{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T11:29:15Z","timestamp":1787052555509,"version":"build-2736575974"},"reference-count":57,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":74,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Manipal Academy of Higher Education, Manipal"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Genetic factors contribute to poor ovarian response (POR) in assisted reproductive technology cycles, with estrogen receptor gene polymorphisms (\n                    <jats:italic>ESR1<\/jats:italic>\n                    and\n                    <jats:italic>ESR2<\/jats:italic>\n                    ) being explored as a causative factor in many studies. However, there is no systematic review and meta-analysis conducted on these studies to assess the association of these receptor polymorphisms on POR. This systematic review and meta-analysis evaluated the association between\n                    <jats:italic>ESR1<\/jats:italic>\n                    and\n                    <jats:italic>ESR2<\/jats:italic>\n                    single nucleotide polymorphisms (SNPs) and ovarian response in women undergoing controlled ovarian stimulation (COS). The study was registered with PROSPERO and conducted according to PRISMA guidelines. 11 eligible studies were included. Among the various SNPs, meta-analysis focused on\n                    <jats:italic>ESR1<\/jats:italic>\n                    rs2234693 and rs9340799, and\n                    <jats:italic>ESR2<\/jats:italic>\n                    rs4986938.\n                    <jats:italic>ESR1<\/jats:italic>\n                    rs2234693 C\u2011allele carriers showed significantly increased odds of POR in both heterozygote (pooled log odds ratio (LOR)\u2009=\u20090.99, standard error (SE)\u2009=\u20090.213; odds ratio (OR)\u2009=\u20092.69,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001)) and dominant models (LOR\u2009=\u20091.69, SE\u2009=\u20090.449, OR\u2009=\u20095.41,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), with consistent findings in European populations. Associations for\n                    <jats:italic>ESR1<\/jats:italic>\n                    rs9340799 and\n                    <jats:italic>ESR2<\/jats:italic>\n                    rs4986938 with POR showed substantial heterogeneity. Overall,\n                    <jats:italic>ESR1<\/jats:italic>\n                    rs2234693 may be associated with POR, in women undergoing COS. Further large-scale studies with appropriate study designs are warranted to clarify the potential role of\n                    <jats:italic>ESR<\/jats:italic>\n                    polymorphisms in COS outcomes.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-53350-5","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T17:54:36Z","timestamp":1780682076000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of ESR1 and ESR2 polymorphisms on ovarian response in assisted reproductive technology cycles: a systematic review and meta-analysis"],"prefix":"10.1038","volume":"16","author":[{"given":"Khan Zahara","family":"Fathima","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vani Lakshmi","family":"R.