Background. Endometriosis is a chronic and debilitating gynecologic disorder, driven by endocrine and immune dysfunctions, which lead to poor endometrial differentiation and attenuated fertility. Escape from immune surveillance and involvement of inflammatory mechanisms appear to be factors in disease progression. Current diagnostic guidelines for endometriosis still lack an efficient biomarker. Here, we report a study on two previously unexplored factors as potential biomarkers for endometriosis. Methods. A case-control study was performed to evaluate the diagnostic potential of serum CD90 and CD83 levels in endometriosis patients (cases validated by surgical and histological examination) compared to healthy controls. Serum was collected from age-matched females and analyzed by ELISA. Results. Comparison of endometriosis patients to the control group showed significantly elevated levels of serum CD90 ( pg/mL vs. pg/mL; ). A threshold value of 479.4 pg/mL was defined based on the control results, and the diagnostic efficiency of the test was estimated. The obtained sensitivity (70.4%), specificity (92.9%), positive predictive value (90.5%), and negative predictive value (76.5%) rated the test as one with promising diagnostic potential. In contrast, the analysis of serum CD83 levels showed comparable values in both groups, suggesting no association with patient status. Conclusion. Elevated soluble CD90 in human serum is associated with endometriosis, which suggests its putative clinical significance as a biomarker in screening and/or diagnosis of the disease.

Endometriosis is a chronic, inflammatory, estrogen-dependent disease that affects approximately 6–10% of women of reproductive age. The present study aimed to investigate the expression of 48 immune-related genes in different types of biological samples from patients with histologically confirmed endometriosis compared to a control group. We analyzed (1) patients’ endometrial tissue, ectopic lesions, and menstrual and venous blood, as well as (2) the control group’s endometrial tissue and menstrual and venous blood. After RNA isolation, expression analysis of 48 immune-related genes was performed using NanoString nCounter^® Elements XT technology. All samples were normalized using nSolver Analysis Software, including control normalization and the use of a reference gene, as well as additional approaches for the detection of reliable differential expression. Expressions of the analyzed genes were similar in venous blood between patients and the controls; no significant dysregulation was found in menstrual blood. Most of the analyzed genes were upregulated in patients’ endometria. Three genes attracted our attention due to their overexpression in ectopic lesions. We were able to demonstrate the differential expression of three genes in ectopic lesions, suggesting their association with the development of endometriosis—THBS1, CHGB, and CYR61. The evidently higher expression of THBS1 in the ectopic lesions nominates this molecule as a potential therapeutic target in endometriosis as well.

Objective: To investigate the incidence, risk factors, and prevention strategies for adnexal torsion (AT) following in vitro fertilization (IVF) procedures at a high-volume fertility center. Methods: A retrospective case-control study was conducted at a single IVF center from January 2017 to December 2023. Medical records of 5,683 patients undergoing 8,932 oocyte retrievals were reviewed. Ovarian torsion was surgically confirmed in 11 cases (0.12%). Patient demographics, ovarian response, and treatment protocols were analyzed to identify risk factors. Preventive strategies for ovarian hyperstimulation syndrome (OHSS) and AT were also examined. Results: All torsion cases occurred after fresh embryo transfer (ET) and without OHSS. Mean patient age and BMI were 33.4 years and 22.2, respectively. Seven patients had a history of abdominal surgery. The mean anti-Müllerian hormone (AMH) level was 3.73 ng/mL. The torquated ovary had an average of 4.55 dominant follicles, with significantly larger ovarian diameter post-symptom onset compared to the contralateral ovary (82.5 mm vs. 50.2 mm, p = 0.037). Right-sided torsion predominated (63.6%). At torsion, 81.8% of patients were pregnant, a rate significantly higher than the overall IVF pregnancy rate (p = 0.01); multiple gestations were present in three cases. All underwent laparoscopic detorsion without complications, and most pregnancies progressed to term. Conclusion: Adnexal torsion is a rare but significant IVF complication, mainly occurring after fresh ET in early pregnancy, even without OHSS. Risk increases in pregnant patients, especially with multiple gestations. Individualized stimulation, freeze-all protocols, and vigilant monitoring may reduce AT risk. Prompt laparoscopic treatment ensures favorable outcomes.