Imaging modalities for the non-invasive diagnosis of endometriosis.

Highlights d RNA-seq of oocytes and granulosa cells mapped transcriptome and signature genes d KEGG/GSEA analysis uncovered pathways involved in primordial follicle activation d Oocyte-granulosa cell interactions exhibit stage-and species-specific patterns d RNA-seq analysis identified candidate secretory biomarkers of ovarian reserve

Of the biomarkers that were subjected to meta-analysis, none consistently met the criteria for a replacement or triage diagnostic test. A subset of blood biomarkers could prove useful either for detecting pelvic endometriosis or for differentiating ovarian endometrioma from other benign ovarian masses, but there was insufficient evidence to draw meaningful conclusions. Overall, none of the biomarkers displayed enough accuracy to be used clinically outside a research setting. We also identified blood biomarkers that demonstrated no diagnostic value in endometriosis and recommend focusing research resources on evaluating other more clinically useful biomarkers.

None of the biomarkers evaluated in this review could be evaluated in a meaningful way and there was insufficient or poor-quality evidence. Laparoscopy remains the gold standard for the diagnosis of endometriosis and using any non-invasive tests should only be undertaken in a research setting.