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Irungu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditi","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay Shree","family":"Dhyani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashanth","family":"Adiga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srabani","family":"Mukherjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish Kumar","family":"Adiga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shubhashree","family":"Uppangala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"issue":"4","key":"53350_CR1","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1016\/J.FERTNSTERT.2022.02.026","volume":"117","author":"MI Cedars","year":"2022","unstructured":"Cedars, M. I. Managing poor ovarian response in the patient with diminished ovarian reserve. Fertil. Steril. 117(4), 655\u2013656. https:\/\/doi.org\/10.1016\/J.FERTNSTERT.2022.02.026 (2022).","journal-title":"Fertil. Steril."},{"issue":"4","key":"53350_CR2","first-page":"241","volume":"12","author":"A Badawy","year":"2011","unstructured":"Badawy, A., Wageah, A., Gharib, M. E. & Osman, E. E. Prediction and diagnosis of poor ovarian response: The dilemma. J. Reprod. Infertil. 12(4), 241 (2011).","journal-title":"J. Reprod. Infertil."},{"issue":"7","key":"53350_CR3","doi-asserted-by":"publisher","first-page":"1616","DOI":"10.1093\/HUMREP\/DER092","volume":"26","author":"AP Ferraretti","year":"2011","unstructured":"Ferraretti, A. P. et al. ESHRE consensus on the definition of \u201cpoor response\u201d to ovarian stimulation for in vitro fertilization: The Bologna criteria. Hum. Reprod. 26(7), 1616\u20131624. https:\/\/doi.org\/10.1093\/HUMREP\/DER092 (2011).","journal-title":"Hum. Reprod."},{"key":"53350_CR4","doi-asserted-by":"publisher","DOI":"10.3389\/FENDO.2018.00589","author":"C Alviggi","year":"2018","unstructured":"Alviggi, C. et al. Understanding ovarian hypo-response to exogenous gonadotropin in ovarian stimulation and its new proposed marker-the follicle-to-oocyte (FOI) index. Front Endocrinol (Lausanne) https:\/\/doi.org\/10.3389\/FENDO.2018.00589 (2018).","journal-title":"Front Endocrinol (Lausanne)"},{"key":"53350_CR5","doi-asserted-by":"publisher","first-page":"148314","DOI":"10.1016\/J.GENE.2024.148314","volume":"909","author":"S Hu","year":"2024","unstructured":"Hu, S., Jing, Y., Fu, Y. & Ye, X. Association of FSHR gene polymorphisms with poor ovarian response in patients undergoing IVF: A systematic review and meta-analysis. Gene 909, 148314. https:\/\/doi.org\/10.1016\/J.GENE.2024.148314 (2024).","journal-title":"Gene"},{"issue":"1","key":"53350_CR6","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1007\/S10815-018-1357-4","volume":"36","author":"M \u010cu\u0161","year":"2019","unstructured":"\u010cu\u0161, M., Vlaisavljevi\u0107, V., Repnik, K., Poto\u010dnik, U. & Kova\u010di\u010d, B. Could polymorphisms of some hormonal receptor genes, involved in folliculogenesis help in predicting patient response to controlled ovarian stimulation?. J. Assist. Reprod. Genet. 36(1), 47\u201355. https:\/\/doi.org\/10.1007\/S10815-018-1357-4 (2019).","journal-title":"J. Assist. Reprod. Genet."},{"issue":"4","key":"53350_CR7","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1016\/J.FERTNSTERT.2013.01.086","volume":"99","author":"A La Marca","year":"2013","unstructured":"La Marca, A. et al. Polymorphisms in gonadotropin and gonadotropin receptor genes as markers of ovarian reserve and response in in vitro fertilization. Fertil. Steril. 99(4), 970\u20138.e1. https:\/\/doi.org\/10.1016\/J.FERTNSTERT.2013.01.086 (2013).","journal-title":"Fertil. Steril."