In a nutshell
This article explored whether the Endometriosis Fertility Index is accurate at predicting the chances of conceiving after endometriosis treatment.
Endometriosis involves the appearance of endometrial tissue (usually found in the uterus) outside the uterus, leading to pelvic pain. It is often associated with infertility.
Laparoscopic surgery is a minimally invasive surgery carried out to treat endometriosis by ablation (removing tissue formed in the incorrect place).
The Endometriosis Fertility Index (EFI) is a tooll used to predict fertility after surgery. This score includes the age, length of infertility and previous pregnancies of the patient, as well as surgical factors (including the type of endometrial tissue found and the result of the surgery on the ovaries). It is based on a scale of 0-10. Those scoring higher are thought to be more likely to become pregnant. The accuracy of the EFI is still being measured.
Methods & findings
The current study measured the accuracy of the EFI, as well as explored predictive factors for successful pregnancies. The records of 392 females were examined in this study. All patients had laparoscopic surgery to treat endometriosis. The EFI was calculated for each patient, based on their medical records.
Patients who were over the age of 40 or who had a low number of eggs in their ovaries were directly referred to artificial reproductive technology (ART) treatments such as in vitro fertilization (when a male sperm fertilizing the females’ egg in a laboratory dish outside the body, and is implanted into the woman's uterus). Other patients were encouraged to try and conceive without ART for 12 months. Patients who did not begin a pregnancy after 12 months were referred to ART.
After surgery, 146 couples conceived without ART. 164 conceived with ART.
Patients with high EFI had higher non-ART pregnancy rates compared with patients with low EFI. Complete removal of endometriotic tissue was associated with higher non-ART pregnancy rates (43.5%) compared to incomplete removeal (22.4%).
Pregnancy rates in patients receiving surgery and ART were 83% in those under 38 years of age. In those aged 38 years and above it was 53.2%.
The bottom line
This study concluded that the EFI score is a good predictor of the chances of becoming pregnant after treatment for endometriosis. It can help determine whether spontaneous conception or ART should be recommended.
The fine print
This study focused on pregnancy rates after treatment, not the number of live births.
Talk to your physician if you would like more information on conceiving with endometriosis.
Published By :
Fertility and Sterility
Apr 29, 2015