Serum kisspeptin combined with the endometriosis fertility index predicts postoperative pregnancy outcomes in patients with moderate-to-severe endometriosis

Background: To investigate the predictive value of the combination of serum kisspeptin and endometriosis fertility index (EFI) in detecting postoperative pregnancy outcomes in patients with moderate-to-severe endometriosis (EM). Methods: 181 patients with EM were collected prospectively and selected as the observation group. Preoperatively, according to the revised American Fertility Society (rAFS) score, they were categorized into mild (n = 93) and moderate-to-severe (n = 88) groups, and another 80 healthy female volunteers who had medical checkups were taken as the control group. Serum kisspeptin levels were measured using ELISA, and the EFI score was calculated. The patients with moderate-to-severe disease were further categorized into the good pregnancy outcome group and the poor pregnancy outcome group. Multifactorial logistic regression was used to analyze the factors affecting postoperative pregnancy outcomes in moderate-to-severe patients. The predictive value of serum Kisspeptin and EFI scores on postoperative adverse pregnancy outcomes in moderate-to-severe patients was analyzed using ROC curves. Results: Serum kisspeptin levels were higher, while EFI scores were lower in the observation group than in the control group. Basal luteinizing hormone, basal follicle-stimulating hormone, basal estradiol, and EFI levels were lower in the poor pregnancy outcome group than in the good pregnancy outcome group, whereas the opposite was true for kisspeptin levels, and the percentage of patients with rAFS stage IV (P<0.05). The results of multifactorial logistic regression analysis showed that rAFS stage and serum kisspeptin level were risk factors for poor postoperative pregnancy outcome in moderate-to-severe EM patients, while elevated EFI was a protective factor (P<0.05). The area under the curve of serum kisspeptin and EFI alone and in combination for predicting poor pregnancy outcomes in patients with moderate-to-severe EM were 0.759, 0.721, and 0.869, respectively. Conclusions: Combining serum kisspeptin and EFI is valuable in predicting adverse pregnancy outcomes in patients with moderate-to-severe EM.