},{"issue":"6","key":"53350_CR8","doi-asserted-by":"publisher","first-page":"1562","DOI":"10.1210\/ENDO-99-6-1562","volume":"99","author":"JS Richards","year":"1976","unstructured":"Richards, J. S. et al. Ovarian follicular development in the rat: Hormone receptor regulation by estradiol, follicle stimulating hormone and luteinizing hormone. Endocrinology 99(6), 1562\u20131570. https:\/\/doi.org\/10.1210\/ENDO-99-6-1562 (1976).","journal-title":"Endocrinology"},{"issue":"20","key":"53350_CR9","doi-asserted-by":"publisher","first-page":"9460","DOI":"10.1073\/PNAS.90.20.9460","volume":"90","author":"Q Hou","year":"1993","unstructured":"Hou, Q. & Gorski, J. Estrogen receptor and progesterone receptor genes are expressed differentially in mouse embryos during preimplantation development. Proc. Natl. Acad. Sci. U. S. A. 90(20), 9460\u20139464. https:\/\/doi.org\/10.1073\/PNAS.90.20.9460 (1993).","journal-title":"Proc. Natl. Acad. Sci. U. S. A."},{"issue":"6","key":"53350_CR10","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1093\/MOLEHR\/5.6.559","volume":"5","author":"S Matsuzaki","year":"1999","unstructured":"Matsuzaki, S. et al. Oestrogen receptor \u03b1 and \u03b2 mRNA expression in human endometrium throughout the menstrual cycle. Mol. Hum. Reprod. 5(6), 559\u2013564. https:\/\/doi.org\/10.1093\/MOLEHR\/5.6.559 (1999).","journal-title":"Mol. Hum. Reprod."},{"issue":"1","key":"53350_CR11","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1210\/ENDO.140.1.6455","volume":"140","author":"T Maruyama","year":"1999","unstructured":"Maruyama, T. et al. Induction of thioredoxin, a redox-active protein, by ovarian steroid hormones during growth and differentiation of endometrial stromal cells in vitro*this work was supported by a grant-in-aid for scientific research Japan. Endocrinology 140(1), 365\u2013372. https:\/\/doi.org\/10.1210\/ENDO.140.1.6455 (1999).","journal-title":"Endocrinology"},{"key":"53350_CR12","doi-asserted-by":"publisher","DOI":"10.3389\/FENDO.2022.839005","author":"P Chen","year":"2022","unstructured":"Chen, P., Li, B. & Ou-Yang, L. Role of estrogen receptors in health and disease. Front Endocrinol (Lausanne) https:\/\/doi.org\/10.3389\/FENDO.2022.839005 (2022).","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"6","key":"53350_CR13","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1042\/EBC20200167","volume":"65","author":"Y Arao","year":"2021","unstructured":"Arao, Y. & Korach, K. S. The physiological role of estrogen receptor functional domains. Essays Biochem. 65(6), 867\u2013875. https:\/\/doi.org\/10.1042\/EBC20200167 (2021).","journal-title":"Essays Biochem."},{"issue":"10","key":"53350_CR14","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.3390\/CELLS8101123","volume":"8","author":"ZR Tang","year":"2019","unstructured":"Tang, Z. R., Zhang, R., Lian, Z. X., Deng, S. L. & Yu, K. Estrogen-receptor expression and function in female reproductive disease. Cells 8(10), 1123. https:\/\/doi.org\/10.3390\/CELLS8101123 (2019).","journal-title":"Cells"},{"key":"53350_CR15","doi-asserted-by":"publisher","first-page":"827032","DOI":"10.3389\/FENDO.2022.827032","volume":"13","author":"XL Xu","year":"2022","unstructured":"Xu, X. L. et al. Estrogen biosynthesis and signal transduction in ovarian disease. Front Endocrinol (Lausanne) 13, 827032. https:\/\/doi.org\/10.3389\/FENDO.2022.827032 (2022).","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"3","key":"53350_CR16","doi-asserted-by":"publisher","first-page":"426","DOI":"10.2174\/138920112799361891","volume":"13","author":"E Anagnostou","year":"2012","unstructured":"Anagnostou, E. et al. ESR1, ESR2 and FSH receptor gene polymorphisms in combination: A useful genetic tool for the prediction of poor responders. Curr. Pharm. Biotechnol. 13(3), 426\u2013434. https:\/\/doi.org\/10.2174\/138920112799361891 (2012).","journal-title":"Curr. Pharm. Biotechnol."