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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 5/2021

01-05-2021 | Fertility | Gynecologic Endocrinology and Reproductive Medicine

Modified endometriosis fertility index is more accurate to predict the non-ART pregnancy rate following surgery: a cohort of Chinese women

Authors: Jiaying Fan, Kang Qin, Kuanrong Li, Xiaojun Li, Qingsheng Huang, Yunsheng Liao, Huiying Liang, Jingying Xie, Yan Yang, Qingfeng Li

Published in: Archives of Gynecology and Obstetrics | Issue 5/2021

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Abstract

Objective

To examine whether a modified endometriosis fertility index (EFI) can better predict the rate of pregnancy without assisted reproductive technologies (ART) after laparoscopic surgery in infertile Chinese women with endometriosis.

Methods

564 infertile women undergoing laparoscopy for endometriosis were retrospectively collected from January 2014 to December 2018. 472 patients were used to modify the EFI based on new, optimal cutoffs for its predictor variables. The predictive accuracy of the modified EFI was examined in the other 92 patients.

Results

Among the patients for the EFI modification, the multivariable Cox regression results showed that historical factors made more contribution in predicting non-ART pregnancy rate than surgical factors both in modified EFI (C-index: historical factors 0.617 vs surgical factors 0.558) and original EFI (C-index: historical factors 0.600 vs surgical factors 0.549). No significant relationship between the prior pregnancy and post-operative non-ART pregnancy rates was detected by both modified EFI and original EFI (p = 0.530 and 0.802, respectively). To assess the predictive effect of modified EFI, the two versions of modified EFI not only had higher predictive accuracy (C-index: 0.627 and 0.632) for non-ART pregnancy rates than that of the original EFI (C-index: 0.602) in the patients undergoing surgery during 2014–2017, but also higher than that of the original EFI (C-index: 0.638 and 0.612 vs 0.560) in the externally validated population in 2018.

Conclusions

A modified EFI based on population-specific optimal cutoffs and weights might be more suitable for estimating the rate of non-ART pregnancy after laparoscopic surgery in infertile women with endometriosis.
Appendix
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Metadata
Title
Modified endometriosis fertility index is more accurate to predict the non-ART pregnancy rate following surgery: a cohort of Chinese women
Authors
Jiaying Fan
Kang Qin
Kuanrong Li
Xiaojun Li
Qingsheng Huang
Yunsheng Liao
Huiying Liang
Jingying Xie
Yan Yang
Qingfeng Li
Publication date
01-05-2021
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 5/2021
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-020-05871-1

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