Reproductive Performance after Surgery for Endometriosis: Predictive Value of the Revised American Fertility Society Classification and the Endometriosis Fertility Index
Reproductive Performance after Surgery for Endometriosis: Predictive Value of the Revised American Fertility Society Classification and the Endometriosis Fertility Index
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子宫内膜异位症手术后的生殖性能：修订后的美国生育协会分类和子宫内膜异位症生育指数的预测价值
DOI：
10.1159/000358390
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发表时间：
2014-01-01
影响因子：
2.1
通讯作者：
Xue, Qing
中科院分区：
文献类型：
--
作者：
Zeng, Cheng;Xu, Jia-ning;Xue, Qing
背景/目标：确定修订后的美国生育协会（rAFS）分类和子宫内膜异位症生育指数（ER）是否可预测手术证实的子宫内膜异位症患者尝试自然受孕的妊娠率（PR）。方法：我们回顾性评估了194例接受腹腔镜手术的子宫内膜异位症患者，其中161例完成了随访。记录妊娠结局、rAFS分期和rAFS评分。使用Kaplan-Meier生存分析比较累积PR。结果如下：术后36个月的累积PR为46.6%（I期，53.6%; II期，36.0%; III期，51.7%; IV期，41.7%;对数秩检验，χ2 = 4.143，p = 0.246）。在第1年，rAFS IV期患者和I-III期患者的PR显著不同（Pearson χ2检验，χ2 = 6.024，p = 0.014）。观察到不同的PR评分之间的累积PR差异有统计学意义（第1组，PR评分0-3，8.3%;第2组，PR评分4-7，41.2%;第3组，PR评分8-10，60.9%;对数秩检验，χ2 = 16.254，p < 0.001）。结论：rAFS评分，而不是rAFS分期，可预测子宫内膜异位症相关不孕患者的PR。可使用手术评分来指导术后治疗。
Background/Aims: 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, χ2 = 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 χ2 test, χ2 = 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, χ2 = 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.