High BAX-BCL-2 ratio expression on granulosa cells from endometriosis patients

Background: Endometriosis is one of the female reproductive disorders that can cause infertility due to low oocyte quality. Granulosa cell apoptosis is one of the processes that affect the oocyte quality. Apoptosis that occurs in granulosa cells is influenced by bax-bcl-2. Objectives: To determine the level of mRNA expression of bcl-2 and bax in granulosa cells endometriosis women compared to normal women using real-time PCR. Methodology: This is an analysis study conducted on 18 patients with endometriosis, comparing them to the granulosa cells from 10 normal women, using real-time PCR, at the Yasmin Clinic, Kencana Cipto Mangunkusumo Hospital in January–June, 2016. The study was approved by the medical ethics committee of Faculty of Medicine, Universitas Indonesia. Informed consent was obtained from all participants. Granulosa cells collected during the oocyte retrieval were preserved using RNAlater® QIAGEN and evaluated by real-time PCR. The Saphiro-Wilk test was used to check normality of the data, and the T -test to assess the differences between the two groups. Result: The ratio of bax mRNA to bcl-2 mRNA expression in patients with endometriosis have a mean value 141.78. On the other hand, in the granulosa cells of normal patients, the mRNA expression of bax is less than the mRNA expression of bcl-2 mRNA (bax/bcl2 ratio 0.026715629–0.596812155). Statistical analysis showed that in patients with endometriosis, the mRNA expression of bax to bcl-2 is significantly higher (p < 0_05). Conclusion: The ratio of bax/bcl-2 mRNA expression in the granulosa cells of women with endometriosis are higher than the bax/bcl-2 mRNA expression ratio in normal female granulosa cells. Further research is needed to assess other factors that may influence the occurrence of granulosa cell apoptosis in patients with endometriosis.