External validation of the Endometriosis Fertility Index in a French population

Capsule:
The Endometriosis Fertility Index (EFI) predicted spontaneous pregnancy after surgery for endometriotic infertile women. Combining surgery and assisted reproductive technologies according to EFI led to a 78% pregnancy rate at 18 months.

Authors:
Jeremy Boujenah, M.D., Claire Bonneau, M.D., Jean-Noel Hugues, M.D., Ph.D., Christophe Sifer, M.D., Christophe Poncelet, M.D., Ph.D.

Volume 104, Issue 1, Pages 119–123

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.

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