BACKGROUND/AIM:Delayed childbearing has increased the reliance on in vitro fertilization (IVF) with donor oocytes for women of advanced maternal age often facing more obstetric complications compared to younger women using self-oocytes. This study evaluated and contrasted key obstetric and perinatal parameters between these two groups. PATIENTS AND METHODS:In this retrospective multicenter study, completed IVF embryo transfer cycles were analyzed. Clinical data including clinical pregnancy, miscarriage, ectopic pregnancy rates, and major pregnancy complications were collected. Obstetric outcomes (e.g., mode of delivery, preterm birth, and neonatal parameters such as birth weight, Apgar scores, and NICU admissions) were compared between the donor-oocyte recipients (DOR-IVF) and self-oocyte (SO-IVF) groups. Statistical analysis comprised chi-square tests, t-tests, and multivariable logistic and linear regressions to adjust for potential confounders. RESULTS:The DOR-IVF group demonstrated a clinical pregnancy rate of 44.8% (196 cases) with an 8.8% miscarriage rate, while the SO-IVF group reported 242 clinical pregnancies with an 8.1% miscarriage rate. Overall, nine ectopic pregnancies (2%) were noted, with statistically significant differences in ectopic and miscarriage rates between the groups (p=0.008 and p=0.025, respectively). Although the mean gestational age was similar and NICU admissions did not differ significantly (p=0.125), the DOR-IVF group exhibited a higher incidence of pregnancy complications (p=0.009). Multivariable logistic regression identified DOR-IVF as an independent predictor for pregnancy complications (adjusted odds ratio 2.38; 95% confidence interval=1.53-3.70). Additionally, subgroup analyses revealed that 1-minute Apgar scores were positively associated with DOR-IVF status (p=0.048) and birth weight was inversely related to the number of babies transferred (p=0.006). CONCLUSION:DOR-IVF patients experience significantly increased risk in obstetric complications compared to younger women using SO-IVF, although neonatal outcomes remain largely similar.

Background and Objectives: Stress urinary incontinence (SUI) is a common condition among women and is frequently associated with impaired sexual function and increased sexual distress. Pelvic floor muscle training (PFMT) is considered a first-line conservative treatment for SUI; however, its effects on female sexual function remain incompletely understood. The present study aimed to evaluate the impact of PFMT on sexual function, sexual distress, and pelvic floor muscle performance in women with SUI. Materials and Methods: This prospective controlled observational study included sexually active women with clinically confirmed SUI and female sexual dysfunction. Participants were allocated either to a control group (Group A) or to a supervised 12-week PFMT program (Group B). Sexual function and distress were assessed using the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale–Revised (FSDS-R), respectively. Pelvic floor muscle performance was evaluated using Peritron perineometry, including peak vaginal squeeze pressure, endurance, and resting tone. Objective severity of SUI was assessed using the one-hour pad test. Results: A total of 102 women completed the study, including 44 in the control group and 58 in the PFMT group. After 12 weeks, women undergoing PFMT demonstrated significant improvements in urinary continence, pelvic floor muscle strength, and sexual function compared with controls (all p < 0.01). Mean FSFI total score increased from 21.5 ± 2.5 to 26.6 ± 3.3, while the proportion of women with clinically significant sexual distress decreased from 100% to 58.6%. Peak vaginal squeeze pressure and endurance also improved significantly following PFMT. Conclusions: PFMT significantly improves sexual function, reduces sexual distress, and enhances pelvic floor muscle performance in women with SUI. These findings support the integration of PFMT into the comprehensive management of women with SUI and associated sexual dysfunction.

Hysteroscopy provides direct visualization of the uterine cavity; however, diagnostic outcomes remain highly operator-dependent and subjective. This study aimed to develop an automated deep learning framework based on the ConvNeXt-XLarge architecture, in comparison with an EfficientNetV2 baseline, to objectively classify common uterine pathologies and thereby reduce diagnostic variability. A prospective dataset of 1262 histopathologically confirmed hysteroscopic images was analyzed using an 80:20 training to validation split and a two-stage transfer learning strategy. In addition to the primary multiclass framework, three binary classification models were developed to evaluate pairwise differentiation between the pathologies. The multiclass model achieved an accuracy of 80.5%, a precision of 82.3%, a weighted Area Under the Receiver Operating Characteristic Curve (AUC) of 94.8%, and a weighted average precision (AP) of 91.6%. In the binary classification tasks, model 1 (fibroids vs. functional polyps) achieved an accuracy of 96.7% and an AUC of 99.8%; model 2 (fibroids vs. hyperplastic polyps) achieved 87.2% accuracy and an AUC of 87.4%; and model 3 (functional vs. hyperplastic polyps) achieved 92.2% accuracy and an AUC of 99.0%. ConvNeXt-XLarge statistically significantly outperformed EfficientNetV2 in the multiclass task in terms of accuracy and AUC, and in model 2 in terms of accuracy, underscoring the added value of the deeper backbone for this hysteroscopic image classification. Overall, these findings demonstrate that deep learning frameworks can accurately automate the classification of hysteroscopic findings. By providing high-precision analysis, these models offer a robust tool to mitigate diagnostic subjectivity and optimize clinical decision-making.

