Impact of non-medical treatments of endometrioma on pregnancy outcome: a systematic review and meta-analysis

Elham Askary, Francisco Carmona, Saeed Alborzi, Cristian de Guirior, Crístian de Guirior
Reproductive biomedicine online · 2025 · vol. 51(5) , pp. 105043 · doi:10.1016/j.rbmo.2025.105043 · PMID:40907337 · W4410199219
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This meta-analysis of 24 studies found cystectomy and ablation yield similar pregnancy rates compared to each other, while sclerotherapy and no treatment also showed acceptable rates, unlike coagulation and fenestration.

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Abstract

This meta-analysis assesses the impact of non-medical endometrioma treatments on pregnancy rates in infertile women with endometriosis. Based on a search of PubMed, Scopus, EMBASE and Web of Science, 24 prospective English-language studies (2000-2022, participant age 15-45 years, n = 2458) were identified that reported treatment and pregnancy rates based on the 2020 PRISMA checklist. Random effects modelling minimized bias; heterogeneity (I²) and publication bias were assessed using MedCalc. The results showed 95% confidence intervals, and statistical comparisons were performed using the Kruskal-Wallis, analysis of variance or chi-squared test. It was found that cystectomy and ablation yielded similar pregnancy rates: 39.28% and 42.94% for ART, and 40.25% and 34.08% for natural pregnancies (P > 0.05). Sclerotherapy and no treatment also resulted in acceptable pregnancy rates while coagulation and fenestration were associated with lower success rates and higher recurrence (up to 38.79%). Overall, cystectomy and ablation were considered as effective alternatives for improving fertility outcomes in this population. Future research on endometriomas and infertility should involve well-designed randomized controlled trials with larger and more diverse populations, additional fertility factors and standardized follow-up periods.

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Condition tags

mesh:D004715endometriosisendometriomainfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (53)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
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pubmed
last seen: 2026-05-26T00:31:02.313197+00:00
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