Relationship between carbohydrate antigen CA-125, CA-19-9, neutrophil-to-lymphocyte ratio and postoperative pregnancy rate in patients with endometriosis

Objective To investigate the relationship between carbohydrate antigen CA-125, CA-19-9, neutrophil-to-lymphocyte ratio (NLR) and spontaneous pregnancy in endometriosis patients after laparoscopic surgery. Methods Sixty-two first-visit patients with endometriosis and infertility, who had underwent laparoscopic surgery and admitted to our hospital between January 2013 and December 2015, were followed up for 1 year. After the treatment, 37 patients were pregnant (pregnant group) , whereas 25 patients were not pregnant (non-pregnant group) . The levels of CA-125, CA-19-9 and NLR, staging and the location distribution of the ectopic foci were compared between the two groups. The receiver operating characteristic (ROC) curve analysis and multivariate logistic regression were used to analyze the relationship between the levels of CA-125, CA-19-9 and NLR, staging and postoperative spontaneous pregnancy rate at the first visit. Results At one year after the follow up, there were 37 cases of spontaneous pregnancy. The levels of CA-125, CA19-9 and NLR and staging in the pregnant patients were significantly lower than those in the non-pregnant patients (both P 0.05) . In the multivariable logistic regression, staging, CA-19-9 and NLR were independent factors related to spontaneous pregnancy after the treatment. The odds ratios were 0.054 (95% CI: 0.008-0.385) and 0.138 (95% CI: 0.033-0.583) , and 0.718 (95% CI: 0.580-0.888) , respectively. Conclusion CA19-9 and NLR may be used to predict the probability of spontaneous pregnancy in endometriosis patients after laparoscopic surgery. Key words: Endometriosis; CA-125 antigen; CA-19-9 antigen; Nutrophil-to-lymphocyte ratio; Pregnancy