O-199 The association between endometriosis and endometrial polyps: a systematic review and meta-analysis
Notice bibliographique
Résumé
Abstract Study question What is the prevalence of endometrial polyps in women with endometriosis and vice versa? Summary answer Available data showed that there is a bidirectional association between endometriosis and endometrial polyps, particularly in infertile women. What is known already Endometriosis is an estrogen-dependent chronic disease that affects women during their reproductive age and is a recognized contributor to infertility. It is associated with some uterine comorbidities which may independently impact fertility by disrupting endometrial receptivity. In this context, however, the relationship between endometriosis and endometrial polyps remains poorly defined, both in the general population and among infertile women. Understanding this association is crucial for improving diagnostic and therapeutic strategies, especially in infertility Study design, size, duration This systematic review and meta-analysis followed PRISMA guidelines. A systematic search of the literature was performed in the databases PubMed, Embase, and Scopus from inception up to October 2024. Only observational, peer-reviewed studies published in English were eligible. We included studies reporting the prevalence of endometrial polyps in women with endometriosis and/or endometriosis in women diagnosed with polyps. Risk of bias was assessed using the Newcastle-Ottawa Scale and evidence certainty was graded using GRADE guidelines. Participants/materials, setting, methods For studies that met inclusion criteria, pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses considered the presence of infertility and the diagnostic modalities of endometriosis and polyps. A gradient effect was evaluated for disease severity (stage III–IV vs. stage I–II) and location (ovarian and deep endometriosis). The protocol was registered in PROSPERO (CRD42024595167). Main results and the role of chance Twenty-two studies encompassing 10,928 patients (8,154 with infertility) were included. Women with endometriosis had a significantly higher risk of endometrial polyps (RR 2.18, 95%CI: 1.58–3.00). In infertile endometriosis women, the risk increased further (RR 2.37, 95%CI: 1.68–3.34, I²=86.3%). The subgroup analysis based on surgery-confirmed endometriosis and histology-confirmed polyps showed even an higher association (RR 2.53, 95%CI: 1.74–3.68, I²=86.8%). Similarly, women with polyps had a higher risk of endometriosis (RR 2.05, 95%CI: 1.61–2.62). This trend was also evident in infertile women with polyps (RR 2.08, 95%CI: 1.62–2.67, I²=86.1%) and in cases where both endometriosis and polyps were confirmed through surgery and histology, respectively (RR 2.01, 95%CI: 1.61–2.51, I²=84.0%). A gradient effect was observed, showing that women with stage III–IV endometriosis had a higher risk of developing polyps compared to those with stage I–II endometriosis (RR 1.19, 95% CI: 1.08–1.32). Furthermore, in the total cohort, stage III–IV endometriosis was associated with a significantly elevated risk of polyps compared to no endometriosis (RR 2.97, 95% CI: 2.41–3.67, I²=50.7%). Limitations, reasons for caution The quality of the evidence was low according to GRADE guidelines, limiting the reliability of the findings. Additionally, we observed substantial heterogeneity across studies. Lastly, the majority of studies focused on infertile population and we cannot rule out the possibility of a selection bias in observational studies. Wider implications of the findings The strong association between endometriosis and endometrial polyps highlights the importance for improved detection and tailored interventions. Exploring shared mechanisms may reveal new therapeutic targets and enhance fertility outcomes. These findings could inform evidence-based guidelines for managing these co-occurring conditions. Trial registration number No
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,054 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,010 | 0,003 |
| Bibliométrie | 0,003 | 0,007 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».