In order to study the effect of peritoneal macrophages (M phi) on conception in patients with
endometriosis, the total numbers of peritoneal M phi and the proportion of the exudate type, defined on the basis of ultracytochemical localization of endogenous
peroxidase (PO) activity, were investigated in 21 patients with
endometriosis, five with uterine
leiomyoma, three with
tubal obstruction and three with carcinomatous
peritonitis. An immunocytochemical observation of
interleukin-1 (IL-1) was also performed in three patients with
endometriosis, one with
tubal obstruction, and one male patient with
cholelithiasis. The total numbers of peritoneal M phi in patients with
endometriosis were significantly higher than in uterine
leiomyoma (2.11 x 10(7) v.s. 0.68 x 10(7), p less than 0.025). The total numbers of peritoneal M phi in
tubal obstruction (0.96 x 10(7)) were not statistically different from those in uterine
leiomyoma. The peritoneal M phi were remarkably increased in number in patients with carcinomatous
peritonitis. On ultracytochemical observation of endogenous PO activity, the proportion of exudate M phi to whole M phi was significantly larger in
endometriosis than that in uterine
leiomyoma (13.3% v.s. 3.5%, p less than 0.025). This type of M phi increased even in stage I
endometriosis (p less than 0.005). These data suggest that the abdominal cavity in women with
endometriosis is in the stimulated conditions which may lead to
infertility. A positive reaction to anti-IL-1 antibody on the cell membrane of all M phi examined in each patient suggests that an immunocytochemical study of
IL-1 in M phi is not suitable for evaluating the degree of activation of M phi.