Background Human papillomavirus (HPV) infection has a negative impact on quality of life (QoL) and sexual function, mainly owing to increased levels of anxiety and distress. Aims To examine the potentially moderating effects of general psychological health on the relationships between (a) HPV-related psychosocial burden and QoL and (b) HPV-related psychosocial burden and sexual function. Method The HPV Impact Profile, Female Sexual Function Index, General Health Questionnaire-28 and Life Satisfaction Inventory questionnaires were completed by 151 women. Results HPV-related psychosocial burden and general psychological health accounted for 23.2% of QoL variability. There was not strong evidence for a moderating effect of general psychological health on the relationship between HPV-related psychosocial burden and QoL. Higher HPV-related psychosocial burden predicted worse sexual function on average. However, HPV-related psychosocial burden accounted for only 4.1% of sexual function variability. Conclusions Higher HPV-related psychosocial burden is associated with lower QoL as well as worse sexual function. General psychological health predicts changes in QoL over and above HPV-related psychosocial burden; thus, a deep understanding of emerging mental health issues soon after diagnosis is crucial to improve counselling and enhance women’s mental empowerment to achieve a better psychological response.

Uterine leiomyomas are common benign tumors, whereas "giant" leiomyomas occupying most of the abdominal cavity are now uncommon and can pose diagnostic and operative challenges. We present the case of a 45-year-old woman with progressive abdominal distension and long-standing menorrhagia. Computed tomography demonstrated a massive uterine fundal mass consistent with a giant subserosal leiomyoma and a separate right adnexal cystic lesion. The patient underwent elective midline laparotomy and total abdominal hysterectomy with bilateral salpingo-oophorectomy. The ovarian cyst was removed intact without capsular rupture, and peritoneal washings were obtained. Estimated blood loss was 80 mL. Postoperative recovery followed an enhanced recovery after surgery (ERAS) pathway, enabling discharge on postoperative day four. Final histopathology confirmed a giant subserosal leiomyoma measuring 44 × 38 × 30 cm and revealed an occult clear cell carcinoma confined to the ovarian cyst (FIGO stage IA), with negative peritoneal cytology. Completion staging surgery and adjuvant-treatment discussion were recommended at a multidisciplinary tumor board; however, the patient declined further extensive surgery and was referred to medical oncology for adjuvant management and close surveillance. This case highlights the complexity of removal in giant uterine tumors, careful handling of adnexal cysts to avoid intraoperative rupture, and the feasibility of ERAS-based recovery.

Background This summary sets a deeper insight into premenstrual disorders in young girls and adolescents. Premenstrual Syndrome refers to a number of symptoms that start in the luteal phase and remit with menses, including emotional instability, depression, bloating, breast tenderness, fatigue or headache. According to the American College of Obstetricians and Gynecologists, symptoms emerge within five days before menstruation and resolute within four days, for at least three consecutive cycles. Premenstrual Dysphoric Disorder is a serious form of PMS, classified into depression disorders. Methods This abstract is a review, performed using PubMed and Google Scholar. Results were limited to reviews published between 2015 and 2024. Key words included “Premenstrual Syndrome”, “Premenstrual Dysphoric Disorder”, “adolescence”, “pathophysiology”. Results PMS affects 30% of young girls, while PMDD about 3-8%. It is associated with childhood trauma, stress,migraine, while it may worsen other disorders such as ADHD or PTSD. The pathophysiology is a combination of genetic, hormonal and environmental factors. Some theories claim that fluctuation of estrogen and progesterone in the luteal phase may set off the symptoms.. Puberty timing is also important as early or late menarche puts adolescents in different risk. Estrogen decrease in the luteal phase leads to deregulation of serotonin, indicating the effectiveness of selective serotonin reuptake inhibitors (SSRIs) as treatment. Changes in lifestyle including exercise on a regular basis, a healthy diet and dietary supplements such as magnesium and vitamin D as well as combined oral contraceptives with both a progesterone derivative and ethinyl estradiol are an efficient treatment. Other treatments include GnRH agonists and non-contraceptive estradiol. Conclusions PMS is a complicated disorder that affects a significant rate of young girls, with an impact on their quality of life, leading to decreased productivity, missing days from school and daily activities. As a newly recognized syndrome, most adolescents are unaware and appropriate information is of crucial importance.

