External validation of the Endometriosis Fertility Index in a French population

Fertil Steril. 2015 Jul;104(1):119-23.e1. doi: 10.1016/j.fertnstert.2015.03.028. Epub 2015 Apr 29.

Abstract

Objective: To show an external validation of the Endometriosis Fertility Index (EFI) and to observe cumulated pregnancy rates after infertility management combining surgery and assisted reproductive technologies (ART).

Design: Observational study from January 2004 to December 2012.

Setting: Tertiary-care university hospital and ART center.

Patient(s): Four hundred twelve infertile and endometriotic patients after laparoscopic surgery.

Intervention(s): Surgical diagnosis and treatment followed by spontaneous fertility or ART management.

Main outcome measure(s): Spontaneous pregnancy rates and cumulative (spontaneous and ART) pregnancy rates according to the EFI.

Result(s): A significant relationship between EFI and spontaneous pregnancy rates was observed at 12 months (P=.001). The least function score and complete removal of endometriotic lesions and pelvic adhesions were significantly associated with spontaneous pregnancy (P=.006). Cumulative pregnancy rate at 18 months was 78.8%. ART benefits for pregnancy rates were higher for patients with poor EFI.

Conclusion(s): External validation of the EFI in a French population was demonstrated. Combining surgery for endometriosis and ART led to a 78.8% pregnancy rate at 18 months after surgery.

Keywords: ART; Endometriosis; fertility; index; laparoscopy; pregnancy.

Publication types

  • Observational Study
  • Validation Study

MeSH terms

  • Adult
  • Birth Rate / trends*
  • Double-Blind Method
  • Endometriosis / diagnosis*
  • Endometriosis / epidemiology*
  • Endometriosis / surgery
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Humans
  • Infertility, Female / diagnosis*
  • Infertility, Female / epidemiology*
  • Infertility, Female / surgery
  • Population Surveillance* / methods
  • Pregnancy
  • Pregnancy Rate / trends
  • Retrospective Studies