Noninvasive BCL6 Preoperative Screening and Anatomic Patterns of Endometriosis in Patients with Unexplained Infertility

Sep 30, 2026

Uploaded by nayy☆

Endometriosis is a chronic, inflammatory, estrogen-dependent disease that is often underdiagnosed, with an average diagnostic delay of 11 years, especially among patients with unexplained infertility. This cross-sectional study compares endometriosis severity and anatomical distribution between women who underwent noninvasive Receptiva BCL6 testing before surgery and those who did not. In 195 women with histologically confirmed endometriosis, Receptiva-positive patients showed fewer affected anatomical regions and a different distribution of severity, supporting noninvasive testing for earlier, more targeted intervention.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Background/Objectives

Methods

Results

Conclusions

Introduction

Article Noninvasive BCL6 Preoperative Screening and Anatomic Patterns of Endometriosis in Patients with Unexplained Infertility Farrah Khoyloo 1,2, Camran Nezhat 1,3,4, *, Zahra Najmi 1, Quincy Harding 1, Dahnia Zarroug 1,5, Angie Tsuei 1 and Farr Nezhat 6,7,8 Academic Editor: Alberto Revelli Received: 20 November 2025 Revised: 22 December 2025 Accepted: 28 December 2025 Published: 4 January 2026 Copyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Camran Nezhat Institute, Center for Minimally Invasive and Robotic Surgery, Woodside, CA 94061, USA; [farrah.khoyloo@berkeley.edu](farrah.khoyloo@berkeley.edu) (F.K.); [zahra.najmi@camrannezhatinstitute.com](zahra.najmi@camrannezhatinstitute.com) (Z.N.); [quincyadamsharding@gmail.com](quincyadamsharding@gmail.com) (Q.H.); [dzarroug@stanford.edu](dzarroug@stanford.edu) (D.Z.); [angie.tsuei@camrannezhatinstitute.com](angie.tsuei@camrannezhatinstitute.com) (A.T.) 2 School of Public Health, University of California Berkeley, Berkeley, CA 94720, USA 3 Stanford University Medical Center, Palo Alto, CA 94305, USA 4 University of California, San Francisco, San Francisco, CA 94143, USA 5 Computer Science Department, Stanford University, Stanford, CA 94305, USA 6 Nezhat Surgery for Gynecology/Oncology, Valley Stream, NY 10128, USA; [farr@farrnezhatmd.com](farr@farrnezhatmd.com) [7](7 Department of OB/GYN)[ Department of OB/GYN](7 Department of OB/GYN), [Weil Cornell Medical College of Cornell University](Weil Cornell Medical College of Cornell University), [New York](New York), [NY 10065](NY 10065), [USA](USA)[ ](USA)[8](8 Department of OB/GYN)[ Department of OB/GYN](8 Department of OB/GYN), [NYU Long Island School of Medicine](NYU Long Island School of Medicine), [Mineola](Mineola), [NY 11501](NY 11501), [USA](USA) * Correspondence: [camran@camrannezhatinstitute.com](camran@camrannezhatinstitute.com) Abstract Background/Objectives: Endometriosis is a chronic, inflammatory, estrogen-dependent disease that has historically been underdiagnosed, especially in patients with unexplained infertility. On average, diagnosis is delayed by 11 years, underscoring the need for precision medicine to improve outcomes. To compare disease severity and anatomical distribution of endometriosis between patients with unexplained infertility who underwent noninvasive Receptiva BCL6 testing before surgery and those who did not. Methods: A cross-sectional analysis was conducted on 195 women with unexplained infertility and histologically confirmed endometriosis following diagnostic video laparoscopy, with or without robotic assistance. Disease severity was staged using updated guidelines. Anatomical sites of endometriosis were documented. Patients were grouped based on whether they had undergone the Receptiva BCL6 overexpression test prior to surgery. Results: Of the 195 patients, 43 underwent Receptiva testing; 41 of them tested positive and were confirmed to have endometriosis during surgery. These patients had fewer affected anatomical regions (3.14 ± 2.09) compared to those without testing (3.93 ± 2.26; p = 0.04) . The No Receptiva group also had more high-stage cases (70.39% vs. 65.12%, p-value: 0.038) . In both groups, endometriosis most frequently involved the periureteral region, rectovaginal septum, and ovaries, though ovarian tissue was rarely excised to preserve fertility. Conclusions: Among patients with unexplained infertility and confirmed endometriosis, those who had preoperative Receptiva testing showed lower disease burden and severity. These findings support the potential utility of noninvasive testing to enrich diagnostic accuracy and guide earlier, more targeted intervention. Keywords: endometriosis; unexplained infertility; precision medicine; endometriosis biomarkers; video laparoscopic surgery; endometr

FAQs

What is the study’s main objective regarding BCL6 testing?

To compare endometriosis severity and anatomical distribution between patients with unexplained infertility who had noninvasive Receptiva BCL6 testing before surgery and those who did not.

How was the study designed and who were the participants?

A cross-sectional analysis included 195 women with unexplained infertility and histologically confirmed endometriosis after diagnostic video laparoscopy, with or without robotic assistance.

What did the results show about disease burden in the tested group?

Patients who underwent preoperative Receptiva testing had fewer affected anatomical regions and a different pattern of high-stage cases compared with those without testing.

Sep 30, 2026

Uploaded by nayy☆