In a nutshell
This study looked at whether the Endometriosis Fertility Index (EFI) can predict pregnancy. This study found that EFI is a good predictor of natural pregnancy in women with endometriosis.
Some background
Endometriosis (EM) is a disease where cells from the womb lining form lesions outside of the womb. It is a common cause of infertility. The lesions grow on the ovaries and the fallopian tubes (which lead from the ovaries to the womb).
The Endometriosis Fertility Index (EFI) is an estimate of fertility. It includes factors such as a woman’s age, history of surgeries, and location of lesions. EFI scores range from 1 to 10, with 10 being the highest likelihood of pregnancy. It is unclear how well EFI scores predict natural pregnancy in women with EM.
Methods & findings
This study looked at the results of 17 studies. These studies included 4958 women with EM. All patients had previous surgery to treat EM. Patients were followed for an average of 36 months.
8 studies (3199 patients) reported pregnancy rates without infertility treatments (natural pregnancy).
At follow-up, significantly more women with higher EFI scores became pregnant compared to women with lower scores. 10% to 18% of women with scores 0-4 became pregnant. 44% to 55% of women with scores 5-8 became pregnant. Among women with the highest score of 9-10, 69% became pregnant.
8 other studies (2082 patients) looked at how well EFI scores can predict pregnancy in women who have EM. These studies found that EFI correctly predicted pregnancy 72% of the time.
The bottom line
This study found that EFI is a good predictor of natural pregnancy in women who have EM. The authors suggest that patients with an EFI score 6 and above pursue natural conception. They suggest that patients with lower scores pursue assisted reproductive technologies.
The fine print
Only 27.77% of studies considered other factors that may affect pregnancy besides EFI. The studies were also different from each other, which makes it difficult to compare them. More studies are needed to confirm these results.
What’s next?
If you have had surgery for endometriosis, talk to your doctor about EFI scores.
Published By :
BJOG : an international journal of obstetrics and gynaecology
Date :
Jan 22, 2020
