{"paper_id":"9002cc6e-57b6-4eb6-9028-b9900ab1ec32","body_text":"陆军军医大学学报 (Aug 2025)\nCausal effects between different sub-phenotypes of endometriosis and female infertility: a bidirectional Mendelian randomization study\nAbstract\nObjective To investigate the bidirectional causal relationship between different subtypes of endometriosis and female infertility using Mendelian randomization (MR). Methods A two-sample MR analysis was performed on the data sourced from publicly available genome-wide association study (GWAS) of endometriosis and infertility. For each subtype of endometriosis, instrumental variables (IVs) satisfying MR assumptions were selected, with inverse variance weighting (IVW) as primary method. Sensitivity analyses, including Cochran’s Q test, MR-Egger regression, and leave-one-out analysis, were conducted to verify the robustness of the results. Statistical significance was set at P0.05). Reverse causality analysis indicated that infertility might lead to fallopian tube endometriosis (IVW: OR=1.46, 95%CI: 1.11~1.93, P=0.007), and was associated with ovarian (IVW: OR=1.56, 95%CI: 1.27~1.93, P0.05). Sensitivity analyses confirmed the robustness of the results. Conclusion Bidirectional causal relationships exist between different subtypes of endometriosis and infertility. Our findings based on MR analysis validate the clinical observation that endometriosis can lead to infertility, and we exploratively propose an important conclusion that infertility itself may also induce endometriosis. However, due to limited data, the causal relationships between intestinal/tubal endometriosis and infertility require further investigation.\nKeywords","source_license":"CC0","license_restricted":false}