Abstract
The aims of this systematic review and meta-analysis were to synthesize and compare measurable parameters researchers have utilized in the different immunocompetent mouse models of endometriosis.
A systematic literature search of English language studies within PubMed/MEDLINE, Scopus, and Google Scholar from inception until January 2024 was performed. We included studies that reported an immunocompetent mouse model of intra-abdominal endometriosis and recorded at least one quantifiable lesion measurement with associated standard deviations or standard errors.
The systematic search retrieved 1421 studies of which 236 underwent a full text review. A total of 163 studies met inclusion criteria for the meta-analysis. Within the suture (n=76 studies) and injection (n=88 studies) models there were multiple outcomes evaluated. The overall effect for lesion weight (33.1 mg, 95% CI 23.8 to 45.9, p<0.001), lesion volume (15.6 mm3, 95% CI 12.2 to 19.9, p<0.001), lesion area (8.6 mm2, 95% CI 5.6 to 13.4, p<0.001), lesion diameter (3.8 mm, 95% CI 2.8 to 5.2, p<0.001) and lesion number (3.33, 95% CI 2.8-3.8, p<0.001). Significant heterogeneity was observed for all outcomes. Meta-regression showed BALB/c strain (p=.046), days of disease (p<.001), and receiving estrogen (p=.043) affected lesion weight, injection (p=.026), days of disease (p<.001) and autologous donor/recipient (p=.006) affected lesion volume, days of disease (p<.001) affected lesion area, days of disease (p<.001) and myometrium plus endometrium (p<.001) affected lesion diameter and BALB/c (p=.025), receiving estrogen (p=.003), and autologous donor/recipient (p=.005) affected lesion number.
The degree of heterogeneity, risk of bias and low quality of evidence, emphasizes the need for a call to action. Model standardization, agreed upon by the clinical and translational research community, would improve reproducibility and allow for evidenced based translational outcomes especially in the setting of pre-clinical endometriosis studies.