Systemic Inflammatory Response Markers Associated with Infertility and Endometrioma or Uterine Leiomyoma in Endometriosis

Xuanxuan Jing, Chen Li, Jintang Sun, Jin Peng, Yu Dou, Xiaofei Xu, Chao Ma, Zhaogang Dong, Yanguo Liu, Hui Zhang, Qianqian Shao, Lijie Wang, Yun Zhang, Xun Qu
Therapeutics and clinical risk management · 2020 · vol. Volume 16 , pp. 403–412 · doi:10.2147/tcrm.s232849 · PMID:32494145 · PMC7229864 · W3021910596
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that lower neutrophil-to-lymphocyte ratio (NLR) is an independent risk factor for infertility in endometriosis patients and that NLR combined with CA125 can help diagnose endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This retrospective study evaluated systemic inflammatory response markers (preoperative white blood cell subtypes, neutrophil:lymphocyte ratio [NLR], platelet:lymphocyte ratio [PLR], and monocyte:lymphocyte ratio [MLR]) and CA125 in 662 pathologically confirmed endometriosis patients undergoing laparoscopy, compared with benign ovarian tumor patients, to assess associations with endometriosis-related infertility and diagnostic performance. Lower NLR was identified as an independent risk factor for infertility, and endometriosis patients showed higher serum CA125 and higher NLR/MLR/PLR with altered lymphocyte levels, while univariate/multivariate analyses additionally linked cyst diameter, endometrioma laterality, pelvic adhesions, and stage to infertility; the paper’s main caveat is that causality cannot be inferred due to its retrospective design and reliance on preoperative blood measures taken about 1 week before surgery. ROC analyses indicated that combining NLR with CA125 improved sensitivity for distinguishing endometriosis from benign ovarian tumors compared with CA125 alone, and both CA125 and NLR correlated positively with stage, oviduct adhesion, and ectopic cyst diameter. This paper is centrally about endometriosis — it focuses on inflammatory and CA125 biomarkers associated with infertility and endometrioma severity in endometriosis patients.

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Abstract

PURPOSE: The aim of this study was to find the most useful marker of endometriosis-related infertility and evaluate predictive and diagnostic values of systemic inflammatory response markers (preoperative white blood-cell subtypes, neutrophil:lymphocyte ratio [NLR], platelet:lymphocyte ratio [PLR], and monocyte:lymphocyte ratio [MLR]) and CA125 levels in endometriosis patients. METHODS: This study comprised 662 women who had undergone laparoscopic surgery and been pathologically confirmed as having endometriosis and 83 patients pathologically confirmed with benign ovarian tumors. Related inflammatory factors in endometriosis complicated by infertility were analyzed via logistic regression analysis. Diagnostic values of the inflammatory response markers were obtained by receiver operating-characteristic analysis. RESULTS: We firstly identified that lower NLR level was an independent risk factor of infertility. Serum lymphocytes were significantly higher in endometriosis patients, while serum CA125, NLR, MLR, and PLR were elevated. For differentiating endometriosis from other benign ovarian tumors, the combination of NLR and CA125 achieved greater sensitivity than CA125 alone. In addition, both CA125 and NLR were positively correlated with stage, oviduct adhesion, and diameter of ovarian ectopic cysts. CONCLUSION: NLR may be used as a simple and easily obtained predictive marker for endometriosis with infertility. Moreover, NLR can be a neoadjuvant biomarker for serum CA125 to diagnose endometriosis.

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endometriosisendometriomainfertility

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