Differential expression of steroidogenic enzymes according to endometriosis type  Sébastien Colette, Ph.D., Sylvie Defrère, Ph.D., Olivier Van Kerk, B.Sc., Anne Van Langendonckt, Ph.D., Marie-Madeleine Dolmans, M.D., Ph.D., Jacques Donnez, M.D., Ph.D.  Fertility and Sterility  Volume 100, Issue 6, Pages 1642-1649 (December 2013) DOI: 10.1016/j.fertnstert.2013.08.003 Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Q-PCR results in eutopic endometrium from control patients and patients with endometriosis analyzed according to the menstrual cycle phase of patients. Box plots show mRNA expression differences between menstrual cycle phases (patients in the proliferative [Prolif] or secretory [Secret] phase or under oral contraception [OC]), for control (disease-free) endometrium (CE; proliferative, n = 7; secretory, n = 5; OC, n = 3) (A, C, E, G) and eutopic endometrium (EE) recovered from patients with endometriosis (proliferative, n = 8; secretory, n = 9; OC, n = 16) (B, D, F, H). A significant increase in HSD17B2 expression was detected during the secretory phase in CE but not in EE. Statistical analysis was performed using the Kruskal-Wallis test, followed by Dunn's post hoc test. *P<.05. Fertility and Sterility 2013 100, 1642-1649DOI: (10.1016/j.fertnstert.2013.08.003) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Q-PCR results in endometriotic lesions. Box plots represent q-PCR results in eutopic endometrium from patients with endometriosis (EE, n = 17), peritoneal lesions (PL, n = 9), ovarian lesions (OL, n = 7), and rectovaginal lesions (RL, n = 6) for HSD17B1 (A), HSD17B2 (B), STS (C), and EST (D) protein expression. HSD17B2 mRNA expression was lower in ovarian and rectovaginal lesions (B) than in their matched eutopic endometrium, while STS mRNA expression was higher in rectovaginal lesions (C) than in ovarian lesions. An increase in the HSD17B1/HSD17B2 ratio was observed in rectovaginal lesions (compared with their matched eutopic endometrium), and in ovarian lesions (compared with their matched eutopic endometrium and peritoneal lesions) (E). The ratio between STS and EST was always highly in favor of estrogens (F). Statistical analysis was performed using the Kruskal-Wallis test, followed by Dunn's post hoc test. *P<.05; **P<.01; ***P<.001. Fertility and Sterility 2013 100, 1642-1649DOI: (10.1016/j.fertnstert.2013.08.003) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Immunohistochemical photomicrographs of lesions and positive control tissues. Immunohistochemical results are shown in a series of representative pictures. Syncytiotrophoblasts were found to be positive for HSD17B1 and STS in control (placental) tissue (A–G), while endothelial cells expressed HSD17B2 (D). Glandular expression was observed for all three enzymes evaluated in eutopic endometrium and endometriotic tissues (B, C, E, F, H, I). Original magnification, ×100 (A, B, D, E, G, I), ×200 (C–F). Fertility and Sterility 2013 100, 1642-1649DOI: (10.1016/j.fertnstert.2013.08.003) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions