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

Elham Askary, Askary E, Carmona F, Francisco Carmona, Alborzi S, Saeed Alborzi, Crístian de Guirior, Cristian de Guirior, De Guirior C
Reproductive BioMedicine Online · 2025 · vol. 51(5) , pp. 105043 · doi:10.1016/j.rbmo.2025.105043 · PMID:40907337 · W4410199219
Systematic review / meta-analysis OA: hybrid CC0
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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

endometriosisendometriomainfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (53)

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