External Validation of the Endometriosis Fertility Index (EFI) for Predicting Spontaneous Pregnancy after Surgery: Further Considerations on Its Validity
External Validation of the Endometriosis Fertility Index (EFI) for Predicting Spontaneous Pregnancy after Surgery: Further Considerations on Its Validity
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DOI：
10.1159/000366443
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发表时间：
2015-01-01
影响因子：
2.1
通讯作者：
Candiani, Massimo
中科院分区：
文献类型：
--
作者：
Garavaglia, Elisabetta;Pagliardini, Luca;Candiani, Massimo
背景/目的：修订后的美国生殖医学会子宫内膜异位症分类对术后妊娠的预测价值有限。一种用于预测自然妊娠或辅助生殖技术（ART）后妊娠的工具代表了临床需求。本研究的目的是（i）提供一个外部验证的预测不孕的意大利子宫内膜异位症妇女怀孕的评分;（ii）评价ART结果的预测价值的评分，以前试图在手术后自发怀孕的患者。方法：在104例子宫内膜异位症患者中，根据前瞻性数据库数据计算ESTA评分。使用Kaplan-Meier（K-M）产品限值估计计算累积妊娠率曲线，并使用对数秩检验评价两组之间的差异。绘制受试者工作特征（ROC）曲线，作为ART结局的预测因子。结果：6个非ART妊娠组的时间差异具有统计学意义（对数秩，p = 1.4 x 10（-4））。作为ART结果预测因子的曲线下面积（AUC）为0.75（95% CI 0.61-0.89，p = 6.2 x 10（-3）），而妊娠的最佳临界点为5.5。结论：子宫内膜异位症术后非ART和ART妊娠结局的预测，子宫内膜异位症评分是一个可靠的评分系统。(C)2015 S. Karger AG，巴塞尔
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 x 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 x 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. (C) 2015 S. Karger AG, Basel