The prevalence and prognostic value of programmed death ligand 1 (PD-L1) expression, as a potential biomarker in vulvar squamous cell carcinomas (VSCCs), remain underexplored. We searched the PubMed, Scopus, Embase, and Cochrane Library databases until July 2024 for articles examining PD-L1 expression in VSCCs. Random-effects meta-analyses summarized PD-L1 expression overall and in subgroups by immunohistochemistry antibody type, positivity cutoff, tumor stage, and HPV positivity. Additionally, random-effects meta-analyses summarized the association between PD-L1 positivity and cancer prognosis. We included 26 studies comprising 1912 VSCC cases. The summary PD-L1 positivity rate in tumor cells was 59.9% (95% confidence interval [CI]: 47.7–71.4%; I2 = 96%, n = 26), influenced by the different cutoff thresholds utilized to define PD-L1 positivity. Compared to tumor cells, positivity rates were higher in intratumoral immune cells (75.6%; 95%CI: 52.9–92.5; I2 = 95.4%, n = 6) and peritumoral cells (78.9%; 95%CI: 54.4–95.5%; I2 = 91%, n = 3) but with overlapping 95%CIs. No heterogeneity was observed in the rates by tumor stage or HPV status. Positive PD-L1 expression was associated with worse overall (hazard ratio [HR] = 1.43; 95%CI: 1.06–1.93; I2 = 28.9%, n = 7) and progression-free survival (HR = 1.57; 95%CI: 1.07–2.3; I2 = 38.3%, n = 5). The PD-L1 expression rate in VSCC tumor cells varied across studies, was influenced by differences in immunohistochemical evaluation, and was identified as an unfavorable prognostic factor. Large, prospective, multicenter studies with standardized protocols are crucial to further elucidate the clinical significance of PD-L1 expression in VSCCs.

Background and Objectives: The use of Artificial Intelligence (AI) in the medical field is rapidly expanding. This review aims to explore and summarize all published research on the development and validation of deep learning (DL) models in gynecologic laparoscopic surgeries. Materials and Methods: MEDLINE, IEEE Xplore, and Google scholar were searched for eligible studies published between January 2000 and May 2025. Selected studies developed a DL model using datasets derived from gynecologic laparoscopic procedures. The exclusion criteria included non-gynecologic datasets, non-laparoscopic datasets, non-Convolutional Neural Network (CNN) models, and non-English publications. Results: A total of 16 out of 621 studies met our inclusion criteria. The findings were categorized into four main application areas: (i) anatomy classification (n = 6), (ii) anatomy segmentation (n = 5), (iii) surgical instrument classification and segmentation (n = 5), and (iv) surgical action recognition (n = 5). Conclusions: This review emphasizes the growing role of AI in gynecologic laparoscopy, improving anatomy recognition, instrument tracking, and surgical action analysis. As datasets grow and computational capabilities advance, these technologies are poised to improve intraoperative guidance and standardize surgical training.

Female sexual dysfunction (FSD) is a multifactorial condition affecting desire, arousal, orgasm, and satisfaction, with wide-ranging implications for women's physical and emotional well-being. Although prevalent, especially among postmenopausal and postpartum populations, FSD remains under-recognized and undertreated. Pelvic floor muscle training (PFMT) has emerged as a promising, non-invasive therapeutic approach for managing FSD, particularly when associated with pelvic floor disorders such as urinary incontinence, pelvic organ prolapse, and overactive bladder. This narrative review synthesizes anatomical, physiological, clinical, and therapeutic insights into the relationship between pelvic floor function and female sexual health. The pelvic floor's structural complexity-comprising muscular, connective, and neurovascular elements-plays a crucial role in sexual response. Dysfunction of this system can contribute to sexual pain, reduced arousal, and orgasmic disorders. PFMT, involving voluntary muscle contractions, biofeedback, or electrical stimulation, has demonstrated benefits across diverse female populations. Variables such as frequency, intensity, supervision, and duration of PFMT significantly influence its effectiveness. Evidence suggests that PFMT improves sexual function in general populations and is particularly beneficial for postpartum, postmenopausal women, and those with neurological or gynecological issues. Improvements are seen in sexual desire, arousal, lubrication, orgasm, and pain reduction. The mechanisms underlying these effects include enhanced muscle strength, increased genital blood flow, and psychological improvements such as body awareness and reduced anxiety. Despite strong supportive evidence, implementation challenges persist, including adherence difficulties, a lack of standardized protocols, and insufficient professional training. Barriers to adherence include misconceptions, discomfort, lack of motivation, and poor understanding of proper technique. Facilitators include clear guidance, customized approaches, technological tools, and professional supervision. Mobile health applications and patient empowerment strategies show promise in enhancing engagement and outcomes. Future research should focus on long-term efficacy, standard intervention protocols, and the integration of PFMT with other therapies, such as pharmacological treatments. Overall, PFMT represents a low-risk, cost-effective intervention capable of significantly improving quality of life and sexual function in women across the lifespan.

This study applies Computational Fluid Dynamics (CFD) and mathematical modeling to examine uterine and umbilical arterial blood flow during pregnancy, providing a more detailed understanding of hemodynamic changes across gestation. Statistical analysis of Doppler ultrasound data from a large cohort of more than 200 pregnant women (in the second and third trimesters) reveals significant increases in the umbilical arterial peak systolic velocity (PSV) between the 22nd and 30th weeks, while uterine artery velocities remain relatively stable, suggesting adaptations in vascular resistance during pregnancy. By combining the Navier–Stokes equations with Doppler ultrasound-derived inlet velocity profiles, we quantify several key fluid dynamics parameters, including time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), Reynolds number (Re), and Dean number (De), evaluating laminar flow stability in the uterine artery and secondary flow patterns in the umbilical artery. Since blood exhibits shear-dependent viscosity and complex rheological behavior, modeling it as a non-Newtonian fluid is essential to accurately capture pulsatile flow dynamics and wall shear stresses in these vessels. Unlike conventional imaging techniques, CFD offers enhanced visualization of blood flow characteristics such as streamlines, velocity distributions, and instantaneous particle motion, providing insights that are not easily captured by Doppler ultrasound alone. Specifically, CFD reveals secondary flow patterns in the umbilical artery, which interact with the primary flow, a phenomenon that is challenging to observe with ultrasound. These findings refine existing hemodynamic models, provide population-specific reference values for clinical assessments, and improve our understanding of the relationship between umbilical arterial flow dynamics and fetal growth restriction, with important implications for maternal and fetal health monitoring.

Endometriosis is a gynaecological condition affecting reproductive-age women. In case of ovarian endometriosis, there is cystic formation, called endometrioma. Although laparoscopic cystectomy is established as the gold standard for the treatment of endometriomas, it is related to damage of healthy ovarian tissue and significant decrease in ovarian reserve. As a result, new strategies have been set for the care of endometriomas, with ethanol sclerotherapy as the most popular alternative. As a part of sclerotherapy, ethanol solution is injected to destroy pseudocapsule. Iatrogenic damage is minimized, making it a safe and less invasive technique. In this study, we compared ultrasound-guided (U/S) ethanol sclerotherapy and laparoscopic ethanol sclerotherapy with laparoscopic cystectomy. Anti-Müllerian hormone (AMH) is used to monitor ovarian preservation. Sclerotherapy seems to have smaller effect on ovarian reserve compared to cystectomy. Recurrence rate and clinical pregnancy rate are similar, though cystectomy has better outcome of symptom relief. Moreover, laparoscopic sclerotherapy seems to achieve the best clinical pregnancy rate and decrease recurrence rate.

A 34-year-old nulligravida with schizophrenia presented after four months of progressive abdominal distension, culminating in severe respiratory compromise. An urgent transabdominal ultrasound was initially interpreted as massive ascites; however, its diagnostic accuracy was limited by the extreme abdominal distension and the patient's inability to change position due to respiratory distress. Further evaluation with CT of the thorax and abdomen revealed a 35 × 42 × 48.5 cm cystic mass arising from the left ovary, causing marked thoracoabdominal compression. Laboratory studies demonstrated leukocytosis, elevated inflammatory markers, and increased carcinoembryonic antigen and carbohydrate antigen 19-9, consistent with an ovarian neoplasm. An urgent midline laparotomy permitted controlled decompression of 37 L of serosanguinous fluid and en bloc resection of the ovarian mass, relieving the patient's respiratory distress. Histopathology identified a mucinous borderline tumor with focal intraepithelial carcinoma, microinvasion (<5 mm), and an incidental benign Brenner component. After an uneventful recovery, the patient elected definitive management and underwent total hysterectomy with right salpingectomy one month later. At six-month follow-up, she remained in good health without evidence of recurrence.

