Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 5/2021

16.11.2020 | Gynecologic Endocrinology and Reproductive Medicine

Modified endometriosis fertility index is more accurate to predict the non-ART pregnancy rate following surgery: a cohort of Chinese women

verfasst von: Jiaying Fan, Kang Qin, Kuanrong Li, Xiaojun Li, Qingsheng Huang, Yunsheng Liao, Huiying Liang, Jingying Xie, Yan Yang, Qingfeng Li

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 5/2021

Einloggen, um Zugang zu erhalten

Abstract

Objective

To examine whether a modified endometriosis fertility index (EFI) can better predict the rate of pregnancy without assisted reproductive technologies (ART) after laparoscopic surgery in infertile Chinese women with endometriosis.

Methods

564 infertile women undergoing laparoscopy for endometriosis were retrospectively collected from January 2014 to December 2018. 472 patients were used to modify the EFI based on new, optimal cutoffs for its predictor variables. The predictive accuracy of the modified EFI was examined in the other 92 patients.

Results

Among the patients for the EFI modification, the multivariable Cox regression results showed that historical factors made more contribution in predicting non-ART pregnancy rate than surgical factors both in modified EFI (C-index: historical factors 0.617 vs surgical factors 0.558) and original EFI (C-index: historical factors 0.600 vs surgical factors 0.549). No significant relationship between the prior pregnancy and post-operative non-ART pregnancy rates was detected by both modified EFI and original EFI (p = 0.530 and 0.802, respectively). To assess the predictive effect of modified EFI, the two versions of modified EFI not only had higher predictive accuracy (C-index: 0.627 and 0.632) for non-ART pregnancy rates than that of the original EFI (C-index: 0.602) in the patients undergoing surgery during 2014–2017, but also higher than that of the original EFI (C-index: 0.638 and 0.612 vs 0.560) in the externally validated population in 2018.

