title: Reproductive performance after surgery for endometriosis: predictive value of the revised American Fertility Society classification and the endometriosis fertility index.
abstract: OBJECTIVE
  To determine whether the revised American Fertility Society (rAFS) classification and endometriosis fertility index (EFI) predict pregnancy rates (PRs) in patients with surgically confirmed endometriosis attempting natural conception.
  
  
  METHODS
  We retrospectively assessed 194 women with endometriosis who underwent laparoscopic surgery; 161 women completed the follow-up. Pregnancy outcomes, rAFS stages and EFI scores were documented. Cumulative PRs were compared using Kaplan-Meier survival analysis.
  
  
  RESULTS
  The cumulative PR 36 months after surgery was 46.6% (stage I, 53.6%; stage II, 36.0%; stage III, 51.7%, and stage IV, 41.7%; log-rank test, χ(2) = 4.143, p = 0.246). In the 1st year, PRs significantly differed between patients with rAFS stage IV and those with stages I-III (Pearson's χ(2) test, χ(2) = 6.024, p = 0.014). Significant differences in cumulative PRs were observed among EFI scores (group 1, EFI score 0-3, 8.3%; group 2, EFI score 4-7 41.2%, and group 3, EFI score 8-10 60.9%; log-rank test, χ(2) = 16.254, p < 0.001).
  
  
  CONCLUSIONS
  EFI scores, but not rAFS stage, predict PRs in patients with endometriosis-associated infertility. EFI scores may be used to guide postoperative treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, PR China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Zeng
authors.forename: Jia-ning
authors.initials: JN
authors.lastname: Xu
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhou
authors.forename: Ying-fang
authors.initials: YF
authors.lastname: Zhou
authors.forename: Sai-nan
authors.initials: SN
authors.lastname: Zhu
authors.forename: Qing
authors.initials: Q
authors.lastname: Xue
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000145:classification* / Q000150:complications / Q000601:surgery*; D005260:Female; D005298:Fertility; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D010535:Laparoscopy; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult