Matrix metalloproteinases 3 polymorphism increases the risk of developing advanced endometriosis and infertility: A case-control study.

Objective: Endometriosis has a complex and multifactorial pathology, and it is considered one of the main causes of infertility nowadays. The angiogenic process, which involves remodeling of extracellular matrix, is crucial for the development of this disease, mainly by the action of the matrix metalloproteinase 3 (MMP-3). It is known that genetic factors can influence endometriosis, thus; we investigated the role of polymorphism as a risk factor for the development of the disease and its symptoms.

Study Design: This case-control study included 283 women with endometriosis (cases) and 217 women without the disease (controls) who were submitted to laparoscopic or laparotomy surgery. Real-time polymerase chain reaction performed by system was applied for all polymorphisms. A multivariate logistic regression was performed to evaluate the association between polymorphism and endometriosis or clinical and gynecological characteristics of the disease, using their respective odds ratios (OR) and 95% confidence intervals (CI).

Results: The allelic frequency of the polymorphism was 33.6% in controls and 40.3% in endometriosis cases. The allelic distribution was significantly different between the two ( = 0.03). The variant genotype of was associated with increased endometriosis risk in the advanced endometriosis cases (OR: 2.08, 95% CI: 1.05 - 4.07 and OR: 1.87, 95% CI: 1.01 - 3.45). Regarding the symptoms, endometriosis-related infertile women had a positive association with the presence of polymorphism (OR: 3.13, 95% CI: 1.08-9.08 and OR: 3.30, 95% CI: 1.31 - 8.33).

Conclusions: These findings suggest that the polymorphism is involved with advanced endometriosis cases and infertility, and these associations may implicate in the behavior of disease.