Predictive Value of the Endometriosis Fertility Index for Post-Surgical Conception: A Single-Center Experience from Yaounde, Cameroon

Isidore Tompeen et al.
2026 · doi:10.5281/zenodo.18078095 · W7117986828
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This Central African study validated the Endometriosis Fertility Index (EFI) for post-surgical conception, finding that surgical pelvic function, not patient history, was the primary predictor.

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This single-center study from Yaoundé, Cameroon evaluated the predictive value of the endometriosis fertility index (EFI) for post-surgical conception among 30 women with endometriosis undergoing surgery, using historical factors and surgical findings to estimate fertility outcomes. The authors reported a 23.3% post-surgical conception rate despite 53.5% of participants having severe disease, and found that the EFI significantly predicted conception (p=0.004). In multivariable analysis, the surgical Least Function Score was the only independent predictor of conception (HR=0.540, p=0.035), while age and infertility history were not, with the main limitation being the small sample size and single-center design. This paper is centrally about endometriosis — it evaluates whether the endometriosis fertility index, particularly the surgical least function score, predicts conception after surgery in a Central African cohort.

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Abstract

What is known. The endometriosis fertility index (EFI) predicts spontaneous pregnancy after endometriosis surgery. It integrates historical factors (age, infertility duration) and surgical findings (disease severity, pelvic function). The problem addressed. The EFI's validity is unproven in Central Africa, where diagnostic delay leads to advanced endometriosis. It is unclear which index components retain predictive power in this high-severity context. What this study adds to our knowledge. This first Central African evaluation of 30 women found a 23.3% post-surgical conception rate. Despite 53.5% having severe disease, the EFI significantly predicted conception (p=0.004). Crucially, the surgical Least Function Score was the sole independent predictor (HR=0.540, p=0.035), whereas patient age and infertility history were not. How this is relevant to clinical practice or further research. The results validate the EFI's use in this setting. They shift clinical focus toward optimizing surgical quality to maximize pelvic anatomical function, as this outweighs the negative prognosis of long-standing infertility. This supports targeted investment in advanced laparoscopic training to improve fertility outcomes. This publication is available in full in Health Sciences and Disease.
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Predictive Value of the Endometriosis Fertility Index for Post-Surgical Conception: A Single-Center Experience from Yaounde, Cameroon Authors/Creators - 1. Department of Gynecology and Obstetrics, Yaoundé Gyneco-Obstetric and Pediatric Hospital, Yaoundé, Cameroon - 2. Department of Gynecology and Obstetrics, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon Description What is known. The endometriosis fertility index (EFI) predicts spontaneous pregnancy after endometriosis surgery. It integrates historical factors (age, infertility duration) and surgical findings (disease severity, pelvic function). The problem addressed. The EFI's validity is unproven in Central Africa, where diagnostic delay leads to advanced endometriosis. It is unclear which index components retain predictive power in this high-severity context. What this study adds to our knowledge. This first Central African evaluation of 30 women found a 23.3% post-surgical conception rate. Despite 53.5% having severe disease, the EFI significantly predicted conception (p=0.004). Crucially, the surgical Least Function Score was the sole independent predictor (HR=0.540, p=0.035), whereas patient age and infertility history were not. How this is relevant to clinical practice or further research. The results validate the EFI's use in this setting. They shift clinical focus toward optimizing surgical quality to maximize pelvic anatomical function, as this outweighs the negative prognosis of long-standing infertility. This supports targeted investment in advanced laparoscopic training to improve fertility outcomes. This publication is available in full in Health Sciences and Disease. Files 007 AO+TOMPEEN+PERFORMANCE+Formate.pdf Files (650.5 kB) | Name | Size | Download all | |---|---|---| | md5:3092103313db976811094ca012ac0d75 | 650.5 kB | Preview Download |

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