The manuscript presents a case of a 29-year-old pregnant woman who developed a severe psychotic episode during the second trimester of her pregnancy. Bipolar disorder (BD) is a serious mood disorder of uncertain etiology marked by significant and long-lasting fluctuations in mood. It is a major cause of disability worldwide, with a higher rate of progression and frequency in women. Pregnancy represents a vulnerable period for women with BD, as hormonal and psychological changes can trigger severe mood episodes. Pharmacological treatment was given, and her pregnancy was closely monitored. A cesarean section was performed at 36 weeks, and postpartum medication adjustments were made. At six months follow-up, the patient showed signs of symptom remission, though she required subsequent psychiatric care.

Background/Aim:This study evaluated the immunohistochemical expression of IRE1 and PERK in breast cancer and explored their associations with clinicopathologic characteristics and survival outcomes. Patients and Methods:A cohort of 72 breast cancer specimens and 16 controls was analyzed for IRE1 and PERK expression using immunohistochemistry. Associations with clinicopathological variables, hormone receptor status, tumor markers and survival outcomes were assessed using statistical analyses, including Kaplan-Meier survival curves and Cox proportional hazard models. Results:IRE1 and PERK expression levels were significantly elevated in breast cancer tissues compared to controls (p<0.001). Strong positive correlation was observed between IRE1 and PERK expression (Spearman's ρ=0.55, p<0.001). High PERK expression was associated with older age (p=0.038) and tumor grade 3 (p=0.042), while high IRE1 expression correlated with advanced TNM stage (p<0.001), estrogen receptor (p=0.031), progesterone receptor (p=0.028), and human epidermal growth factor receptor 2 positivity (p=0.028), as well as increased Ki-67 index (p=0.003), suggesting a more aggressive tumor phenotype. IRE1 expression was significantly associated with sentinel lymph node positivity (p=0.001) but inversely related to axillary lymph node involvement (p=0.031). Multivariate Cox regression analysis revealed that high IRE1 expression [immunoreactivity score (IRS) 5-12] was linked to an increased mortality risk [hazard ratio (HR)=12.19, 95% confidence interval (CI)=0.99-150.35, p=0.05], and high PERK expression (IRS 4-12) was similarly associated with worse survival (HR=12.10, 95%CI=1.16-126.30, p=0.04). Tumor stage was the strongest predictor of mortality (HR=79.89, p<0.01). Conclusion:High IRE1 and PERK expression levels are associated with aggressive tumor characteristics and reduced survival in breast cancer, underscoring the importance of the unfolded protein response in carcinogenesis and disease progression.

Objective: This retrospective observational study evaluated the efficacy and safety of an ovarian stimulation protocol for embryo banking that involves continuous administration of clomiphene citrate (CC) in combination with gonadotropins, without the use of GnRH antagonists. Methods: Conducted at the Serum IVF Clinic in Athens, Greece, the study included 250 women aged 25–45 who underwent IVF for embryo banking. The protocol involved administering 150 mg of CC daily from day 2 of the menstrual cycle until the day before hCG trigger, alongside 150 IU/day of Meriofert. Outcomes assessed included oocyte yield, fertilization rates, incidence of ovarian hyperstimulation syndrome (OHSS), and hormonal correlations. Comparative and regression analyses explored differences between age groups and predictors of success. Results: The protocol demonstrated a favorable safety profile with no cases of OHSS and yielded a mean of 10.25 oocytes per patient. Group analysis showed significantly more oocytes retrieved in women under 40 (mean: 12.5) versus those over 40 (mean: 8.43), while fertilization rates were paradoxically higher in the older cohort (59.16% vs. 30.68%, p < 0.0001). Regression models revealed basal FSH to be a significant inverse predictor of oocyte yield, but it was positively associated with fertilization rate. Continuous CC use effectively suppressed premature LH surges without compromising oocyte or embryo quality, allowing flexible and cost-effective stimulation with minimal monitoring. Conclusions: Continuous administration of clomiphene citrate in combination with gonadotropins presents a promising, antagonist-free ovarian stimulation protocol for embryo banking. The approach is economically efficient, reduces monitoring requirements, and maintains safety and effectiveness and is particularly notable in women over 40. Further studies are warranted to validate these findings and refine protocol mechanisms.

