Endometriosis fertility index predicts pregnancy in women operated on for moderate and severe symptomatic endometriosis

Daisy Martins Rodrigues, Rodrigues DM, Ivete de Ávila, de Ávila I, Amorim LVC, Leci Veiga Caetano Amorim, Márcia Mendonça Carneiro, Márcia Cristina França Ferreira, Ferreira MCF
Women & health · 2021 · vol. 62(1) , pp. 3–11 · doi:10.1080/03630242.2021.1986458 · PMID:34852729 · W3215997071
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The Endometriosis Fertility Index (EFI) was evaluated and found to predict pregnancy outcomes in Brazilian women with moderate to severe endometriosis after surgical treatment, correlating with both natural conception and IVF success.

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Abstract

Endometriosis Fertility Index (EFI) is a clinical staging system created to predict spontaneous pregnancy outcomes in patients with endometriosis. The present study aimed at evaluating the performance of EFI in symptomatic patients, submitted to laparoscopy for moderate and severe endometriosis associated to infertility in a Brazilian population. Seventy-seven women with endometriosis and pelvic pain, who desired to become pregnant, were selected from a tertiary care unit between those operated on between May 2007 and March 2017. All of them were submitted to laparoscopy for the surgical treatment of endometriosis and allowed to attempt natural conception for 36 months or immediately referred to in vitro fertilization (IVF). EFI was calculated according to surgical description and clinical information in medical records. Pregnancy rates and live birth rates after natural conception or IVF are reported and correlated to EFI. Fifty-three women tried natural conception and 24 were referred to IVF. Of the 53 who tried natural conception, 29 achieved pregnancy (54.7%) and 28 had live birth (52.8%). The majority of pregnancies (82.7%) occurred in the first 12 months after surgery and 75% of the patients who became spontaneously pregnant had EFI ≥ 7. Of the 24 patients referred to IVF, 13 became pregnant (54.1%) and 10 had live birth (41.7%). Infertility duration of 36 months or more and the presence of endometrioma increased the probability of having EFI ≤ 5. The overall live birth rate (LBR) for patients with low EFI scores (2-4) was 17% compared with 83.8% for those with higher EFI scores (6-9). EFI predicts pregnancy rates in patients operated on for moderate and severe endometriosis. Scores seem also to predict pregnancy rates after IVF.

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Condition tags

endometriosisendometriomainfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Infertility, Female Infertility, Female Infertility, Female Infertility, Female Female Fertility Humans Pregnancy Pregnancy Outcome Pregnancy Outcome Pregnancy Rate Retrospective Studies

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