Evaluation of the prognostic role of placental growth factor and soluble fms-like tyrosine kinase-1 in the diagnosis of infertility in patients with endometriosis (pilot study)

Sharifat T. Suleimanova, Maria I. Yarmolinskaya, Д. И. Соколов
In: Journal of obstetrics and women's diseases · 2026 · vol. 75(4) , pp. 66–72 · doi:10.17816/jowd713571 · W7214909219
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In a pilot study of 20 women with endometriosis, lower placental growth factor levels and higher soluble fms-like tyrosine kinase-1/placental growth factor ratios were associated with infertility compared to those without fertility disorders.

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This pilot study evaluated serum levels of placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in 20 reproductive-aged women with confirmed endometriosis to assess their prognostic value for infertility. Participants were divided into groups based on the presence or absence of fertility disorders, revealing that patients with infertility exhibited significantly lower PlGF levels and a higher sFlt-1/PlGF ratio compared to those without fertility issues. The authors noted significant correlations between the sFlt-1/PlGF ratio and both age at menarche and pain severity, suggesting that this angiogenic imbalance serves as a potential biomarker for endometriosis-associated infertility. This paper is centrally about endometriosis — specifically evaluating angiogenic markers for diagnosing infertility in patients with the condition.

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Abstract

BACKGROUND: Endometriosis plays a leading role in the impairment of fertility. An imbalance of angiogenic factors underlies the pathogenesis of infertility, however, the prognostic value of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) markers for assessing the risk of impaired fertility in patients with endometriosis remains poorly studied. AIM: The aim of this study was to evaluate serum sFlt-1 and PlGF levels, as well as the sFlt-1/PlGF ratio, in patients with endometriosis, and to assess the predictive value of these parameters in the diagnosis of endometriosis-associated infertility. METHODS: This pilot prospective study was conducted on 20 reproductive-aged patients with confirmed endometriosis. All patients were divided into two groups: Group 1 (the main group) included patients with endometriosis and infertility (n = 10), and Group 2 included patients with endometriosis without fertility disorders (n = 10). Serum sFlt-1 and PlGF levels were assessed using electrochemiluminescence immunoassay (Cobas E 411, Roche). Statistical analysis was performed using the Mann–Whitney U test. RESULTS: In patients with infertility, PlGF level was lower than in patients without infertility: 11.28 (10.60–13.28) vs. 16.38 (12.14–19.29) pg/ml (p = 0.028). However, sFlt-1 values did not differ between the two groups (p = 0.32). The sFlt-1/PlGF ratio in the infertile group was higher: 8.65 (7.09–10.80) vs. 6.06 (5.10–7.13) (p = 0.046). We found a negative correlation between the sFlt-1/PlGF ratio and the age at menarche (p = 0.036) and a positive correlation with the severity of pain according to the visual analog scale (p = 0.041). CONCLUSION: In patients with infertility and endometriosis, an imbalance of angiogenesis factors is manifested by a decrease in PlGF level and an increase in the sFlt-1/PlGF ratio. The data obtained suggest that the sFlt-1/PlGF ratio can be used as a potential prognostic marker for the risk of infertility in patients with endometriosis.
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Abstract

BACKGROUND: Endometriosis plays a leading role in the impairment of fertility. An imbalance of angiogenic factors underlies the pathogenesis of infertility, however, the prognostic value of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) markers for assessing the risk of impaired fertility in patients with endometriosis remains poorly studied. AIM: The aim of this study was to evaluate serum sFlt-1 and PlGF levels, as well as the sFlt-1/PlGF ratio, in patients with endometriosis, and to assess the predictive value of these parameters in the diagnosis of endometriosis-associated infertility.

Methods

This pilot prospective study was conducted on 20 reproductive-aged patients with confirmed endometriosis. All patients were divided into two groups: Group 1 (the main group) included patients with endometriosis and infertility (n = 10), and Group 2 included patients with endometriosis without fertility disorders (n = 10). Serum sFlt-1 and PlGF levels were assessed using electrochemiluminescence immunoassay (Cobas E 411, Roche). Statistical analysis was performed using the Mann–Whitney U test.

