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Researchers at the SUNY Health Science Center at Syracuse find more clues to growth of ovarian cysts

Researchers at the State University of New York Health Science Center at Syracuse have found that the fluid inside endometriomas contains a high concentration of transforming growth factor beta 1, which stimulates the growth of the cyst.

The study, "Effects of Chocolate Cyst Fluid on Endometrioma Cell Growth in Culture," is published in the November issue of Fertility & Sterility, the journal of the American Society of Reproductive Medicine.

"This study demonstrates that the endometrioma cyst fluid stimulates proliferation of cultured human endometrioma cells," said Shawky Z.A. Badawy, M.D., professor and chair of the Department of Obstetrics and Gynecology at the SUNY Health Science Center. "The findings from this study add to expanding experimental evidence that transforming growth factor beta 1 plays a role in the growth of ovarian endometriomas."

Endometriomas are often called chocolate cysts because the fluid inside looks like chocolate. The cysts are progressive lesions that frequently cause the ovary to adhere to surrounding structures such as the pelvic wall, broad ligament and even loops of bowel.

Normally, natural killer cells attack foreign cells such as those in ovarian cysts, but the natural killer cell activity decreases in women with endometriosis, Dr. Badawy said.

"We hypothesize that transforming growth factor beta 1 in endometrioma fluid leads to continued enlargement of endometriomas by decreasing natural killer cell activity," said Dr. Badawy. "Transforming growth factor beta 1 likely leads to increased blood flow and fibrin deposits around endometriomas. This may cause these cysts to adhere to surrounding tissues."

About one of every four women suffers from endometriosis during her reproductive years. This painful, recurring disease is the leading cause of infertility among women. It occurs when the mucus membrane lining of the uterus grows outside the uterus in the fallopian tubes, ovaries and intestines.

Dr. Badawy's previous research on endometriosis has shown that endometriosis is an autoimmune disease, that antibodies form in the peritoneal fluid of women with endometriosis, and that laparoscopic laser surgery is a more effective treatment for endometriosis than medication.

The SUNY Health Science Center at Syracuse is one of 125 academic health centers in the nation and one of four health science centers in the State University of New York system. The SUNY Health Science Center serves as central New York's regional referral center for professional education, patient care and biomedical research. It consists of the colleges of medicine, graduate studies, nursing and health professions, the 350-bed University Hospital, and more than 80 specialty clinics.

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