Role of soluble EGFR, Fas, and Fas ligand in pelvic pain severity and their association with endometriosis in infertile woman: a case-control study

Endometriosis, a chronic inflammatory condition linked to pelvic pain and infertility, is characterized by immune dysfunction involving dysregulated apoptosis and cell proliferation. This case-control study included 87 infertile women undergoing diagnostic laparoscopy and assessed serum and peritoneal levels of sEGFR, sFas, and sFasL using ELISA. Pain intensity was evaluated via the Visual Analog Scale (VAS). Peritoneal sFasL concentrations were significantly higher in infertile women with pelvic pain (p = 0.012) and correlated with VAS scores (r = 0.261, p = 0.014). Serum and peritoneal sFasL levels were significantly elevated in endometriosis patients with pelvic pain compared to controls (p = 0.003, p = 0.002, respectively). Peritoneal sFasL levels were also associated with dysmenorrhea and dyspareunia. ROC analysis demonstrated that serum sFasL differentiated endometriosis from controls (AUC = 0.797, p < 0.001). These findings suggest that sFasL may serve as a potential noninvasive biomarker for endometriosis. Further research should investigate its regulatory role in endometriosis-related pain.