Endometriosis and Infertility: Medical versus Surgical Approaches – A Systematic Review and Meta-Analysis

This paper is a registered systematic review and meta-analysis protocol aiming to compare the fertility outcomes of medical versus surgical management of endometriosis. It will include comparative studies (randomized trials, prospective/retrospective studies, and meta-analyses) in women with surgically or radiologically confirmed endometriosis, extracting spontaneous pregnancy and IVF-related outcomes while stratifying by endometriosis stage when available, and also assessing surgical complications and, when reported, cost-effectiveness. The methods specify a comprehensive search of PubMed, Embase, Scopus, and the Cochrane Library (January 2000–June 2025), PRISMA 2020–guided independent screening, random-effects meta-analysis with subgroup analyses, and risk-of-bias assessment (ROBINS-I/ RoB 2) plus GRADE certainty, with the explicit limitation of English-language/full-text availability. This paper is centrally about endometriosis — it specifically addresses medical versus surgical approaches for endometriosis-related infertility, including spontaneous conception and IVF outcomes.

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