Impact of endometriosis and its staging on assisted reproduction outcome: systematic review and meta-analysis

M A P Barbosa, D M Teixeira, P A A S Navarro, Paula Andrea Navarro, Rui Alberto Ferriani, R A Ferriani, C O Nastri, Wellington P. Martins, W P Martins
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2014 · vol. 44(3) , pp. 261–278 · doi:10.1002/uog.13366 · PMID:24639087 · W1521037711
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This meta-analysis found that endometriosis presence or severity did not significantly impact live birth or clinical pregnancy rates in assisted reproduction, though miscarriage rates were higher and oocyte retrieval lower in those with endometriosis.

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Abstract

OBJECTIVE: To evaluate whether the presence or severity of endometriosis affects the outcome of assisted reproductive techniques (ART). METHODS: In this systematic review, all studies comparing the outcome of ART in women with and those without endometriosis, or at different stages of the disease, were considered eligible. We used either risk ratio (RR) or mean difference (MD) and their 95%CIs for comparisons. The primary outcome was live birth; the secondary outcome was clinical pregnancy. Miscarriage and the number of oocytes retrieved were examined as additional outcomes. RESULTS: We included 92 studies in the review and 78 in the meta-analysis: 20,167 women with endometriosis were compared with 121,931 women without endometriosis, and 1703 women with Stage-III/IV endometriosis were compared with 2227 women with Stage-I/II endometriosis. The following results were observed for the comparison of women with endometriosis vs women without endometriosis: live birth, RR = 0.99 (95%CI, 0.92-1.06); clinical pregnancy, RR = 0.95 (95%CI, 0.89-1.02); miscarriage, RR = 1.31 (95%CI, 1.07-1.59); number of oocytes retrieved, MD = -1.56 (95%CI, -2.05 to -1.08). The following results were observed for the comparison of women with Stage-III/IV vs Stage-I/II endometriosis: live birth, RR = 0.94 (95%CI, 0.80-1.11); clinical pregnancy, RR = 0.90 (95%CI, 0.82-1.00); miscarriage, RR = 0.99 (95%CI, 0.73-1.36); number of oocytes retrieved, MD = -1.03 (95%CI, -1.67 to -0.39). CONCLUSIONS: Women with endometriosis undergoing ART have practically the same chance of achieving clinical pregnancy and live birth as do women with other causes of infertility. No relevant difference was observed in the chance of achieving clinical pregnancy and live birth following ART when comparing Stage-III/IV with Stage-I/II endometriosis. The quality of the evidence for the additional examined outcomes was very low, not allowing meaningful conclusions to be drawn.

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Condition tags

mesh:D004715endometriosisinfertility

MeSH descriptors

Abortion, Spontaneous Endometriosis Live Birth Pregnancy Rate Reproductive Techniques, Assisted Reproductive Techniques, Assisted Abortion, Spontaneous Abortion, Spontaneous Adult Endometriosis Endometriosis Female Humans Infant, Newborn Oocyte Retrieval Pregnancy Pregnancy Outcome Severity of Illness Index

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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.

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