External validation of the Endometriosis Fertility Index in a French population.
OBJECTIVE
To show an external validation of the Endometriosis Fertility Index (EFI) and to observe cumulated pregnancy rates after infertility management combining surgery and assisted reproductive technologies (ART).


METHODS
Observational study from January 2004 to December 2012.


METHODS
Tertiary-care university hospital and ART center.


METHODS
Four hundred twelve infertile and endometriotic patients after laparoscopic surgery.


METHODS
Surgical diagnosis and treatment followed by spontaneous fertility or ART management.


METHODS
Spontaneous pregnancy rates and cumulative (spontaneous and ART) pregnancy rates according to the EFI.


RESULTS
A significant relationship between EFI and spontaneous pregnancy rates was observed at 12 months (P=.001). The least function score and complete removal of endometriotic lesions and pelvic adhesions were significantly associated with spontaneous pregnancy (P=.006). Cumulative pregnancy rate at 18 months was 78.8%. ART benefits for pregnancy rates were higher for patients with poor EFI.


CONCLUSIONS
External validation of the EFI in a French population was demonstrated. Combining surgery for endometriosis and ART led to a 78.8% pregnancy rate at 18 months after surgery.
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France. Electronic address: jeremy.boujenah@gmail.com.
Jeremy
J
Boujenah
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France.
Claire
C
Bonneau
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France.
Jean-Noel
JN
Hugues
Reproductive Biology, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France.
Christophe
C
Sifer
Department of Obstetrics, Gynecology and Reproductive Medecine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bondy, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France.
Christophe
C
Poncelet
D000328:Adult; D001723:Birth Rate / Q000639:trends*; D004311:Double-Blind Method; D004715:Endometriosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D011159:Population Surveillance / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends; D012189:Retrospective Studies
ART; Endometriosis; fertility; index; laparoscopy; pregnancy