Acrochordons are benign skin neoplasms that originate from mesenchymal and ectodermal tissues. These lesions are commonly found in regions of the skin that experience friction or folding. This report presents a 48-year-old female patient who exhibited a 3 cm acrochordon located on the right labia majora of her vulva. A thorough review of her medical history did not reveal any identifiable risk factors that could account for the onset and rapid growth of the polyp. A wide surgical excision was conducted, and the subsequent histopathological examination confirmed a polypoid proliferation of the stroma, accompanied by a hypocellular stroma composed of spindle cells and loose collagenous stroma. At the six-month follow-up, the patient showed no signs of recurrence.

Objective: The aim of this narrative review is to evaluate existing questionnaires on predictive models for endometriosis. These symptom-based models have the potential to serve as screening tools for adult women to detect endometriosis. Data sources: A comprehensive search of PubMed and Embase databases was conducted to identify studies on endometriosis screening. Selection of studies: The search targeted predictive models for endometriosis localisation, bowel involvement, need for bowel surgery and fertility. Due to the heterogeneity identified, a systematic review was not possible. A total of 23 studies were identified. Data extraction and synthesis: Among these studies, twelve included measures for general endometriosis, two targeted specific sites, four focused on deep infiltrating endometriosis (DIE), and three addressed the need for endometriosis-related bowel surgery. Many measures combined clinical, imaging and laboratory tests with patient questionnaires. Validation of these models as screening tools was lacking in all studies, as the focus was on diagnosis rather than screening. Conclusion: This review did not identify any fully validated, symptom-based questionnaires for endometriosis screening in adult women. Substantial validation work remains to establish the efficacy of such tools.

Contraceptive use in adolescence remains a challenging issue. Adolescents are at high risk of unintended pregnancies and sexual transmitted infections. During the past few decades intrauterine devices are recommended from global health organization, including the American Academy of Pediatrics, American College of Obstetricians and Gynecologists and World Health Organization as a method of contraception for adolescents. Intrauterine devices are part of the long-acting reversible contraceptives (LARCs) and include the copper bearing device (CU-IUD) and the levonorgestrel intrauterine system (LNG-IUS). IUDs are a safe and effective contraceptive method for adolescents with a failure rate less than 1%. Their use is not limited only in contraception. LNG-IUS 52 mg is approved for treating heavy menstrual bleeding and protection from endometrial hyperplasia in women receiving hormone replacement therapy. It can also be an effective tool in the management of dysmenorrhea, while CU-IUD can provide emergency contraception. Nevertheless, IUDs remain underutilized in this group of population. Adolescents' lack of proper education about contraception and sexual behavior creates myths and misconceptions about the possible side effects and the suitability of IUDs in this age group. Furthermore, health care providers remain skeptical and hesitate to suggest IUDs to adolescents. Other barriers including high cost, concern about confidentiality and difficulties in access contribute to its limited use. It is of high importance to eliminate barriers and offer more accessible contraceptive services to adolescents.

Introduction: Abdominal masses in the pediatric population most commonly derive from the ovaries. Ovarian masses are divided into non-neoplastic lesions (functional cysts, abscesses, ovarian torsion and endometriosis) and neoplastic tumors (epithelial, sex cord-stromal, germ cell and miscellaneous).

Endometriosis is a chronic benign inflammatory disease that affects women of reproductive age. The clinical presentations of endometriosis include dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. There is a well-established association between endometriosis and infertility. Therefore, there is a need for an early diagnosis of endometriosis-related infertility. In this study, we aim to identify the role of biomarkers as predictive factors of the presence of the disease and its severity and their correlation with the pregnancy outcome. We performed an electronic database search of all published studies in PubMed and EMBASE from January 2018 to May 2023. Numerous innovative biomarkers identified in cases of endometriosis and infertility have been studied over the past years, including micro-RNAs, BCL6 endometrial expression, cytotoxic T-lymphocyte antigen 4, human leukocyte antigen G, programmed cell death protein 1, programmed cell death ligand 1 immune checkpoint molecules, plasma fibronectin-fibrin complexes, homeobox A10 gene, systemic inflammatory response markers, uterine natural killer cells, and the eutopic endometrium proteome. Considerable research has been done to identify diagnostic biomarkers for the early detection and prevention of endometriosis-associated infertility. However, none of these biomarkers displayed enough diagnostic accuracy to be used in daily clinical practice. Future research is valuable to establish them as reliable diagnostic tools.