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Recurrence and Pregnancy Rate After Surgery Treatment of Deep Infiltrating Endometriosis: A Systematic Review and Meta-Analysis Publisher



Abdi F1, 2 ; Alimoradi Z3 ; Safavi Ardabili N4 ; Shirdel E5 ; Rahimi F6 ; Mirzadeh N7 ; Rahnemaei FA8
Authors
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Authors Affiliations
  1. 1. Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
  2. 2. Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
  3. 3. Research Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
  4. 4. Department of Midwifery, Ardabil Branch, Islamic Azad University, Ardabil, Iran
  5. 5. Department of Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran
  6. 6. Department of Obstetrics and Gynecology, Jiroft University of Medical Sciences, Jiroft, Iran
  7. 7. School of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran
  8. 8. Reproductive Health Research Center, Guilan University of Medical Sciences, Rasht, Iran

Source: Middle East Journal of Rehabilitation and Health Studies Published:2025


Abstract

Context: Deep infiltrating endometriosis (DIE) is a specific form of endometriosis in women, causing infertility and pelvic pain during reproductive age. Surgery is the treatment of choice for managing DIE, as medical therapy alone cannot adequately control symptoms. Objectives: The present study aims to investigate the recurrence and pregnancy rates following surgical treatment of DIE in women of reproductive age. Methods: PubMed, Web of Science, Scopus, Google Scholar, Cochrane Library, and ProQuest databases were searched from 2010 to August 25, 2024, using appropriate MeSH keywords. The quality of the included studies was assessed using the Mixed Method Appraisal Tool (MMAT), version 2018. Results: A total of 41 studies were included in the systematic review, and 34 studies were included in the meta-analysis. The meta-analysis comprised 6,585 individuals from 14 countries. The pooled estimated prevalence of endometriosis recurrence was 13% (95% CI: 11–17%, I²: 96.5%, Tau²: 0.01, Observations: 35). The corrected pooled estimated pregnancy rate after surgery for endometriosis was 47% (95% CI: 36–57%, I²: 96.47%, Tau²: 0.05). Conclusions: Recurrence and pregnancy rates remain controversial challenges in the surgical management of DIE. This study indicates a relatively low recurrence rate after DIE surgery and an improvement in the approximate pregnancy rate following the surgical approach. © 2025, Abdi et al.
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