Reproductive Performance after Surgery for Endometriosis: Predictive Value of the Revised American Fertility Society Classification and the Endometriosis Fertility Index

Cheng Zeng, Jia-ning Xu, Jianing Xu, Yan Zhou, Yingfang Zhou, Ying-fang Zhou, Sai-nan Zhu, Sainan Zhu, Qing Xue
Gynecologic and obstetric investigation · 2014 · vol. 77(3) , pp. 180–185 · doi:10.1159/000358390 · PMID:24603632 · W2070307026
article OA: closed CC0 ⤵ 45 in-corpus citations
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The endometriosis fertility index, but not the revised American Fertility Society classification, significantly predicted pregnancy rates in women with surgically treated endometriosis attempting natural conception.

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Abstract

Background/Aims: To determine whether the revised American Fertility Society (rAFS) classification and endometriosis fertility index (EFI) predict pregnancy rates (PRs) in patients with surgically confirmed endometriosis attempting natural conception. Methods: We retrospectively assessed 194 women with endometriosis who underwent laparoscopic surgery; 161 women completed the follow-up. Pregnancy outcomes, rAFS stages and EFI scores were documented. Cumulative PRs were compared using Kaplan-Meier survival analysis. Results: The cumulative PR 36 months after surgery was 46.6% (stage I, 53.6%; stage II, 36.0%; stage III, 51.7%, and stage IV, 41.7%; log-rank test, &#x03C7;2 = 4.143, p = 0.246). In the 1st year, PRs significantly differed between patients with rAFS stage IV and those with stages I-III (Pearson's &#x03C7;2 test, &#x03C7;2 = 6.024, p = 0.014). Significant differences in cumulative PRs were observed among EFI scores (group 1, EFI score 0-3, 8.3%; group 2, EFI score 4-7 41.2%, and group 3, EFI score 8-10 60.9%; log-rank test, &#x03C7;2 = 16.254, p < 0.001). Conclusions: EFI scores, but not rAFS stage, predict PRs in patients with endometriosis-associated infertility. EFI scores may be used to guide postoperative treatment.

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Condition tags

mesh:D004715endometriosisinfertility

MeSH descriptors

Endometriosis Endometriosis Fertility Infertility, Female Adult Endometriosis Endometriosis Female Humans Infertility, Female Laparoscopy Predictive Value of Tests Pregnancy Pregnancy Rate Retrospective Studies Severity of Illness Index Treatment Outcome Young Adult

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