The Impact of Endometriosis on Embryo Quality in in-vitro Fertilization/Intracytoplasmic Sperm Injection: A Systematic Review and Meta-Analysis

Houjin Dongye, Xiaofeng Ji, Xiaopei Ma, Jialun Song, Lei Yan
Frontiers in medicine · 2021 · vol. 8 , pp. 669342 · doi:10.3389/fmed.2021.669342 · PMID:34150804 · W3167009356
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This meta-analysis of 22 studies found that endometriosis does not significantly impact high-quality embryo rate, cleavage rate, or embryo formation rate in IVF/ICSI cycles.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This systematic review and meta-analysis evaluated whether endometriosis affects embryological outcomes in women undergoing IVF/ICSI by searching PubMed, EMBASE, and Web of Science and pooling data from 22 cohort studies, with outcomes assessed morphologically at the cleavage stage (high-quality embryo rate, cleavage rate, and embryo formation rate). Across comparisons with control groups, women with endometriosis had similar high-quality embryo rates, cleavage rates, and embryo formation rates, and there were also no statistically significant differences for stage III-IV disease versus controls or for unilateral endometrioma comparing affected versus contralateral normal ovaries. A major caveat explicitly acknowledged in the paper is that the included studies and embryo-quality metrics may not fully align with consensus-recommended reporting, and that non-English studies were excluded (with the manuscript noting limitations such as this). This paper is centrally about endometriosis — it specifically meta-analyzes how endometriosis status and severity relate to IVF/ICSI embryo quality from a morphological perspective.

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Abstract

Background: The association between endometriosis and embryological outcomes remains uncertain. The meta-analysis aimed to evaluate the impact of endometriosis on embryo quality. Methods: A systematic review and meta-analysis was conducted to investigate the association between the endometriosis and embryo quality. Searches were performed on the three electronic databases: PubMed, EMBASE, and Web of Science. The detailed characteristics and data of the included studies were extracted. The risk ratio with 95% confidence intervals were calculated using the random and fixed effects model. The main outcome measures were high-quality embryo rate, cleavage rate, and embryo formation rate. Results: A total of 22 studies included were analyzed. Compared with the control group, women with endometriosis had a similar high-quality embryo rate (RR = 1.00; 95% CI, 0.94–1.06), a comparable cleavage rate (RR = 1.00; 95% CI, 0.97–1.02), and a similar embryo formation rate (RR = 1.10; 95% CI, 0.97–1.24). In women with stage III-IV endometriosis, there was no statistically significantly difference in high-quality embryo rate (RR = 1.02; 95% CI, 0.94–1.10), cleavage rate (RR = 1.00; 95% CI, 0.98–1.02), and embryo formation rate (RR = 1.05; 95% CI, 0.97–1.14), compared with those without endometriosis. For women with unilateral endometrioma, pooling of results from the affected ovaries did not show a statistically significantly difference in high-quality embryo rate (RR = 0.99; 95% CI, 0.60–1.63) in comparison to the normal contralateral ovaries. Conclusions: Our results seem to indicate that endometriosis does not compromise embryo quality from the perspective of morphology.

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endometriosisendometrioma

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