},{"issue":"2","key":"53350_CR17","doi-asserted-by":"publisher","first-page":"100499","DOI":"10.1016\/J.REPBIO.2021.100499","volume":"21","author":"I Ahmed","year":"2021","unstructured":"Ahmed, I., Abdelateef, S., Abdel-Lah, M. A. K., Amor, H. & Hammadeh, M. E. Association between FSHR and ESR1 gene variants and ovarian response to gonadotropin in Egyptian women undergoing ICSI treatment. Reprod. Biol. 21(2), 100499. https:\/\/doi.org\/10.1016\/J.REPBIO.2021.100499 (2021).","journal-title":"Reprod. Biol."},{"issue":"4","key":"53350_CR18","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1016\/J.FERTNSTERT.2012.05.048","volume":"98","author":"N M\u2019Rabet","year":"2012","unstructured":"M\u2019Rabet, N. et al. The CC-allele of the PvuII polymorphic variant in intron 1 of the \u03b1-estrogen receptor gene is significantly more prevalent among infertile women at risk of premature ovarian aging. Fertil. Steril. 98(4), 965-972.e5. https:\/\/doi.org\/10.1016\/J.FERTNSTERT.2012.05.048 (2012).","journal-title":"Fertil. Steril."},{"issue":"4","key":"53350_CR19","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1007\/S10815-013-9971-7","volume":"30","author":"E Anagnostou","year":"2013","unstructured":"Anagnostou, E. et al. Do estrogen receptor alpha polymorphisms have any impact on the outcome in an ART program?. J. Assist. Reprod. Genet. 30(4), 555. https:\/\/doi.org\/10.1007\/S10815-013-9971-7 (2013).","journal-title":"J. Assist. Reprod. Genet."},{"key":"53350_CR20","doi-asserted-by":"publisher","DOI":"10.1186\/S13048-014-0114-2","author":"CS De Mattos","year":"2014","unstructured":"De Mattos, C. S. et al. ESR1 and ESR2 gene polymorphisms are associated with human reproduction outcomes in Brazilian women. J. Ovarian Res. https:\/\/doi.org\/10.1186\/S13048-014-0114-2 (2014).","journal-title":"J. Ovarian Res."},{"issue":"3","key":"53350_CR21","doi-asserted-by":"publisher","first-page":"143","DOI":"10.3233\/HAB-180332","volume":"26","author":"T Zamaniara","year":"2017","unstructured":"Zamaniara, T., Taheripanah, R., Ghaderian, S. M. H., Zamaniara, E. & Aghabozorgi, S. S. A. Polymorphism FSHR (-29G\/A) as a genetic agent together with ESRI (XbaIG\/A) in women with poor response to controlled ovarian hyperstimulation. Hum. Antibodies 26(3), 143\u2013147. https:\/\/doi.org\/10.3233\/HAB-180332 (2017).","journal-title":"Hum. Antibodies"},{"issue":"17","key":"53350_CR22","doi-asserted-by":"publisher","first-page":"1889","DOI":"10.3390\/DIAGNOSTICS14171889\/S1","volume":"14","author":"JY Lee","year":"2024","unstructured":"Lee, J. Y. et al. Association of Polymorphisms in FSHR, ESR1, and BMP15 with Primary Ovarian Insufficiency and Meta-Analysis. Diagnostics. 14(17), 1889. https:\/\/doi.org\/10.3390\/DIAGNOSTICS14171889\/S1 (2024).","journal-title":"Diagnostics."},{"issue":"8","key":"53350_CR23","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1007\/S10815-014-0257-5","volume":"31","author":"AD Greene","year":"2014","unstructured":"Greene, A. D., Patounakis, G. & Segars, J. H. Genetic associations with diminished ovarian reserve: A systematic review of the literature. J. Assist. Reprod. Genet. 31(8), 935. https:\/\/doi.org\/10.1007\/S10815-014-0257-5 (2014).","journal-title":"J. Assist. Reprod. Genet."