Preoperative Neutrophil-to-Lymphocyte Ratio Level is a Predictor of Postoperative Fertility in Infertile Patients with Ovarian Endometrioma

To investigate the predictive efficacy of the preoperative neutrophil–lymphocyte ratio (NLR) for natural pregnancy outcome after laparoscopic cystectomy in infertile patients with ovarian endometrioma (OMA). Current evidence suggests that endometriosis likely induces local and systemic inflammatory processes. The NLR has been demonstrated to be of great utility in the diagnosis of endometriosis. However, the association between NLR and natural pregnancy outcome after laparoscopic surgery for endometriosis remains unknown. Data on infertile OMA patients undergoing laparoscopic surgery from January 2014 to October 2019 were retrospectively analyzed. Cox regression analysis was used to identify predictors of natural pregnancy outcome. A predictive model was then established using the nomogram. Among 217 patients, 115 patients (53.0%) experienced natural pregnancy after surgery. Compared with patients with pregnancy failure, those with pregnancy success had a significantly higher NLR (P < 0.05). Multivariate analysis revealed that age, least function (LF) score, and NLR were independent predictors of postoperative pregnancy (all P < 0.05). The NLA (NLR, LF score and age) scoring was then established and had a high predictive ability (AUC = 0.725). Patients were divided into three groups (low-, intermediate- and high-risk) based on the scoring, and the 1-year pregnancy rates were 43.5%, 34.4%, and 21.0%, respectively (P < 0.05). The preoperative NLR level was significantly associated with natural pregnancy outcome in infertile OMA patients after surgery. A predictive model combining NLR, LF score, and age could assist in the clinical decision-making process. Similar content being viewed by others Availability of Data and Material The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Code Availability X-tile software (version: 3.6.1 software 20, http://medicine.yale.edu/lab/rimm/research/software.aspx). SPSS version.22.0 for Windows (SPSS Inc., Chicago, IL, USA) and R software (version 3.6.1; R Foundation for Statistical Computing; https://www.r-project.org/). Change history 30 January 2022 This article was updated to correct the National Nature Science Foundation of China grant number in the Funding section. 04 February 2022 A Correction to this paper has been published: https://doi.org/10.1007/s43032-022-00847-9

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Lizhen Lin and Guan Lin wrote the manuscript; Xi Xie and Chaobin Liu helped revise the manuscript critically for important intellectual content; all authors read and approved the final manuscript. Corresponding authors Ethics declarations Ethics Approval and Consent to Participate All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or substitute for it was obtained from all patients for being included in the study. Consent for Publication Not applicable. Conflict of Interest The authors declare no competing interests. Supplementary Information Below is the link to the electronic supplementary material. Rights and permissions About this article Cite this article Lin, L., Lin, G., Lian, H. et al. Preoperative Neutrophil-to-Lymphocyte Ratio Level is a Predictor of Postoperative Fertility in Infertile Patients with Ovarian Endometrioma. Reprod. Sci. 29, 1145–1155 (2022). https://doi.org/10.1007/s43032-021-00782-1 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-021-00782-1