Results

In patients with infertility, PlGF level was lower than in patients without infertility: 11.28 (10.60–13.28) vs. 16.38 (12.14–19.29) pg/ml (p = 0.028). However, sFlt-1 values did not differ between the two groups (p = 0.32). The sFlt-1/PlGF ratio in the infertile group was higher: 8.65 (7.09–10.80) vs. 6.06 (5.10–7.13) (p = 0.046). We found a negative correlation between the sFlt-1/PlGF ratio and the age at menarche (p = 0.036) and a positive correlation with the severity of pain according to the visual analog scale (p = 0.041).

Conclusion

In patients with infertility and endometriosis, an imbalance of angiogenesis factors is manifested by a decrease in PlGF level and an increase in the sFlt-1/PlGF ratio. The data obtained suggest that the sFlt-1/PlGF ratio can be used as a potential prognostic marker for the risk of infertility in patients with endometriosis. Full Text About the authors Sharifat T. Suleimanova The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott Author for correspondence. Email: [email protected] ORCID iD: 0009-0005-5778-3311 Russian Federation, Saint Petersburg Maria I. Yarmolinskaya The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott Email: [email protected] ORCID iD: 0000-0002-6551-4147 SPIN-code: 3686-3605 MD, Dr. Sci. (Medicine), Professor, Professor of the Russian Academy of Sciences, Honoured Scientist of Russian Federation Russian Federation, Saint PetersburgDmitriy I. Sokolov The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott Email: [email protected] ORCID iD: 0000-0002-5749-2531 SPIN-code: 3746-0000 Cand. Sci. (Biology), Assistant Professor Russian Federation, Saint PetersburgReferences - Moazen S, Arjmand MH. The role of local angiotensin II/angiotensin type 1 receptor in endometriosis: a potential target for new treatment approaches. Curr Mol Pharmacol. 2024;17:e18761429315431. doi: 10.2174/0118761429315431240712100124 EDN: EDFQQV - Kurjak A, Kupesic S. Scoring system for prediction of ovarian endometriosis based on transvaginal color and pulsed Doppler sonography. Fertil Steril. 1994;62(1):81–88. doi: 10.1016/s0015-0282(16)56820-4 - Taylor RN, Lebovic DI, Mueller MD. Angiogenic factors in endometriosis. Ann N Y Acad Sci. 2002;955:89–406. doi: 10.1111/j.1749-6632.2002.tb02769.x - Bo C, Wang Y. Angiogenesis signaling in endometriosis: molecules, diagnosis and treatment (review). Mol Med Rep. 2024;29(3):43. doi: 10.3892/mmr.2024.13167 EDN: HNZUCL - Macedo F, Ladeira K, Longatto-Filho A, Martins SF. Gastric cancer and angiogenesis: is vegf a useful biomarker to assess progression and remission? J Gastric Cancer. 2017;17(1):1–10. doi: 10.5230/jgc.2017.17.e1 - Li C, Zhao HL, Li YJ, et al. The expression and significance of leukemia inhibitory factor, interleukin-6 and vascular endothelial growth factor in Chinese patients with endometriosis. Arch Gynecol Obstet. 2021;304(1):163–170. doi: 10.1007/s00404-021-05980-5 EDN: IYQAVH - Zucchini C, De Sanctis P, Facchini C, et al. Performance of circulating placental growth factor as a screening marker for diagnosis of ovarian endometriosis: a pilot study. Int J Fertil Steril. 2016;9(4):483–489. doi: 10.22074/ijfs.2015.4606 - Suzumori N, Sugiura-Ogasawara M, Katano K, Suzumori K. Women with endometriosis have increased levels of placental growth factor in the peritoneal fluid compared with women with cystadenomas. Hum Reprod. 