Conclusions

A modified EFI based on population-specific optimal cutoffs and weights might be more suitable for estimating the rate of non-ART pregnancy after laparoscopic surgery in infertile women with endometriosis.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat de Ziegler D, Borghese B, Chapron C (2010) Endometriosis and infertility: pathophysiology and management. Lancet 376:730–738PubMedCrossRef de Ziegler D, Borghese B, Chapron C (2010) Endometriosis and infertility: pathophysiology and management. Lancet 376:730–738PubMedCrossRef
2.
Zurück zum Zitat Eisenberg VH et al (2018) Epidemiology of endometriosis: a large population-based database study from a healthcare provider with 2 million members. BJOG : an international journal of obstetrics and gynaecology 125:55–62CrossRef Eisenberg VH et al (2018) Epidemiology of endometriosis: a large population-based database study from a healthcare provider with 2 million members. BJOG : an international journal of obstetrics and gynaecology 125:55–62CrossRef
3.
Zurück zum Zitat Dunselman GA et al (2014) ESHRE guideline: management of women with endometriosis. Hum Reprod 29:400–412PubMedCrossRef Dunselman GA et al (2014) ESHRE guideline: management of women with endometriosis. Hum Reprod 29:400–412PubMedCrossRef
4.
Zurück zum Zitat Hughes E et al (2007) Ovulation suppression for endometriosis. Cochrane Database Syst Rev 2007:CD000155PubMedCentral Hughes E et al (2007) Ovulation suppression for endometriosis. Cochrane Database Syst Rev 2007:CD000155PubMedCentral
5.
Zurück zum Zitat Chern CJ, Beutler E (1976) Biochemical and electrophoretic studies of erythrocyte pyridoxine kinase in white and black Americans. Am J Hum Genet 28:9–17PubMedPubMedCentral Chern CJ, Beutler E (1976) Biochemical and electrophoretic studies of erythrocyte pyridoxine kinase in white and black Americans. Am J Hum Genet 28:9–17PubMedPubMedCentral
6.
Zurück zum Zitat Marcoux S, Maheux R, Berube S (1997) Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med 337:217–222PubMedCrossRef Marcoux S, Maheux R, Berube S (1997) Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med 337:217–222PubMedCrossRef
7.
Zurück zum Zitat Parazzini F (1999) Ablation of lesions or no treatment in minimal-mild endometriosis in infertile women: a randomized trial. Gruppo Italiano per lo Studio dell’Endometriosi. Hum Reprod 14:1332–1334PubMedCrossRef Parazzini F (1999) Ablation of lesions or no treatment in minimal-mild endometriosis in infertile women: a randomized trial. Gruppo Italiano per lo Studio dell’Endometriosi. Hum Reprod 14:1332–1334PubMedCrossRef
8.
Zurück zum Zitat Darai E et al (2005) Fertility after laparoscopic colorectal resection for endometriosis: preliminary results. Fertil Steril 84:945–950PubMedCrossRef Darai E et al (2005) Fertility after laparoscopic colorectal resection for endometriosis: preliminary results. Fertil Steril 84:945–950PubMedCrossRef
9.
Zurück zum Zitat Meuleman C et al (2014) Clinical outcome after radical excision of moderate-severe endometriosis with or without bowel resection and reanastomosis: a prospective cohort study. Ann Surg 259:522–531PubMedCrossRef Meuleman C et al (2014) Clinical outcome after radical excision of moderate-severe endometriosis with or without bowel resection and reanastomosis: a prospective cohort study. Ann Surg 259:522–531PubMedCrossRef
10.
Zurück zum Zitat de Ziegler D et al (2019) Assisted reproduction in endometriosis. Best Pract Res Clin Endocrinol Metab 33:47–59PubMedCrossRef de Ziegler D et al (2019) Assisted reproduction in endometriosis. Best Pract Res Clin Endocrinol Metab 33:47–59PubMedCrossRef
12.
Zurück zum Zitat (1997) Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertility and sterility 67:817–821 (1997) Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertility and sterility 67:817–821
13.
Zurück zum Zitat Adamson GD et al (1993) Laparoscopic endometriosis treatment: is it better? Fertil Steril 59:35–44PubMedCrossRef Adamson GD et al (1993) Laparoscopic endometriosis treatment: is it better? Fertil Steril 59:35–44PubMedCrossRef
14.
Zurück zum Zitat Guzick DS et al (1997) Prediction of pregnancy in infertile women based on the American Society for Reproductive Medicine’s revised classification of endometriosis. Fertil Steril 67:822–829PubMedCrossRef Guzick DS et al (1997) Prediction of pregnancy in infertile women based on the American Society for Reproductive Medicine’s revised classification of endometriosis. Fertil Steril 67:822–829PubMedCrossRef
15.