},{"issue":"5","key":"53350_CR24","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1097\/00008571-200405000-00003","volume":"14","author":"F De Castro","year":"2004","unstructured":"De Castro, F. et al. Human controlled ovarian hyperstimulation outcome is a polygenic trait. Pharmacogenetics 14(5), 285\u2013293. https:\/\/doi.org\/10.1097\/00008571-200405000-00003 (2004).","journal-title":"Pharmacogenetics"},{"issue":"1","key":"53350_CR25","doi-asserted-by":"publisher","first-page":"70","DOI":"10.4103\/JHRS.JHRS_2_23","volume":"16","author":"A Udumudi","year":"2023","unstructured":"Udumudi, A., Chaitra Lava, K. & Hegde, V. High-risk genotypes associated with poor response to controlled ovarian stimulation in Indian women. J. Hum. Reprod. Sci. 16(1), 70. https:\/\/doi.org\/10.4103\/JHRS.JHRS_2_23 (2023).","journal-title":"J. Hum. Reprod. Sci."},{"issue":"8","key":"53350_CR26","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1093\/MOLEHR\/GAM035","volume":"13","author":"S Altm\u00e4e","year":"2007","unstructured":"Altm\u00e4e, S. et al. Allelic estrogen receptor 1 (ESR1) gene variants predict the outcome of ovarian stimulation in in vitro fertilization. Mol. Hum. Reprod. 13(8), 521\u2013526. https:\/\/doi.org\/10.1093\/MOLEHR\/GAM035 (2007).","journal-title":"Mol. Hum. Reprod."},{"issue":"6","key":"53350_CR27","doi-asserted-by":"publisher","first-page":"e38700","DOI":"10.1371\/JOURNAL.PONE.0038700","volume":"7","author":"R Boudjenah","year":"2012","unstructured":"Boudjenah, R. et al. Genetic polymorphisms influence the ovarian response to rFSH stimulation in patients undergoing in vitro fertilization programs with ICSI. PLoS ONE 7(6), e38700. https:\/\/doi.org\/10.1371\/JOURNAL.PONE.0038700 (2012).","journal-title":"PLoS ONE"},{"issue":"3","key":"53350_CR28","doi-asserted-by":"publisher","first-page":"121","DOI":"10.3233\/HAB-170329","volume":"26","author":"M Kaviani","year":"2017","unstructured":"Kaviani, M., Ghaderian, S. M. H., Arefi, S., Hashemi, M. & Afjeh, S. S. A. Role of FSHR rs6165 and ESR2 rs4986938 polymorphisms in ovarian stimulation of Iranian women who underwent assisted reproduction treatment. Hum. Antibodies 26(3), 121\u2013126. https:\/\/doi.org\/10.3233\/HAB-170329 (2017).","journal-title":"Hum. Antibodies"},{"issue":"1","key":"53350_CR29","doi-asserted-by":"publisher","first-page":"69","DOI":"10.5653\/CERM.2020.03706","volume":"48","author":"AM Sindiani","year":"2021","unstructured":"Sindiani, A. M. et al. Association of single-nucleotide polymorphisms in the ESR2 and FSHR genes with poor ovarian response in infertile Jordanian women. Clin. Exp. Reprod. Med. 48(1), 69\u201379. https:\/\/doi.org\/10.5653\/CERM.2020.03706 (2021).","journal-title":"Clin. Exp. Reprod. Med."},{"issue":"12","key":"53350_CR30","doi-asserted-by":"publisher","first-page":"1659","DOI":"10.1007\/S10815-017-1013-4","volume":"34","author":"TMK Motawi","year":"2017","unstructured":"Motawi, T. M. K. et al. The role of gene polymorphisms and AMH level in prediction of poor ovarian response in Egyptian women undergoing IVF procedure. J. Assist. Reprod. Genet. 34(12), 1659. https:\/\/doi.org\/10.1007\/S10815-017-1013-4 (2017).","journal-title":"J. Assist. Reprod. Genet."},{"key":"53350_CR31","unstructured":"Genome Aggregation Database (gnomAD)\u2014Registry of Open Data on AWS [Internet]. [cited 2026 Jan 6]. Available from: https:\/\/registry.opendata.aws\/broad-gnomad\/"},{"issue":"3","key":"53350_CR32","first-page":"150","volume":"9","author":"M Mahdavipour","year":"2017","unstructured":"Mahdavipour, M. et al. Polymorphisms in the estrogen receptor beta gene and the risk of unexplained recurrent spontaneous abortion. Avicenna J. Med. Biotechnol. 9(3), 150 (2017).","journal-title":"Avicenna J. Med. Biotechnol."