Application of Laparoscopic Endometriosis Fertility Index in Patients with Endometriosis-Associated Fertility

Objective:To investigate the clinical application of laparoscopic endometriosis fertility index (EFI) and its predicting value of fertility outcome in patients with endometriosis-associated infertility.Methods:118 patients with endometriosis-associated infertility who underwent laparoscopic treatment in our hospital were followed up to assess fertility outcome.Meanwhile,EFI scores were obtained during laparoscopic procedure.The clinical data was analyzed retrospectively.Results:The overall postoperative pregnancy rate within 36 months was 46.6%.The postoperative pregnancy rate was 28.8%,14.4% and 3.4% in the first,the second and the third year respectively.There were significant differences among the three groups(P0.05).The postoperative pregnancy rate of patients whose EFI scoring 9～10,5～8 and ≤4 was 76.2%,47.4% and 10.5% respectively.The postoperative pregnancy rate was positively correlated with EFI scoring and ovarian stimulation treatment(P0.01).However,the postoperative pregnancy rate had no correlation with r-AFS staging,EMT categories and GnRH-a treatment (P0.05).Conclusions:EFI is proved to be very valuable in predicting the fertility outcome and in selecting the follow-up treatment in patients with endometriosis-associated infertility after laparoscope surgery.Therefore,comprehensive evaluation of the fertility outcome based on EFI after laparoscopic surgery is preferable in patients of endometriosis-associated infertility.Meanwhile,therapeutic selection should be individualized.To improve the pregnancy rate of patients with endometriosis,long term expectant management is not recommended.