Use of the Endometriosis Fertility Index to Predict Natural Pregnancy after Endometriosis Surgery: A Single-Center Study

Jeong Sook Kim, Jeong Sook Kim, Chung Won Lee, Jisun Yun, Jae Hoon Lee, Bo Hyon Yun, Bo Hyun Yun, Joo Hyun Park, Seok Kyo Seo, SiHyun Cho, Young Sik Choi, Byung Seok Lee
Gynecologic and obstetric investigation · 2018 · vol. 84(1) , pp. 86–93 · doi:10.1159/000493264 · PMID:30235446 · W2890798459
article OA: green CC0 ⤵ 12 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This study found that the Endometriosis Fertility Index (EFI) significantly predicted natural pregnancy after endometriosis surgery, with an EFI cut-point of 6 maximizing outcomes, unlike the revised American Fertility Society stage.

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Abstract

AIMS: Our objective was to predict natural pregnancy after endometriosis surgery using the endometriosis fertility index (EFI). METHODS: A retrospective medical records review was conducted, examining patients surgically treated for endometriosis at a single center in Korea between January 2009 and February 2015. In total, 68 women attempting natural conception were analyzed by assessing age, preoperative serum CA-125, body mass index, revised American Fertility Society (rAFS) stage, EFI, and pregnancy outcome. Kaplan-Meier estimates and log-rank tests were used to generate cumulative natural pregnancy rate curves based on an EFI cut-point. A receiver-operating characteristic (ROC) curve was plotted for EFI. RESULTS: Seventy-seven patients attempted conceptions, resulting in 33 natural and 9 assisted conceptions. Excluding assisted conceptions, the mean EFI scores of 68 women who were not pregnant and pregnant were 5.43 ± 0.36 and 6.88 ± 0.28 respectively. The relation between EFI and natural pregnancy was significant (cumulative overall pregnancy rate, p = 0.006), whereas rAFS stage was not (univariate logistics, p = 0.853). The cut-point for maximum natural pregnancy outcomes was 6 (area under ROC curve = 0.710, 95% CI 0.586-0.835). CONCLUSION: The EFI is a reliable staging system for predicting natural pregnancy after endometriosis surgery. EFI scores can be used to guide postoperative treatment of women with endometriosis.

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Condition tags

mesh:D004715endometriosis

MeSH descriptors

Endometriosis Fertility Infertility, Female Pregnancy Rate Adult Body Mass Index CA-125 Antigen CA-125 Antigen Endometriosis Endometriosis Female Humans Infertility, Female Infertility, Female Kaplan-Meier Estimate Postoperative Period Pregnancy Pregnancy Outcome Retrospective Studies ROC Curve

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