Prediction of Endometriosis Fertility Index in patients with endometriosis-associated infertility after laparoscopic treatment

The effect of endometriosis on fecundity is unclear. Although surgery plays a vital role in the treatment of related infertility, pregnancy outcomes after laparoscopy are poorly correlated with the currently used staging system. To address this, the Endometriosis Fertility Index (EFI) was developed. This retrospective study was designed to assess the predictive value of the EFI for patients with endometriosis-associated infertility. A total of 1325 patients with endometriosis-associated infertility were eligible for inclusion, 1097 of whom were successfully interviewed and 228 lost to follow-up (17.21%). Cumulative pregnancy incidence (CPI) according to EFI scores were calculated by life table and by Kaplan-Meier survival curve analyses. The log-rank test was used to evaluate difference between the EFI groups. Receiver operating characteristic curves were plotted to obtain the optimal cut-off point for pregnancy prediction. A total of 505 (46.03%) patients conceived naturally. The difference in CPI among EFI scores 10, 7-9, 4-6, and 2-3 was statistically significant (P < 0.001) and increased with increasing EFI score. The optimal cut-off point was 7.5: sensitivity (68.51%); specificity (52.20%). This retrospective study indicates the value of the EFI score for predicting spontaneous pregnancy in women treated by laparoscopy for endometriosis-associated infertility.