External Validation of the Endometriosis Fertility Index (EFI) for Predicting Spontaneous Pregnancy after Surgery: Further Considerations on Its Validity

Elisabetta Garavaglia, Luca Pagliardini, Iacopo Tandoi, Cristina Sigismondi, Paola Viganò, Stefano Ferrari, Massimo Candiani

Obstetrics and Gynecology Unit and Vita-Salute University, Milano, San Raffaele Scientific Institute, Milano , Italy

Gynecol Obstet Invest DOI: 10.1159/000366443 - Received: May 13, 2014 Accepted after revision: August 6, 2014

"External Validation of the Endometriosis Fertility Index (EFI) for Predicting Spontaneous Pregnancy after Surgery: Further Considerations on Its Validity"

Abstract
Background/Aims: The revised American Society for Reproductive Medicine classification of endometriosis has a limited predictive value for pregnancy after surgery. 
A tool for predicting spontaneous pregnancy or pregnancy following assisted reproduction technology (ART) represents a clinical need. 
This study aimed to (i) provide an external validation of the EFI score in predicting pregnancy in infertile Italian endometriosis women; (ii) evaluate the predictive value of EFI score on ART outcome for patients who previously attempted to spontaneously conceive after surgery.
Methods:
In 104 women with endometriosis, EFI score was calculated based on a prospective database data. Cumulative pregnancy rates curves were calculated using Kaplan-Meier (K-M) product limit estimate and log-rank test was used to evaluate differences between EFI groups.
A receiver operating characteristic (ROC) curve was plotted for EFI as a predictor of ART outcome.
Results: Differences in time to non-ART pregnancy for the six EFI groups were statistically significant (log-rank, p = 1.4 × 10 –4 ).
The area under the curve (AUC) for EFI as ART outcome predictor was 0.75 (95% CI 0.61–0.89, p = 6.2 × 10 –3 ), while the best cut-point for pregnancy was 5.5.
Conclusion: The EFI score is a reliable scoring system to predict non-ART and ART pregnancy outcome after surgery for endometriosis.
© 2015 S. Karger AG, Basel

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https://www.ncbi.nlm.nih.gov

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