Objective: To determine whether endometrial expression of endothelial nitric oxide synthase (eNOS) or inducible NOS (iNOS) protein in women with endometriosis-associated infertility is different from that in the fertile controls, whether GnRH agonist (GnRH- a) regulates the endometrial expression of NOS in women with endometriosis- associated infertility, and whether there is a correlation between serum E2 or P levels, and the endometrial expression of eNOS or iNOS. Design: Prospective controlled study. Setting: University hospital for reproductive medicine and gynecologic endocrinology. Patient(s): Thirty patients with endometriosis-associated infertility and 19 patients with carcinoma in situ of the cervix. Intervention(s): Endometrial biopsy specimens and blood samples. Main Outcome Measure(s): Endometrial eNOS and iNOS protein relative levels and serum concentrations of E2 or P. Result(s): By Western blot analysis, iNOS was not detected, and a unique menstrual cycle-dependent expression of eNOS was observed. Eutopic endometrium in women with endometriosis-associated infertility before GnRH-a treatment showed higher levels of eNOS than that of the control group. After 3 months of GnRH-a therapy, eNOS levels in the endometrium were reduced. In addition, a significant positive correlation was found between serum E2 or P concentrations, and the endometrial expression of eNOS. Conclusion(s): The GnRH-a treatment attenuated the endometrial expression of eNOS in women with endometriosis-associated infertility. Endogenous ovarian steroids influence endometrial eNOS expression.
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