Identification of risk factors associated with endometriosis recurrence and pregnancy after surgery

Xiaojing Zhao, Yan Liu, Liang Wang
2025 · doi:10.37766/inplasy2025.9.0055 · W4414258761
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review identified risk factors associated with endometriosis recurrence and pregnancy after surgery in patients with ovarian endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This paper is a registered systematic review protocol aiming to identify risk factors for endometriosis recurrence and for pregnancy after surgery in patients with ovarian endometriosis, comparing groups with versus without recurrence and/or pregnancy. The authors plan to search PubMed, Embase, Web of Science, CNKI, Wanfang, Weipu (and Cochrane Library), include randomized controlled trials, cohort studies, or case-control studies, and exclude reviews, non-article publications, case reports, and non-English/Chinese or non-relevant studies. Outcomes are recurrence status or pregnancy status, with quality assessed using RoB 2 for RCTs and NOS for non-RCTs, and synthesis planned using standard meta-analytic approaches (e.g., metan/midas) with subgroup and sensitivity analyses if feasible. The protocol does not report actual results, so its limitation is that it provides no evidence about specific risk factors at this time. This paper is centrally about endometriosis — it is a systematic review protocol focused on ovarian endometriosis recurrence risk factors and pregnancy outcomes after surgery.

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Abstract

R eview question / Objective The review aims to identify risk factors associated with recurrence of endometriosis and pregnancy gain after surgery.P: Ovarian endometriosis patients after surgery I: No artificial intervention C:Patients without recurrence or without pregnancy O: Recurrence of endometriosis or pregnancy S:Randomized controlled study, cohort study or case-controlled study.Rationale Ovarian endometriosis is a refractory disease in gynecology that has high recurrent rate and infertility rate.We aim to summarize published articles associated with the topic to evaluate risk factors.This can help clinical practice in the future.Condition being studied Endometriosis, also known as endometrioma, is a complex disease with unclear etiologies.The manifestations of the disease include dysmenorrhea, infertility and pelvic pain.Surgery and hormone therapy are the main therapies of endometriosis. METHODSSearch strategy MeSH terms of "risk factors", "endometriosis", "pregnancy", "recurrence" and their free texts are applied.Pubmed, Embase, Web of Science, CNKI, Wanfang and Weipu are searched. Participant or populationOvarian endometriosis patients after surgery.Intervention No artificial intervention.Comparator Patients without recurrence or without pregnancy.Study designs to be included Randomized controlled study, cohort study or case-controlled study.
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Introduction

Review question / Objective The review aims to identify risk factors associated with recurrence of endometriosis and pregnancy gain after surgery. P: Ovarian endometriosis patients after surgery I: No artificial intervention C:Patients without recurrence or without pregnancy O: Recurrence of endometriosis or pregnancy S:Randomized controlled study, cohort study or case-controlled study. Rationale Ovarian endometriosis is a refractory disease in gynecology that has high recurrent rate and infertility rate. We aim to summarize published articles associated with the topic to evaluate risk factors. This can help clinical practice in the future. Condition being studied Endometriosis, also known as endometrioma, is a complex disease with unclear etiologies. The manifestations of the disease include dysmenorrhea, infertility and pelvic pain. Surgery and hormone therapy are the main therapies of endometriosis.

Methods

Search strategy MeSH terms of "risk factors", “endometriosis", "pregnancy", "recurrence" and their free texts are applied. Pubmed, Embase, Web of Science, CNKI, Wanfang and Weipu are searched. Participant or population Ovarian endometriosis patients after surgery. Intervention No artificial intervention. Comparator Patients without recurrence or without pregnancy. Study designs to be included Randomized controlled study, cohort study or case-controlled study. INPLASY 1 International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASYIdentification of risk factors associated with endometriosis recurrence and pregnancy after surgery Zhao, XJ; Liu, Y; Wang, L. ADMINISTRATIVE INFORMATION Support - Zhejiang Traditional Chinese Medicine Administration. Review Stage at time of this submission - Preliminary searches. Conflicts of interest - None declared. INPLASY registration number: INPLASY202590055 Amendments - This protocol was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) on 14 September 2025 and was last updated on 14 September 2025. Corresponding author: Liang Wang [email protected] Author Affiliation: The Second Affiliated Hosptial, Zhejiang University School of Medicine. Zhao et al. INPLASY protocol 202590055. doi:10.37766/inplasy2025.9.0055 Zhao et al. INPLASY protocol 202590055. doi:10.37766/inplasy2025.9.0055 Downloaded from https://inplasy.com/inplasy-2025-9-0055/ INPLASY202590055 doi: 10.37766/inplasy2025.9.0055 Received: 14 September 2025 Published: 14 September 2025 Eligibility criteria All articles that are associated with endometriosis recurrence risk factors or infertility risk factors are included. Exclusion criteria: 1. Reviews, meta-analysis, thesis, editorial and other non-article publications, 2. Case report, 3. Animal studies or in-vitro studies, 4. Articles that are not written in English or Chinese, 5. Articles that are not associated with endometriosis or recurrence risk factors or infertility risk factors. Information sources Electronic databases: Pubmed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang and Weipu. Main outcome(s) Recurrence situation or pregnancy situation. Quality assessment / Risk of bias analysis Randomized controlled studies are evaluated by RoB 2. Non-RCT studies are evaluated by NOS scale. Strategy of data synthesis Continuous variables are synthesized in the form of mean, standard deviation and sample sizes and analyzed by metan. Categorical variables are synthesized in the form of positive number and negative number and analyzed by metan. Effect value are synthesized and analyzed by midas. Subgroup analysis Subgroup analysis are conducted if various variables are available in the same outcomes. Sensitivity analysis Sensitivity analysis is conducted by metaninf if applicable. Language restriction English or Chinese. Country(ies) involved China.

Keywords

Endometriosis; Recurrence; Pregnancy; Risk factors. Contributions of each author Author 1 - Xiaojing Zhao - Author 1 searched the database, selected articles and will analyze result and draft the manuscript. Email: [email protected] Author 2 - Yang Liu - Author 2 will selected articles. Email: [email protected] Author 3 - Liang Wang - Author 3 raised the idea and will revise the manuscript. Email: [email protected] INPLASY 2Zhao et al. INPLASY protocol 202590055. doi:10.37766/inplasy2025.9.0055 Zhao et al. INPLASY protocol 202590055. doi:10.37766/inplasy2025.9.0055 Downloaded from https://inplasy.com/inplasy-2025-9-0055/

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endometriosisendometriomadysmenorrheainfertility

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