Association between endometriosis and adverse reproductive and perinatal outcomes in women undergoing assisted reproductive technology: a systematic review and meta-analysis.

Yan Wei, Xiong Xiao, Xixi Wu, Cong Xie, Tingting Li

Abstract readSystematic Review

In one paragraph

Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed

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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

Influence of endometriosis on the outcomes of assisted reproductive technology in poor ovarian responders with previous implantation failures.Obstetrics & gynecology science · 2026
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5 · Who and what money

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5 authors.

Yan Wei *Department of Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Xiong Xiao *Department of Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Xixi WuDepartment of Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Cong XieDepartment of Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Tingting LiDepartment of Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: With the increasing use of assisted reproductive technology (ART), more women with endometriosis are achieving pregnancy through ART. However, the impact of endometriosis on pregnancy and perinatal outcomes following ART remains controversial. This study aimed to clarify the association between endometriosis and adverse pregnancy and perinatal outcomes through a meta-analysis. Methods: A systematic search of PubMed, Embase, Web of Science, and Cochrane Library was conducted to identify relevant studies published before March 12, 2025. Cohort studies comparing adverse pregnancy and perinatal outcomes between women with and without endometriosis undergoing ART were included. Meta-analysis was performed using STATA 12.0 and R 4.3.2 software to calculate risk ratios (RRs) and 95% confidence intervals (CIs) for the association between endometriosis and adverse outcomes. Heterogeneity among studies was quantified using Cochran's Q test, I Results: A total of 29 cohort studies, including 93,071 women with endometriosis and 1,350,005 controls, were included in the meta-analysis. Compared with women without endometriosis, those with endometriosis undergoing ART had significantly lower clinical pregnancy rate (RR 0.850, 95% CI 0.726-0.994, 95% PI 0.570-1.267) and live birth rate (RR 0.716, 95% CI 0.556-0.923, 95% PI 0.341-1.504). They were also at higher risk for preterm birth (RR 1.277, 95% CI 1.187-1.373, 95% PI 1.024-1.591), placenta previa (RR 2.246, 95% CI 1.759-2.869, 95% PI 1.028-4.910), postpartum hemorrhage (RR 1.310, 95% CI 1.198-1.432, 95% PI 1.154-1.486), cesarean section (RR 1.296, 95% CI 1.165-1.441, 95% PI 0.944-1.779), low birth weight (RR 1.159, 95% CI 1.050-1.279, 95% PI 1.025-1.310), stillbirth (RR 1.219, 95% CI 1.032-1.440, 95% PI 0.930-1.597), and hypertensive disorders of pregnancy (RR 1.161, 95% CI 1.096-1.231, 95% PI 1.057-1.276). However, no significant differences were observed between the two groups in the risk of small for gestational age, miscarriage, preeclampsia, large for gestational age, or ectopic pregnancy (all Conclusion: Endometriosis significantly impacts pregnancy and perinatal outcomes following ART, increasing the risk of multiple adverse outcomes. These findings provide critical evidence for individualized reproductive treatment and perinatal care in women with endometriosis.

Indexed as

adverse pregnancy outcomesassisted reproductive technologyendometriosismeta-analysisplacenta previapreterm birth

Identifiers

PMID41684928

DOI10.3389/fmed.2026.1630529

PMCPMC12891222

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