Immunocompetent mouse models of endometriosis: a systematic review and meta-analysis

Objective

To synthesize and compare measurable parameters researchers have used in the different immunocompetent mouse models of endometriosis.

Evidence Review

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 SDs or standard errors.

Results

The systematic search retrieved 1,421 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% confidence interval [CI], 23.8–45.9), lesion volume (15.6 mm³, 95% CI, 12.2–19.9), lesion area (8.6 mm², 95% CI, 5.6–13.4), lesion diameter (3.8 mm, 95% CI, 2.8–5.2), and lesion number (3.33, 95% CI, 2.8–3.8). Significant heterogeneity was observed for all outcomes. Meta-regression showed BALB/c strain, days of disease, and receiving estrogen affected lesion weight, injection, days of disease, and autologous donor/recipient affected lesion volume, days of disease affected lesion area, days of disease, and myometrium plus endometrium affected lesion diameter and BALB/c, receiving estrogen, and autologous donor/recipient affected lesion number.

Conclusion

The degree of heterogeneity, risk of bias, and low quality of evidence emphasize the need for a call to action. Model standardization, agreed on by the clinical and translational research community, would improve reproducibility and allow for evidenced-based translational outcomes, especially in the setting of preclinical endometriosis studies.