{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:18:35Z","timestamp":1754162315471,"version":"3.41.2"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007613","name":"Ankara Universitesi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007613","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>In this study, we aimed to investigate whether serum NGAL, MMP-9 and the MMP-9\/NGAL ratio, which are inflammatory markers used for the diagnosis and follow-up of some diseases, can be used as diagnostic and follow-up markers for the diagnosis of endometriomas in infertile patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty-five patients with unexplained infertility and 45 infertile patients with endometriomas were included in the study. Patients with endometriomas of at least 3 cm in size were included in the study. NGAL and MMP-9 levels in venous blood samples and the MMP-9\/NGAL ratios of the unexplained infertility and endometrioma groups and the preoperative and postoperative results of the endometrioma group were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean blood NGAL and MMP-9 levels in the endometrioma and unexplained groups were 22.0 \u00b1 4.0 ng\/ml and 25.4 \u00b1 4.9 ng\/ml and 43.7 \u00b1 8.0 ng\/ml and 39.3 \u00b1 10.7 ng\/ml, respectively, and all the results were statistically significant (p=0.001; p=0.012). The mean blood levels of NGAL and MMP-9 in endometriomas and the same patients at three months after surgery were 24.9 \u00b1 4.9 ng\/ml and 27.0 \u00b1 4.9 ng\/ml and 43.9 \u00b1 7.3 ng\/ml and 36.7 \u00b1 8.7 ng\/ml, respectively (p=0.179; p=0.006). The mean ratios of MMP-9\/NGAL in the endometrioma, unexplained and postoperative groups were 2.0 \u00b1 0.2, 1.5 \u00b1 0.2 and 1.4 \u00b1 0.2, respectively. All these results were significantly different between the endometrioma-unexplained group and the endometrioma-postoperative group (p=0.001; p=0.001). When we performed a ROC curve analysis for the presence of endometrioma, an MMP-9\/NGAL ratio greater than 1.75 had 86.1% sensitivity and 84% specificity in indicating the presence of endometrioma (AUC=0.898). There was a positive correlation between the VAS score and the MMP-9\/NGAL ratio.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Interestingly, the NGAL blood NGAL level was lower in the endometrioma group than in the control group. The MMP-9\/NGAL ratio can be useful in the diagnosis of endometrioma, and this ratio reflects the clinical findings of the disease.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1624717","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T04:13:47Z","timestamp":1753848827000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Can the MMP-9\/NGAL ratio be a diagnostic biomarker for the diagnosis of endometrioma in infertile 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