Does the Endometriosis Fertility Index (EFI) predict the likelihood of spontaneous pregnancy in women with infertility?

This study investigated if the Endometriosis Fertility Index (EFI) can predict if a woman will have a spontaneous pregnancy following endometriosis (EM) treatment. They found that EFI score accurately predicts if a patient will have a spontaneous pregnancy following treatment for EM.

Endometriosis (EM) is a condition where the endometrium (uterus lining) grows outside of the uterus. It causes pain and can lead to infertility. To treat EM, patients may undergo a procedure called laparoscopic surgery (LS; surgery performed through cables with a camera inserted through small cuts in the belly).

After treatment, fertility can improve and some patients can become pregnant. This is not true for all patients. It is important to try to predict if a patient will see an improvement in fertility. The Endometriosis Fertility Index (EFI) measures fertility in women with EM. Evidence suggests that EFI scores can predict if a patient will have a spontaneous pregnancy after LS for EM. However, what is the value of EFI that can best predict if a woman will become pregnant remains under investigation.

This study included the records of 1097 patients with EM that underwent LS. They analyzed EFI scores and the number of spontaneous pregnancies. The cut-off EFI point for predicting pregnancy success was calculated. Patients were followed-up for 3 years.

Patients with higher EFI scores had higher pregnancy rates. At the end of 3 years, women with an EFI score of 10 had a 71.31% pregnancy change. Women with an EFI score of 9 had a 52.47% chance and those with an EFI of 8 had a 49.58% chance of getting pregnant. An EFI score of 7.5 was the cut-off point for predicting pregnancy.

The authors concluded that the EFI score can predict if a patient will have a spontaneous pregnancy following surgery for endometriosis.

This study was looked back in time and analyzed records. This means that the surgical procedure and management of EM varied. A randomized controlled trial is needed to confirm these results.

If you have any concerns regarding endometriosis and infertility, please consult with your doctor.