Can staging systems for endometriosis based on anatomic location and lesion type predict pregnancy rates?
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This retrospective study found that neither individual anatomic sites nor lesion types in endometriosis were sufficient on their own to predict pregnancy rates in infertile women.
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Abstract
OBJECTIVE: Development of an endometriosis classification system based on empirically derived stages of the disease, to supplant the Acosta (1973), Kistner (1977), and American Fertility Society (1985) classifications, which are based on arbitrarily defined stages and often fail to predict pregnancy rates. DESIGN: Retrospective cohort analysis. SETTING: University infertility clinic. PATIENTS AND METHODS: Women with endometriosis and > or = 1 year of infertility. Diagnosis of endometriosis was made by direct visualization, with type of lesion (implant or adhesion) at multiple sites recorded; total of 202 patients. All diagnosed infertility problems were treated based on semen analysis, postcoital test, and endometrial biopsy. Pregnancy rates were analyzed by life-table and cluster analyses, and combinations of site and type were also analyzed by Cox's regression model. RESULTS: No individual anatomic site or type significantly affected prognosis, nor was any cluster useful for predicting outcome. CONCLUSION: Anatomic site and type of lesion are insufficient for predicting fertility when used as sole components of a clinical staging system for endometriosis.
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Cited by (19)
- The Impact of Laparoscopic Surgery on Fertility Outcomes in Patients with Minimal/Mild Endometriosis 2024
- The Impact of Laparoscopic Surgery on Fertility Outcomes in Patients with Minimal/Mild Endometriosis 2024
- Outcomes between non-IVF and IVF treatment after laparoscopic conservative surgery of advanced endometriosis with Endometriosis Fertility Index score >3 2022
- Estimation of the Endometriosis Fertility Index prior to operative laparoscopy 2020
- A New Hypothesis for Endometriosis: To Change the Classification and Consider A New Concept of its Origin 2019
- Reproducibility of the Endometriosis Fertility Index: a prospective inter‐/intra‐rater agreement study 2019
- It Is Necessary to Purpose an Add-on to the American Classification of Endometriosis? This Disease Can Be Compared to a Malignant Proliferation While Remaining Benign in Most Cases. EndoGram® Is a New Profile Witness of Its Evolutionary Potential 2019
- Fertility performance and the predictive value of the endometriosis fertility index staging system in women with recurrent endometriosis 2019
- Use of the Endometriosis Fertility Index to Predict Natural Pregnancy after Endometriosis Surgery: A Single-Center Study 2018
- Receptor status of endometrioid heterotopias as the indication for hormonal therapy of nodular and diffuse forms of adenomyosis 2015
- Development of peritoneal endometriosis: Characterisation of immune environment in peritoneal endometriotic lesions 2015
- External validation of the Endometriosis Fertility Index in a French population 2015
- Endometriosis: Disease Classification and Behavior 2011
- Negotiating science and experience in medical knowledge: Gynaecologists on endometriosis 2009
- Surgery for endometriosis-associated infertility: a pragmatic approach 2008
- Reproductive performance, pain recurrence and disease relapse after conservative surgical treatment for endometriosis: the predictive value of the current classification system 2006
- Endometriosis 2000
- Outcome of IVF in Patients with Endometriosis in Comparison with Tubal-Factor Infertility 1998
- Prediction of pregnancy in infertile women based on the American Society for Reproductive Medicine's revised classification of endometriosis 1997
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