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External validation of the Endometriosis Fertility Index in a French population
Jeremy Boujenah1, Claire Bonneau2, Jean-Noel Hugues1
1Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France.
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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