Endometriosis (EMs) is one of the commonest chronic inflammatory disorder affecting women and is characterized by the presence and growth of endometrial-like glandular epithelial and stromal cells outside the uterus leading to multiple clinical symptoms affecting patients quality of life and fertility with high recurrence rate . The systemic immune inflammatory index (SII) and systemic inflammatory response index (SIRI) are documented as prognostic serum biomarker in many kinds of cancer and for the need and outcomes of adjuvant therapies for various cancers .

Inclusion Criteria:

• Women with clinical manifestations suggestive of having EM;
• Women who was professionally diagnosed;
• Women who was diagnosed by radiologic workup;
• Women were free of exclusion criteria.

Exclusion Criteria:

• Women with EM and were maintained on treatment or underwent operative interference during the last three months;
• Patients had autoimmune diseases, maintained on immunosuppressive therapy for any indication;
• Women with cancer elsewhere in the body or receiving adjuvant therapies for cancer;
• Patients receiving therapies for viral disorders especially COVID;
• Patients refusing to undergo the exploratory laparoscopy.

All women attending the outpatient of Gynecology department with clinical picture suggestive of having EM or had previously diagnosed depending on radiologic workup were evaluated for the enrolment criteria.