},{"issue":"2","key":"53350_CR33","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1080\/14767058.2020.1717463","volume":"35","author":"Y Ke","year":"2022","unstructured":"Ke, Y., Bin, L., Lin, L. & MingRong, X. ESR1 polymorphisms and risk of preeclampsia. J. Matern. Fetal Neonatal Med. 35(2), 402\u2013409. https:\/\/doi.org\/10.1080\/14767058.2020.1717463 (2022).","journal-title":"J. Matern. Fetal Neonatal Med."},{"issue":"2","key":"53350_CR34","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1007\/S10815-014-0393-Y","volume":"32","author":"M He","year":"2014","unstructured":"He, M., Shu, J., Huang, X. & Tang, H. Association between estrogen receptora gene (ESR1) PvuII (T\/C) and XbaI (A\/G) polymorphisms and premature ovarian failure risk: evidence from a meta-analysis. J. Assist Reprod Genet. 32(2), 297. https:\/\/doi.org\/10.1007\/S10815-014-0393-Y (2014).","journal-title":"J. Assist Reprod Genet."},{"issue":"296","key":"53350_CR35","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/J.EJOGRB.2024.01.008","volume":"1","author":"X Huang","year":"2024","unstructured":"Huang, X., Yin, T., Song, M. & Pan, J. Association of estrogen receptor and progesterone receptor genetic polymorphisms with recurrent pregnancy loss: A systematic review and meta-analysis. Europ. J. Obstetrics Gynecol. Reproduct. Biol. 1(296), 65\u201375. https:\/\/doi.org\/10.1016\/J.EJOGRB.2024.01.008 (2024).","journal-title":"Europ. J. Obstetrics Gynecol. Reproduct. Biol."},{"issue":"16","key":"53350_CR36","doi-asserted-by":"publisher","first-page":"1879","DOI":"10.1161\/01.CIR.0000016173.98826.88","volume":"105","author":"DM Herrington","year":"2002","unstructured":"Herrington, D. M. et al. Common estrogen receptor polymorphism augments effects of hormone replacement therapy on E-selectin but not C-reactive protein. Circulation 105(16), 1879\u20131882. https:\/\/doi.org\/10.1161\/01.CIR.0000016173.98826.88 (2002).","journal-title":"Circulation"},{"issue":"24","key":"53350_CR37","doi-asserted-by":"publisher","first-page":"2969","DOI":"10.1001\/JAMA.291.24.2969","volume":"291","author":"SCE Schuit","year":"2004","unstructured":"Schuit, S. C. E. et al. Estrogen receptor alpha gene polymorphisms and risk of myocardial infarction. JAMA 291(24), 2969\u20132977. https:\/\/doi.org\/10.1001\/JAMA.291.24.2969 (2004).","journal-title":"JAMA"},{"issue":"4","key":"53350_CR38","doi-asserted-by":"publisher","first-page":"149","DOI":"10.3233\/DMA-2009-0625","volume":"26","author":"S Govindan","year":"2009","unstructured":"Govindan, S. et al. Estrogen receptor-alpha gene (T\/C) Pvu II polymorphism in endometriosis and uterine fibroids. Dis Markers. 26(4), 149\u2013154. https:\/\/doi.org\/10.3233\/DMA-2009-0625 (2009).","journal-title":"Dis Markers."},{"issue":"6","key":"53350_CR39","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1093\/MOLEHR\/GAH174","volume":"11","author":"CD Swartz","year":"2005","unstructured":"Swartz, C. D., Afshari, C. A., Yu, L., Hall, K. E. & Dixon, D. Estrogen-induced changes in IGF-I, Myb family and MAP kinase pathway genes in human uterine leiomyoma and normal uterine smooth muscle cell lines. Mol Hum Reprod. 11(6), 441\u2013450. https:\/\/doi.org\/10.1093\/MOLEHR\/GAH174 (2005).","journal-title":"Mol Hum Reprod."},{"issue":"3","key":"53350_CR40","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1291\/hypres.30.205","volume":"30","author":"A Molvarec","year":"2007","unstructured":"Molvarec, A. et al. Association between estrogen receptor (ESR1) gene polymorphisms and severe preeclampsia. Hypertens Res. 30(3), 205\u2013211 (2007).","journal-title":"Hypertens Res."