2003;18(12):2595–2598. doi: 10.1093/humrep/deg491 EDN: IPJIXL - Cho HY, Kyung MS. CYFRA 21-1 and placental growth factor as screening markers for endometriosis. Med Sci Monit. 2019;25:1087–1092. doi: 10.12659/MSM.912787 - Ruggiero D, Nutile T, Nappo S, et al. Genetics of PlGF plasma levels highlights a role of its receptors and supports the link between angiogenesis and immunity. Sci Rep. 2021;11(1):16821. doi: 10.1038/s41598-021-96256-0 EDN: GHZJAT - Nagy JA, Dvorak AM, Dvorak HF. VEGF-A (164/165) and PlGF: roles in angiogenesis and arteriogenesis. Trends Cardiovasc Med. 2003;13(5):169–175. doi: 10.1016/s1050-1738(03)00056-2 - Graupner O, Verlohren S, Groten T, et al. Significance of the sFlt-1/PlGF ratio in certain cohorts — what needs to be considered? Geburtshilfe Frauenheilkd. 2024;84(7):629–634. doi: 10.1055/a-2320-5843 EDN: ZKBNLM - Tang T, Lai H, Huang X, Gu L, Shi H. Application of serum markers in diagnosis and staging of ovarian endometriosis. J Obstet Gynaecol Res. 2021;47(4):1441–1450. doi: 10.1111/jog.14654 EDN: GAUXKE - Cho S, Choi YS, Jeon YE, et al. Expression of vascular endothelial growth factor (VEGF) and its soluble receptor-1 in endometriosis. Microvasc Res. 2012;83(2):237–242. doi: 10.1016/j.mvr.2011.12.004 EDN: PGZKLR - Ramos-Nino ME. Non-hormonal strategies in endometriosis: targets with future clinical potential. J Clin Med. 2025;14(14):5091. doi: 10.3390/jcm14145091 EDN: FBIFAE - Vercellini P, Bandini V, Viganò P, et al. Proposal for targeted, neo-evolutionary-oriented secondary prevention of early-onset endometriosis and adenomyosis. Part II: medical interventions. Hum Reprod. 2024;39(1):18–34. doi: 10.1093/humrep/dead206 EDN: LNIKIK - Lao J, Shen D, Hu P, et al. Endometriosis-related infertility in China: analysis of the global burden of disease study 2021. Front Public Health. 2025;13:1651254. doi: 10.3389/fpubh.2025.1651254 EDN: TMKMZC - Beyer S, Drazic P, Bitto F, et al. Endometriosis and fertility: a practical guide: results of the working group of the Weissensee 2025 workshop of the scientific endometriosis foundation. Geburtshilfe Frauenheilkd. 2025;86(2):123–132. doi: 10.1055/a-2663-4218 EDN: GNXMGH - Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility: a committee opinion. Fertil Steril. 2012;98(3):591–598. doi: 10.1016/j.fertnstert.2012.05.031 - Maynard SE, Min JY, Merchan J, et al. Excess placental soluble fms-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J Clin Invest. 2003;111(5):649–658. doi: 10.1172/JCI17189 - Andrikos A, Andrikos D, Schmidt B, et al. Course of the sFlt-1/PlGF ratio in fetal growth restriction and correlation with biometric measurements, feto-maternal Doppler parameters and time to delivery. Arch Gynecol Obstet. 2022;305(3):597–605. doi: 10.1007/s00404-021-06186-5 EDN: DTYAEJ - Kalaitzopoulos DR, Kohl Schwartz AS. Fertility preservation in women with endometriosis: How, when, and for whom? J Int Med Res. 2026;54(2):3000605261422887. doi: 10.1177/03000605261422887 - Santi A, Felser RS, Mueller MD, et al. Increased endometrial placenta growth factor (PLGF) gene expression in women with successful implantation. Fertil Steril. 2011;96(3):663–668. doi: 10.1016/j.fertnstert.2011.06.039

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