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

Arzu BOSTANCI DURMUŞ, B. B., Aslı Yarcı Gürsoy, Hakan Yılmaz, Tuba Çandar, Sevim Dinçer Cengiz, Gamze Sinem YÜCEL
In: Türk Üreme Tıbbı ve Cerrahisi Dergisi · 2025 · vol. 9(1) , pp. 26–30 · doi:10.24074/tjrms.2025-108413 · W4409346670
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This study identified serum MMP-9 as the sole non-surgical predictor of a favorable Endometriosis Fertility Index score in women with histologically confirmed endometriosis.

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This cross-sectional study evaluated the utility of serum Matrix Metalloproteinase 9 (MMP 9) levels in predicting fertility outcomes for thirty-four infertile women with histologically confirmed endometriosis. Researchers analyzed correlations between MMP 9, CA-125, disease severity, and the Endometriosis Fertility Index (EFI), defining a good prognosis as an EFI score of seven or higher. The analysis identified MMP 9 as an independent predictor of severe disease and the sole non-surgical factor capable of predicting a favorable fertility prognosis. This paper is centrally about endometriosis — specifically investigating serum biomarkers for fertility prognosis in patients with the condition.

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Abstract

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.
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Abstract

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.

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endometriosisinfertility

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