Endometriosis Fertility Index for Predicting Pregnancy after Endometriosis Surgery

Qing Xue, Xin Li, Cheng Zeng, Ying-Fang Zhou, Yingfang Zhou, Hui-Xia Yang, Jing Shang, Huixia Yang, Sai-Nan Zhu, Sainan Zhu
Chinese medical journal · 2017 · vol. 130(16) , pp. 1932 · doi:10.4103/0366-6999.211892 · PMID:28776545 · W2741688972
article OA: gold CC0 ⤵ 24 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study validated the Endometriosis Fertility Index (EFI) as a predictor of spontaneous pregnancy after surgery, identifying the least function score as the most influential factor and recommending IVF-ET for patients with an EFI score ≥5.

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Abstract

BACKGROUND: The endometriosis fertility index (EFI) has a predictive value for pregnancy after surgery. In vitro fertilization and embryo transfer (IVF-ET) is a good treatment to infertility. This study aimed to provide external validation of EFI, assess the factors affecting the ability of EFI to predict cumulative spontaneous pregnancy rates (PRs), and propose reasonable advice for treatment by evaluating the effect of infertility management combining surgery and IVF-ET. METHODS: This retrospective study enrolled 345 endometriosis-related infertile women after laparoscopic surgery from January 2012 to January 2016. Among them, 234 patients tried to conceive naturally and were divided into six groups according to their different EFI scores. Of the 345 patients, 307 with an EFI score ≥5 were divided into non-IVF-ET group (n = 209) and IVE-ET group (n = 98) to compare the cumulative PRs. Cumulative PRs' curves were calculated using the Kaplan-Meier product limit estimate and the differences were evaluated by log-rank test. Independent predictive factors for pregnancy were assessed using the Cox regression model. RESULTS: Significant differences in spontaneous PRs among different EFI scores were identified (χ2=29.945, P< 0.05). The least function score was proved to be the most important factor for EFI (χ2 = 6.931, P< 0.05) staging system. In patients with an EFI score ≥5 after 12 months from surgery, the cumulative PRs of those who received both surgery and IVF-ET were much higher than the spontaneous PRs of those who received surgery alone (χ2=4.160, P= 0.041). CONCLUSIONS: The EFI is a reliable staging system to predict the spontaneous PR of patients. The least function score was the most influential factor to predict the spontaneous PR. Patients with an EFI score ≥5 after 12 months from surgery are recommended to receive IVF-ET to achieve a higher PR.

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Condition tags

mesh:D004715endometriosisinfertility

MeSH descriptors

Endometriosis Infertility, Female Endometriosis Female Humans Infertility, Female Kaplan-Meier Estimate Laparoscopy Laparoscopy Pregnancy Pregnancy Rate Retrospective Studies

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