Interleukin-6 as a useful predictor of endometriosis-associated infertility: a systematic review

Document Type : Systematic Review


1 Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy

2 Department of Obstetrics and Gynaecology, Azienda di Rilievo Nazionale e di Alta Specializzazione (ARNAS) Garibaldi Nesima, Catania, Italy

3 Unit of Medical Statistics and Molecular Epidemiology, University Campus Bio-Medico of Rome, Rome, Italy

4 Department of Drug and Health Sciences, University of Catania, Catania, Italy.



Background: Endometriosis is a chronic inflammatory disease defined by the presence of endometrial-like tissue outside the uterine cavity. Several authors have reported on the association between changes of inflammatory markers levels and maintenance or progression of endometriosis and associated infertility. Interleukin-6 (IL-6) is the most studied cytokine in endometriosis and has important functions in reproductive physiology. The aim of this study is to review systematically available evidence about altered IL-6 concentrations in endometriosis-related infertility.

Material and methods: We included all studies until December 2022 in which IL-6 in serum, peritoneal fluid, follicular fluid, or endometrial biopsy specimens was measured and that correlated their findings with endometriosis-associated infertility.

Results: 15 studies were included in the systematic review. There seems to be a correlation between elevated serum and peritoneal fluid IL-6 concentrations and the occurrence of endometriosis-associated infertility.

Conclusion: IL-6 may be a potential diagnostic or biomarker tool to predict endometriosis-related infertility. However, the numerous biases affecting the available studies and challenges in endometriosis research reproducibility must be considered. Future investigations should pay attention on the choice of suitable control groups and carefully consider other pathological conditions affecting the patients, the endometriosis stage, and the type of lesions that may affect the results.


Main Subjects