Endometriosis and ovarian aging: a pilot study exploring oxidative stress and DNA damage markers
- 1Women and Infants Hospital of Rhode Island, Providence, United States
- 2Warren Alpert Medical School of Brown University, Providence, United States
Abstract
Purpose: To assess whether specific markers of oxidative stress and DNA damage are expressed at higher levels in primordial follicles of patients with endometriomas compared to age-matched controls.
Methods: A retrospective pilot cohort study was conducted using ovarian tissue from patients who underwent unilateral or bilateral salpingo-oophorectomy for symptomatic endometriomas, with controls undergoing an identical procedure for other benign gynecologic conditions. Immunohistochemistry (IHC) was used to assess percent positivity in primordial follicles for 4-hydroxy-2-nonenal (4-HNE) as a marker of oxidative stress; 8-Oxoguanine (8-Oxo) and phosphorylated H2AX (γH2AX) for DNA damage. Chi-square tests were used for categorical variables and Student t-tests for continuous variables, with p < 0.05 considered significant.
Results: Twenty-nine patients were included (8 controls, 21 with endometriomas). Age (39.4 ± 5.1 vs. 37.1 ± 4.6 years, p = 0.269), BMI (33.6 ± 10.6 vs. 29.5 ± 7.8 kg/m2, p = 0.310) were similar between groups. Racial distribution, nulliparity, hormonal therapy use, and smoking status were also comparable. The average endometrioma size was 6.6 ± 2.8 cm. All molecular markers showed higher percent positivity in the endometrioma group compared to the control group. γH2AX demonstrated a statistically significant increase (63.6% vs. 50.1%, p = 0.033). 8-Oxo (67.5% vs. 55.8%, p = 0.070) and 4-HNE (65.1% vs. 61.8%, p = 0.168) were also elevated in the endometrioma group but did not reach statistical significance.
Conclusion: Patients with endometriomas demonstrated increased follicular DNA damage, with elevated γH2AX expression, supporting the notion that endometriomas may impair follicular quality through DNA damage mechanisms.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10815-026-03990-3.
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BibTeX
@article{kassi2026endometriosis,
title = {{Endometriosis and ovarian aging: a pilot study exploring oxidative stress and DNA damage markers}},
author = {Luce A. Kassi and Sanjana Konda and Joyce Ou and Julia McAdams and Robin Cram and May-Tal Sauerbrun-Cutler and Kathryn Grive},
journal = {Journal of Assisted Reproduction and Genetics},
year = {2026},
month = aug,
doi = {10.1007/s10815-026-03990-3},
url = {https://doi.org/10.1007/s10815-026-03990-3},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Endometriosis and ovarian aging: a pilot study exploring oxidative stress and DNA damage markers
AU - Luce A. Kassi
AU - Sanjana Konda
AU - Joyce Ou
AU - Julia McAdams
AU - Robin Cram
AU - May-Tal Sauerbrun-Cutler
AU - Kathryn Grive
PY - 2026
DA - 2026/08/11
JO - Journal of Assisted Reproduction and Genetics
DO - 10.1007/s10815-026-03990-3
UR - https://doi.org/10.1007/s10815-026-03990-3
AB - Purpose: To assess whether specific markers of oxidative stress and DNA damage are expressed at higher levels in primordial follicles of patients with endometriomas compared to age-matched controls. Methods: A retrospective pilot cohort study was conducted using ovarian tissue from patients who underwent unilateral or bilateral salpingo-oophorectomy for symptomatic endometriomas, with controls undergoing an identical procedure for other benign gynecologic conditions. Immunohistochemistry (IHC) was used to assess percent positivity in primordial follicles for 4-hydroxy-2-nonenal (4-HNE) as a marker of oxidative stress; 8-Oxoguanine (8-Oxo) and phosphorylated H2AX (γH2AX) for DNA damage. Chi-square tests were used for categorical variables and Student t-tests for continuous variables, with p < 0.05 considered significant. Results: Twenty-nine patients were included (8 controls, 21 with endometriomas). Age (39.4 ± 5.1 vs. 37.1 ± 4.6 years, p = 0.269), BMI (33.6 ± 10.6 vs. 29.5 ± 7.8 kg/m2, p = 0.310) were similar between groups. Racial distribution, nulliparity, hormonal therapy use, and smoking status were also comparable. The average endometrioma size was 6.6 ± 2.8 cm. All molecular markers showed higher percent positivity in the endometrioma group compared to the control group. γH2AX demonstrated a statistically significant increase (63.6% vs. 50.1%, p = 0.033). 8-Oxo (67.5% vs. 55.8%, p = 0.070) and 4-HNE (65.1% vs. 61.8%, p = 0.168) were also elevated in the endometrioma group but did not reach statistical significance. Conclusion: Patients with endometriomas demonstrated increased follicular DNA damage, with elevated γH2AX expression, supporting the notion that endometriomas may impair follicular quality through DNA damage mechanisms. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10815-026-03990-3.
SN - 1058-0468
SN - 1573-7330
ER -