Garavaglia Elisabetta, Pagliardini Luca, Tandoi Iacopo, Sigismondi Cristina, Viganò Paola, Ferrari Stefano, Candiani Massimo
Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy.
Gynecol Obstet Invest. 2015;79(2):113-8. doi: 10.1159/000366443. Epub 2015 Jan 27.
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.
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.
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.
The EFI score is a reliable scoring system to predict non-ART and ART pregnancy outcome after surgery for endometriosis.
背景/目的：美国生殖医学学会修订的子宫内膜异位症分类对手术后的妊娠预测价值有限。一种预测自然妊娠或辅助生殖技术（ART）后妊娠的工具是一种临床需求。本研究旨在：（i）对EFI评分在预测意大利子宫内膜异位症不孕女性妊娠方面进行外部验证；（ii）评估EFI评分对术后曾尝试自然受孕患者ART结局的预测价值。
在104例子宫内膜异位症女性中，基于前瞻性数据库数据计算EFI评分。使用Kaplan-Meier（K-M）乘积限估计计算累积妊娠率曲线，并使用对数秩检验评估EFI组之间的差异。绘制EFI作为ART结局预测指标的受试者工作特征（ROC）曲线。
六个EFI组非ART妊娠时间的差异具有统计学意义（对数秩检验，p = 1.4×10⁻⁴）。EFI作为ART结局预测指标的曲线下面积（AUC）为0.75（95%CI 0.61 - 0.89，p = 6.2×10⁻³），而妊娠的最佳切点为5.5。
EFI评分是预测子宫内膜异位症手术后非ART和ART妊娠结局的可靠评分系统。