},{"issue":"10","key":"53350_CR41","doi-asserted-by":"publisher","first-page":"e13379","DOI":"10.7717\/PEERJ.13379\/SUPP-1","volume":"10","author":"MP Gallegos-Arreola","year":"2022","unstructured":"Gallegos-Arreola, M. P. et al. ESR2 gene variants (rs1256049, rs4986938, and rs1256030) and their association with breast cancer risk. PeerJ 10(10), e13379. https:\/\/doi.org\/10.7717\/PEERJ.13379\/SUPP-1 (2022).","journal-title":"PeerJ"},{"issue":"6","key":"53350_CR42","doi-asserted-by":"publisher","first-page":"1942","DOI":"10.1016\/J.FERTNSTERT.2008.12.040","volume":"93","author":"JJ Kim","year":"2010","unstructured":"Kim, J. J. et al. Estrogen receptor beta gene +1730 G\/A polymorphism in women with polycystic ovary syndrome. Fertil Steril. 93(6), 1942\u20131947. https:\/\/doi.org\/10.1016\/J.FERTNSTERT.2008.12.040 (2010).","journal-title":"Fertil Steril."},{"issue":"4","key":"53350_CR43","doi-asserted-by":"publisher","first-page":"239","DOI":"10.2174\/187569208786733820","volume":"6","author":"SL Nott","year":"2008","unstructured":"Nott, S. L. et al. Do estrogen receptor \u03b2 polymorphisms play a role in the pharmacogenetics of estrogen signaling?. Curr Pharmacogenomics Person Med. 6(4), 239. https:\/\/doi.org\/10.2174\/187569208786733820 (2008).","journal-title":"Curr Pharmacogenomics Person Med."},{"issue":"9\u201310","key":"53350_CR44","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1007\/S10815-009-9354-2","volume":"26","author":"\u00d6\u00dc Ayvaz","year":"2009","unstructured":"Ayvaz, \u00d6. \u00dc., Ekmek\u00e7i, A., Baltaci, V., \u00d6nen, H. I. & \u00dcnsal, E. Evaluation of in vitro fertilization parameters and estrogen receptor alpha gene polymorphisms for women with unexplained infertility. J. Assist. Reprod. Genet. 26(9\u201310), 503\u2013510. https:\/\/doi.org\/10.1007\/S10815-009-9354-2 (2009).","journal-title":"J. Assist. Reprod. Genet."},{"issue":"1","key":"53350_CR45","doi-asserted-by":"publisher","first-page":"22","DOI":"10.22034\/CAJMPSI.2021.01.04","volume":"1","author":"R Asgari","year":"2021","unstructured":"Asgari, R. Role of ESR1 PvuII T\/C variant in female reproductive process: A review. Central Asian J. Med. Pharmaceutical Sci. Innovat. 1(1), 22\u201327. https:\/\/doi.org\/10.22034\/CAJMPSI.2021.01.04 (2021).","journal-title":"Central Asian J. Med. Pharmaceutical Sci. Innovat."},{"key":"53350_CR46","unstructured":"Al-Gazally, M.E., Al-Jeborry, M.M., Al-Intaki, A.M.A. Association of estrogen receptor 1 RS9340799 polymorphism with intracytoplasmic sperm injection failure in iraqi infertile women [Internet]. [cited 2025 Aug 5]. Available from: www.connectjournals.com\/bca"},{"issue":"1","key":"53350_CR47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1755-8166-7-S1-P61","volume":"7","author":"AK Patnam","year":"2014","unstructured":"Patnam, A. K., Vinu, R., Vijayalakshmi, J., Venkatachalam, P. & Rani, G. U. Association of ESR and FOXP3 gene polymorphisms with outcome of ovarian stimulation in infertile females undergoing IVF. Mol. Cytogenet. 7(1), 1\u20131. https:\/\/doi.org\/10.1186\/1755-8166-7-S1-P61 (2014).","journal-title":"Mol. Cytogenet."},{"issue":"10","key":"53350_CR48","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1177\/1933719118765970","volume":"26","author":"K Kalinderi","year":"2019","unstructured":"Kalinderi, K., Asimakopoulos, B., Nikolettos, N. & Manolopoulos, V. G. Pharmacogenomics in IVF: A new era in the concept of personalized medicine. Reprod. Sci. 26(10), 1313\u20131325. https:\/\/doi.org\/10.1177\/1933719118765970 (2019) (Oct 1;).","journal-title":"Reprod. Sci."},{"issue":"7716","key":"53350_CR49","doi-asserted-by":"publisher","first-page":"b2535","DOI":"10.1136\/BMJ.B2535","volume":"339","author":"D Moher","year":"2009","unstructured":"Moher, D., Liberati, A., Tetzlaff, J. & Altman, D. G. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ 339(7716), b2535. https:\/\/doi.org\/10.1136\/BMJ.B2535 (2009).","journal-title":"BMJ"},{"key":"53350_CR50","doi-asserted-by":"publisher","DOI":"10.1186\/S13643-016-0384-4","author":"M Ouzzani","year":"2016","unstructured":"Ouzzani, M., Hammady, H., Fedorowicz, Z. & Elmagarmid, A. Rayyan\u2014a web and mobile app for systematic reviews. Syst. Rev. https:\/\/doi.org\/10.1186\/S13643-016-0384-4 (2016).","journal-title":"Syst. Rev."},{"key":"53350_CR51","unstructured":"JBI Critical Appraisal Tools|JBI [Internet]. [cited 2025 Dec 13]. Available from: https:\/\/jbi.global\/critical-appraisal-tools"},{"key":"53350_CR52","unstructured":"The Jamovi Project (2025). Jamovi (Version 2.6) [Computer Software]. - References - Scientific Research Publishing [Internet]. [cited 2026 Jan 6]. Available from: https:\/\/www.scirp.org\/reference\/referencespapers?referenceid=4044704"},{"issue":"1","key":"53350_CR53","doi-asserted-by":"publisher","first-page":"101","DOI":"10.2307\/3001666","volume":"10","author":"WG Cochran","year":"1954","unstructured":"Cochran, W. G. The combination of estimates from different experiments. Biometrics 10(1), 101. https:\/\/doi.org\/10.2307\/3001666 (1954).","journal-title":"Biometrics"},{"issue":"3","key":"53350_CR54","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","volume":"7","author":"R DerSimonian","year":"1986","unstructured":"DerSimonian, R. & Laird, N. Meta-analysis in clinical trials. Control. Clin. Trials 7(3), 177\u2013188. https:\/\/doi.org\/10.1016\/0197-2456(86)90046-2 (1986).","journal-title":"Control. Clin. Trials"},{"issue":"21","key":"53350_CR55","doi-asserted-by":"publisher","first-page":"3555","DOI":"10.1093\/BIOINFORMATICS\/BTV402","volume":"31","author":"MJ Machiela","year":"2015","unstructured":"Machiela, M. J. & Chanock, S. J. LDlink: A web-based application for exploring population-specific haplotype structure and linking correlated alleles of possible functional variants. Bioinformatics 31(21), 3555\u20133557. https:\/\/doi.org\/10.1093\/BIOINFORMATICS\/BTV402 (2015) (Nov 1;).","journal-title":"Bioinformatics"},{"key":"53350_CR56","unstructured":"jamovi - open statistical software for the desktop and cloud [Internet]. [cited 2025 Dec 13]. Available from: https:\/\/www.jamovi.org\/"},{"issue":"7109","key":"53350_CR57","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/BMJ.315.7109.629","volume":"315","author":"M Egger","year":"1997","unstructured":"Egger, M., Smith, G. D., Schneider, M. & Minder, C. Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109), 629\u2013634. https:\/\/doi.org\/10.1136\/BMJ.315.7109.629 (1997).","journal-title":"BMJ"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-53350-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-53350-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-53350-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T11:01:51Z","timestamp":1787050911000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-53350-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":57,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["53350"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-53350-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,5]]},"assertion":[{"value":"30 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The review study was exempt from institutional review board approval, as the study did not include any intervention.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"25749"}}