Miscarriage on Endometriosis and Adenomyosis in Women by Assisted Reproductive Technology or with Spontaneous Conception: A Systematic Review and Meta-Analysis

Yangxue Huang, Xianhong Zhao, Yiyuan Chen, Jie Wang, Weilin Zheng, Lixing Cao · BioMed Research International · 2020 December 8

DOI 10.1155/2020/4381346

Objective

The present study is aimed at assessing the impact of endometriosis and adenomyosis on miscarriage.

Conclusions

Women with endometriosis had an augmented miscarriage risk in SC and a similar miscarriage risk during ART. Adenomyosis was associated with miscarriage in pregnant women using ART.

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Insights

Endometriosis and Adenomyosis can have impact on miscarriage risk in pregnancy.

The study analyzed 39 publications involving 697,984 women to assess the impact of endometriosis (EMS) and adenomyosis (AD) on miscarriage risk. Women with EMS showed increased miscarriage risk in spontaneous conception (SC), but similar risk in assisted reproductive technology (ART) compared to tubal infertility. AD was associated with higher miscarriage risk in ART. Sensitivity analyses supported these conclusions. EMS staging did not significantly alter miscarriage risk. Early-stage EMS showed higher early abortion risk. No significant associations were found between EMS and low birthweight, placental abruption, intrauterine growth restriction, or preeclampsia. EMS correlated with higher odds of antepartum hemorrhage, postpartum hemorrhage, preterm birth, placenta praevia, and stillbirth. SUP and DIE were linked to increased miscarriage risk, while OMA showed no significant association. The findings suggest the need for closer monitoring and follow-up for pregnant women with EMS or AD, particularly in early pregnancy. Standardized recording of EMS types, stages, and miscarriage timing is recommended for future studies.