{"paper_id":"c61666fd-393f-4dbc-8bdc-b96c677215c4","body_text":"Abstract\nBackground\nEndometriosis (EMS) is a prevalent gynecological condition, and its diagnosis remains challenging. Hematological indicators such as platelet count (PLT), mean platelet volume (MPV), and platelet-to-lymphocyte ratio (PLR) have recently received attention for their potential diagnostic value in EMS.\nObjective\nTo assess the association of PLT, MPV, and PLR in EMS by a meta-analysis.\nMethods\nWe systematically searched Embase, PubMed, Cochrane Library, and Web of Science up to June 2025 for studies on the association of platelet-related parameters (PLT, MPV, and PLR) with EMS. Standardized mean difference (SMD) with 95% confidence interval (CI) was calculated for PLT, MPV, and PLR using a random-effects model. All statistical analyses were performed using Stata16.0.\nResults\nNineteen studies with 5675 subjects were included. Overall pooled analyses showed no statistically significant differences in PLT (SMD 0.35 [− 0.02, 0.71], I²=97.6%, P = 0.063) and PLR (SMD 0.24 [− 0.16, 0.64], I²=96.6%, P = 0.224) between EMS and non-EMS populations. However, MPV was significantly elevated in EMS compared with non-EMS populations (SMD 0.30 [0.09, 0.52], I²=82.7%, P = 0.006). Subgroup analyses by control group type revealed context-dependent associations. Compared with benign gynecological conditions (e.g., ovarian cysts, uterine fibroids), EMS showed significantly elevated PLT (SMD 0.20 [0.01, 0.38], I²=53.7%, P = 0.042) and PLR (SMD 0.33 [0.22, 0.43], I²=0.0%, P < 0.01). PLT was significantly lower in EMS than in ovarian cancer (SMD − 0.56 [− 0.81, − 0.32], I²=0.0%, P < 0.001). MPV was significantly elevated in EMS compared with healthy individuals (SMD 0.46 [0.11, 0.81], I²=84.7%, P = 0.010), whereas no significant difference was observed between EMS and other benign gynecological conditions (SMD 0.04 [− 0.10, 0.19], I²=0.0%, P = 0.547).\nConclusion\nMPV shows potential as an adjunctive marker for EMS, while PLT and PLR have limited independent diagnostic value but may be useful in specific clinical contexts.\nSimilar content being viewed by others\nAbbreviations\n- EMS:\n-\nEndometriosis\n- PLT:\n-\nPlatelet count\n- MPV:\n-\nMean platelet volume\n- PLR:\n-\nPlatelet-to-lymphocyte ratio\n- SMD:\n-\nStandardized mean difference\n- NOS:\n-\nNewcastle-Ottawa Scale\nAcknowledgements\nNot applicable.\nFunding\nThe authors declare that they did not receive any funding from any source.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nEthics approval and consent to participate\nNot applicable.\nConsent for publication\nNot applicable.\nCompeting interests\nThe authors declare no competing interests.\nAdditional information\nPublisher’s Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nSupplementary Information\nRights and permissions\nOpen Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.\nAbout this article\nCite this article\nQiu, J., Li, J., Wang, A. et al. Association of platelets and platelet-related parameters (PLT/MPV/PLR) in endometriosis: a meta-analysis. BMC Women's Health (2026). https://doi.org/10.1186/s12905-026-04630-9\nReceived:\nAccepted:\nPublished:\nDOI: https://doi.org/10.1186/s12905-026-04630-9","source_license":"CC0","license_restricted":false}