Role of some biomarkers in chronic pelvic pain for early detection of endometriosis in infertile women

Objective: Diagnosis of endometriosis in infertile women with chronic pelvic pain depends mainly on laparoscopy, but it has many risks. The aim of this study was to evaluate the value of some biomarkers as a reliable non-invasive method for the diagnosis of early stages of endometriosis in infertile women with chronic pelvic pain. Materials and methods: A total of 95 women who underwent laparoscopy were divided into two groups: control cases (30 cases) with no pathologic findings; and endometriosis patients (65 cases) {subdivided into stages 1–2 or minimal–mild (MM) and stages 3–4 or moderate–severe (MS) cases}. Blood was drawn on cycle days 6–10 and stored at −70 °C for subsequent analysis of IL-6, CA-125, TNF-α, HsCRP and VEGF levels. Results: High levels of serum IL-6 and serum TNF-α were observed in MM endometriosis as compared to controls (P < 0.001) and to MS endometriosis (P < 0.05). Levels of serum CA-125, Hs-CRP & VEGF were significantly elevated in MS endometriosis when compared with MM endometriosis and controls (P < 0.001, P < 0.001 & P < 0.008 respectively). Conclusion: Serum IL-6 and TNF-α levels are reliable non-invasive biomarkers for the diagnosis of early stages of endometriosis because they increased significantly in early cases than in late cases. CA125, Hs-CRP & VEGF are significantly increased in late cases, so they cannot be used for early diagnosis