Tumor Necrosis Factor in Peritoneal Fluid From Asymptomatic Infertile Women

Background necrosis factor-α (TNF-α) is a cytokine that can be found in the peritoneal fluid (PF) of patients with endometriosis and pelvic inflammatory disease (PID) as a response to inflammatory disorders and infections. The cytotoxic effect of this cytokine could be a factor participating in the pathology of various gynecological diseases, and could also be accountable for the high immunological response and damage to the tubal epithelium. The objective of this study was to establish the presence of TNF-α in asymptomatic infertility and its association with various isolated bacteria. s lliliters of PF were collected from each of 73 patients by means of laparoscopy and cultured in synthetic medium and McCoy cells for the isolation of aerobic and anaerobic bacteria, as well as for Chlamydia trachomatis. The activity of TNF-α was determined by means of a bioassay using L-929 cells. s three percent of the PFs showed positive TNF-α activity, while the laparoscopic evaluation showed that 32 patients had Fallopian tube occlusion (FTO), 7 had endometriosis, 30 had PID, and 4 had myomas and adhesions. TNF-α activity was found to be high in FTO patients (p <0.05). Positive cultures were found in 50.7% of patients; of these, 31.5% had PID (p <0.05), and only 20.5% of positive cultures were TNF-α positive. Chlamydia trachomatis (16%) was the most frequently isolated bacteria in these patients. sions tection of TNF-α could be useful in the diagnosis of active infectious and inflammatory diseases in asymptomatic infertile patients.