Clinical Value of Serum MMP 9 Levels for Fertility Prognosis in Women with Endometriosis

Objectives:The prevalence of endometriosis ranges between 2-10% among reproductive age women.For cases suffering from endometriosis and infertility, the surgical assessment of pelvis and reproductive organs by r-ASRM scoring does not guide the clinicians to an appropriate management strategy after surgery.This study aims to reveal the value of Matrix Metalloproteinase 9 (MMP 9) levels in infertile women who have histo-pathologically confirmed endometriosis and its correlation with EFI scores and prediction of good fertility prognosis.Material and Methods: This cross-sectional study conducted in the university hospital settingThirty-four infertile women with histo-pathologically confirmed endometriosis were included.Age, body mass index, duration of infertility, and levels of Ca-125, MMP 9 and, revised American Society of Reproductive Medicine(r-AFS) and Endometriosis Fertility Index (EFI) scoresof each patient were recorded.The good fertility prognosis was defined as an EFI score 7.Results: EFI scores were correlated with, age, duration of infertility, severity of the disease, Ca-125 and MMP 9 levels.The multiple linear regression analysis revealed that MMP 9is an independent predictor for severe endometriosis andfor EFI scores.The multivariate logistic regression analysis revealed that MMP 9 was the sole non-surgical factor predicting an EFI score 7.Conclusion: If validated by larger prospective trials, MMP 9 seems to be a promising serum marker for prediction of good fertility prognosis for women with endometriosis.