The Relationship Between Serum Sex Hormones and Sex Hormone Binding Protein Levels and Infertility in Patients with Endometriosis
Objective To explore the relationship between serum sex hormones and sex hormone binding protein (SHBG) levels and infertility in patients with endometriosis. Method A retrospective analysis was conducted on 88 pa-tients diagnosed with endometriosis at our hospital from January 2022 to December 2023. Patients were divided into an infer-tility group (n=41) and a normal pregnancy group (n=47) based on their infertility status,and the general clinical data of the two groups were compared. Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of serum luteiniz-ing hormone (LH),estradiol (E2),follicle-stimulating hormone (FSH),and SHBG. Logistic regression analysis was performed to identify the influencing factors of infertility in patients with endometriosis. The evaluation value of receiver operating char-acteristic (ROC) analysis was evaluated for serum sex hormones and SHBG in the occurrence of infertility in patients with endometriosis. Results There was no statistically significant difference in age,body mass index (BMI),course of disease,comorbidities,history of dysmenorrhea,number of abortions,or history of uterine cavity surgery between the infertile and normal pregnancy groups (P>0.05). The serum LH,E2,and FSH levels of patients in the infertility group were higher than those in the normal pregnancy group (P<0.05). The serum SHBG levels of patients in the infertility group were lower than those in the normal pregnancy group (P<0.05). The results of logistic multivariate analysis showed that LH,E2,and FSH were all risk factors for infertility in patients with endometriosis (P<0.05),while SHBG was a protective factor for infertility in patients with endometriosis (P<0.05). The ROC curve analy-sis results showed that the sensitivity of LH,E2,FSH,SHBG,and their combination in predicting infertility in patients with endometriosis was 70.73％,78.05％,73.17％,85.37％,and 90.24％,respectively. The specificity was 93.62％,87.23％,91.49％,63.83％,and 93.62％,respectively. The AUC was 0.889,0.867,0.860,0.811,and 0.959,respectively. The combined predictive value of LH,E2,FSH,and SHBG was higher than individual prediction (ZFour combined-LH=2.157,P=0.031;ZFour combined-E2=2.542,P=0.011;ZFour combined-FSH=2.357,P=0.018;ZFour combined-SHBG=3.469,P=0.001). Conclusion Patients with endometriosis who suffer from infertility exhibit increased serum LH,E2,and FSH levels and decreased SHBG levels. LH,E2,FSH,and SHBG have predictive power for infertility in patients with endometriosis,and the combined predictive value of the four is better than individual prediction.
EndometriosisSex hormonesSex hormone binding proteinInfertilityPredictive performanceLogistic modelROC curveArea under the curve (AUC)
万方数据
维普
