Insights from an observational matched case-control study on the association between endometriosis and benign uterine disorders in infertile patients

Abstract The link between endometriosis and other medical conditions is gaining attention. Such insights could enhance clinical approaches to manage the disease and potentially reveal new, unrecognized mechanisms of its development. The aim of this study was to assess the association between endometriosis and four benign uterine conditions - adenomyosis, endometrial polyps, uterine fibroids, and non-obstructive Müllerian malformations - each analyzed separately. A retrospective analysis was conducted on n = 200 infertile patients with a history or current diagnosis of endometriosis, who were matched 1:1 by age and study period to n = 200 infertile individuals without endometriosis, whose partners had severe male infertility. These patients, representing the general population, were used as controls. The evaluation considered a history of surgery or current diagnosis of adenomyosis, endometrial polyps, uterine fibroids, and non-obstructive Müllerian malformations. Baseline characteristics were similar between the two groups, except for BMI. The adjusted Odds Ratios (ORs) for the association between endometriosis and adenomyosis, endometrial polyps, uterine fibroids, and non-obstructive Müllerian malformations were 12.7 (95%CI: 4.9–33.0), 3.5 (95%CI: 1.5–8.1), 6.0 (95%CI: 2.2–17.0), and 3.5 (95%CI: 0.7–17.5), respectively. No subgroup of patients with endometriosis was identified for whom the association was stronger. These findings indicate a significant association between endometriosis and several benign uterine conditions, suggesting that further investigation is needed to understand the underlying mechanisms. Similar content being viewed by others Funding The study was funded by Italian Ministry of Health – Current Research IRCCS. Author information Authors and Affiliations Corresponding author Ethics declarations Competing interests P.VE. is a member of the Editorial Board of Human Reproduction Open, the Journal of Obstetrics and Gynaecology Canada, and the International Editorial Board of Acta Obstetricia et Gynecologica Scandinavica, and has received royalties from Wolters Kluwer for chapters on endometriosis management in the clinical decision support resource UpToDate; P.VI. is Co-editor-in-Chief of the Journal of Endometriosis and Uterine Disorders. E.S. is Editor-in-Chief of Human Reproduction Open; discloses payments from Ferring and Theramex for research grants and personal honoraria from Merck-Serono, Ibsa, and Gedeon-Richter; and maintains both a public and private gynaecological practice. All the other authors do not have any Conflict of interest to declare. Additional information Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information Below is the link to the electronic supplementary material. Rights and permissions Open 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/. About this article Cite this article Tuccitto, M., Reschini, M., Buggio, L. et al. Insights from an observational matched case-control study on the association between endometriosis and benign uterine disorders in infertile patients. Sci Rep (2026). https://doi.org/10.1038/s41598-026-46835-w Received: Accepted: Published: DOI: https://doi.org/10.1038/s41598-026-46835-w