O-199 The association between endometriosis and endometrial polyps: a systematic review and meta-analysis
Bibliographic record
Abstract
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
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.054 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.010 | 0.003 |
| Bibliometrics | 0.003 | 0.007 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".