to a change of inflow and outflow equilibrium at the level of the peritoneal membranes and ovarian\p=n-\peritoneal transfer of fluid after and possibly also before follicular rupture.

The acute-phase response in endometriosis of women

“…Peritoneal fluid is mainly the result of ovarian exudation, while peritoneal exudation, follicular rupture and tubai secretion contribute only a small volume (Maathuis et al, 1978;Koninckx et al, 1980;Bouckaert et al, 1986a). The supposed inflammatory reaction secondary to endometriosis may cause an increased permeability of the subperitoneal capillaries, resulting in a change of the equilibrium between in-and outflow of fluid across the peritoneal membrane, leading to an increased peritoneal fluid volume.…”

A case of inflammatory ascites

“…Tale gradiente oggi è impiegato a fianco della tradizionale classificazione dell'ascite in essudatizia, da aumentata permeabilità del mesotelio peritoneale, o trasudatizia, da squilibrio delle forze di Frank-Starling. In base a questa classificazione, viene definita essudatizia un'ascite con una concentrazione di proteine totali > di 2,5 g/dl; tale cut-off ha tuttavia dimostrato una bassa specificità (55,6%) nella pratica clinica, in quanto molte asciti cardiogene hanno un' elevata concentrazione proteica, mentre questa risulta bassa in molte peritoniti batteriche spontanee [10][11][12]. Nella Tabella III è riportata una classificazione delle asciti sulla base delle caratteristiche del fluido peritoneale.…”

Multiplexed quantitation of endogenous estrogens and estrogen metabolites in human peritoneal fluid

“…Peritoneal fluid surrounds the Fallopian tube and oocyte immediately after ovulation, and may influence oocyte maturation, fertilization, and tube transport process. In addition, peritoneal fluid allows direct secretion of ovarian hormones into peritoneal and endometrial cavities, influencing the endometrial cycle [1][2][3][4][5]. Peritoneal fluid represents a suitable medium for studying estrogen metabolism in endometriosis, a disorder associated with pelvic pain and infertility which affects 2-10% of child-bearing age women [6].…”

“…To the best of our knowledge, data describing the estrogen content of peritoneal fluid is limited to RIA data acquired for 17β-estradiol and estrone [2][3][4][5]. Micellar EKC (MEKC) with UV detection was used in our laboratory for the separation of a standard mixture of estrone (E 1 ), estradiol (E 2 ), estriol (E 3 ) and seven other metabolites [9].…”

“…Micellar EKC (MEKC) with UV detection was used in our laboratory for the separation of a standard mixture of estrone (E 1 ), estradiol (E 2 ), estriol (E 3 ) and seven other metabolites [9]. Ji et al [10] used MEKC for the analysis of E 1 , E 2 , and E 3 in urine obtained from a pregnant woman, and they were only able to reliably quantify E 1 . Although CE provides high resolution and rapid separation which is ideal for analyzing isomers of endogenous estrogens and EM, the two previously reported MEKC-UV methods lack the required sensitivity for the quantitation of endogenous estrogens and their metabolites in biological samples [9,10].…”