Fertility outcomes of deep infiltrating endometriosis with fertility desire—a meta analysis

yue shen, Ziyi Feng, Lili Jiang, Yue Li, Kuiran Liu
2020 · doi:10.21203/rs.2.21329/v1 · W3152533178
preprint OA: gold CC0
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This meta-analysis of 17 articles found no significant difference in pregnancy rates between surgery alone and surgery combined with assisted reproductive technology for patients with deep infiltrating endometriosis desiring fertility.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This meta-analysis examined fertility outcomes in women with deep infiltrating endometriosis (DIE) who desired pregnancy, comparing pregnancy after surgery with spontaneous conception versus pregnancy after surgery using assisted reproductive technology (ART). The authors searched PubMed, OVID Medline, and the Cochrane Library for studies published before 2019-10-31 and included 17 non-randomized studies plus 1 RCT, with pooled clinical pregnancy outcomes analyzed using a random-effects model. Across 1172 women, 32.40% (370/1142) conceived spontaneously after surgery versus 27.62% (306/1108) achieved pregnancy after surgery and ART, with no significant difference (P=0.36) but high heterogeneity (I²=82%); subgroup and sensitivity analyses did not identify a clear source of heterogeneity. The paper relates to endometriosis: it is centrally about endometriosis—specifically deep infiltrating endometriosis—and compares spontaneous versus ART-assisted post-surgical pregnancy outcomes in fertility-desiring patients.

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Abstract

Abstract Background: The morbidity of endometriosis has been ascending in recent years. Deep infiltrating endometriosis is the most advanced type of endometriosis. The treatments for patients with DIE and fertility desire are controversial. Materials and Methods: We had search Pubmed, OVID Medline, Cochrane Library published before 2019-10-31, According to the inclusion criteria and exclusion criteria, a total of 17 articles were selected. A 95% confidence interval (CI) was used for clinical pregnancy data, and a random-effect model was used for meta-analysis. Subgroup analysis and sensitivity analysis were performed using Review manager 5.3. Results: Among patients with fertility desire, 370/1142 (32.40%) conceived spontaneously after surgery, compared with 306/1108(27.62%) got pregnant after surgery and assisted reproductive technology（P=0.36,I2=82%）.There is no significant statistical significance in this comparison and the heterogeneity is high. Then，we performed subgroup analysis and found that the heterogeneity was not caused by fertility status ,surgical methods or study characteristics. Conclusion: Through this meta-analysis, we think that surgery combined ART or not doesn’t effect on pregnancy rate in patients with DIE. But further investigations are required to determine fertility outcomes according to age, endometrioma, adenomyosis, ASRM scores and so on.

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Condition tags

endometriosisadenomyosisdie_deep_infiltratingendometrioma

Citation neighborhood

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