Zurück zum Zitat Vercellini P et al (2006) Reproductive performance, pain recurrence and disease relapse after conservative surgical treatment for endometriosis: the predictive value of the current classification system. Hum Reprod 21:2679–2685PubMedCrossRef Vercellini P et al (2006) Reproductive performance, pain recurrence and disease relapse after conservative surgical treatment for endometriosis: the predictive value of the current classification system. Hum Reprod 21:2679–2685PubMedCrossRef
16.
Zurück zum Zitat Adamson GD (2011) Endometriosis classification: an update. Curr Opin Obstet Gynecol 23:213–220PubMedCrossRef Adamson GD (2011) Endometriosis classification: an update. Curr Opin Obstet Gynecol 23:213–220PubMedCrossRef
17.
Zurück zum Zitat Adamson GD, Pasta DJ (2010) Endometriosis fertility index: the new, validated endometriosis staging system. Fertil Steril 94:1609–1615PubMedCrossRef Adamson GD, Pasta DJ (2010) Endometriosis fertility index: the new, validated endometriosis staging system. Fertil Steril 94:1609–1615PubMedCrossRef
18.
Zurück zum Zitat Boujenah J et al (2015) External validation of the endometriosis fertility index in a French population. Fertil Steril 104(119–123):e111 Boujenah J et al (2015) External validation of the endometriosis fertility index in a French population. Fertil Steril 104(119–123):e111
19.
Zurück zum Zitat Tomassetti C et al (2013) External validation of the endometriosis fertility index (EFI) staging system for predicting non-ART pregnancy after endometriosis surgery. Hum Reprod 28:1280–1288PubMedCrossRef Tomassetti C et al (2013) External validation of the endometriosis fertility index (EFI) staging system for predicting non-ART pregnancy after endometriosis surgery. Hum Reprod 28:1280–1288PubMedCrossRef
20.
Zurück zum Zitat Zhang X et al (2018) Prediction of Endometriosis Fertility Index in patients with endometriosis-associated infertility after laparoscopic treatment. Reprod Biomed Online 37:53–59PubMedCrossRef Zhang X et al (2018) Prediction of Endometriosis Fertility Index in patients with endometriosis-associated infertility after laparoscopic treatment. Reprod Biomed Online 37:53–59PubMedCrossRef
22.
Zurück zum Zitat Maheux-Lacroix S et al (2017) Endometriosis fertility index predicts live births following surgical resection of moderate and severe endometriosis. Hum Reprod 32:2243–2249PubMedCrossRef Maheux-Lacroix S et al (2017) Endometriosis fertility index predicts live births following surgical resection of moderate and severe endometriosis. Hum Reprod 32:2243–2249PubMedCrossRef
23.
Zurück zum Zitat Hobo R et al (2018) The endometriosis fertility index is useful for predicting the ability to conceive without assisted reproductive technology treatment after laparoscopic surgery, regardless of endometriosis. Gynecol Obstet Invest 83:493–498PubMedCrossRef Hobo R et al (2018) The endometriosis fertility index is useful for predicting the ability to conceive without assisted reproductive technology treatment after laparoscopic surgery, regardless of endometriosis. Gynecol Obstet Invest 83:493–498PubMedCrossRef
24.
Zurück zum Zitat Kim JS et al (2019) Use of the endometriosis fertility index to predict natural pregnancy after endometriosis surgery: a single-center study. Gynecol Obstet Invest 84:86–93PubMedCrossRef Kim JS et al (2019) Use of the endometriosis fertility index to predict natural pregnancy after endometriosis surgery: a single-center study. Gynecol Obstet Invest 84:86–93PubMedCrossRef
25.
Zurück zum Zitat Boujenah J et al (2017) Use of the endometriosis fertility index in daily practice: a prospective evaluation. Eur J Obstet Gynecol Reprod Biol 219:28–34PubMedCrossRef Boujenah J et al (2017) Use of the endometriosis fertility index in daily practice: a prospective evaluation. Eur J Obstet Gynecol Reprod Biol 219:28–34PubMedCrossRef
26.
Zurück zum Zitat Camp RL, Dolled-Filhart M, Rimm DL (2004) X-tile: a new bio-informatics tool for biomarker assessment and outcome-based cut-point optimization. Clin Cancer Res 10:7252–7259PubMedCrossRef Camp RL, Dolled-Filhart M, Rimm DL (2004) X-tile: a new bio-informatics tool for biomarker assessment and outcome-based cut-point optimization. Clin Cancer Res 10:7252–7259PubMedCrossRef
27.
Zurück zum Zitat Johnson NP et al (2017) World Endometriosis Society consensus on the classification of endometriosis. Hum Reprod 32:315–324PubMedCrossRef Johnson NP et al (2017) World Endometriosis Society consensus on the classification of endometriosis. Hum Reprod 32:315–324PubMedCrossRef
28.
Zurück zum Zitat Ford WC (2010) Comments on the release of the 5th edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen. Asian J Androl 12:59–63PubMedPubMedCentralCrossRef Ford WC (2010) Comments on the release of the 5th edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen. Asian J Androl 12:59–63PubMedPubMedCentralCrossRef
29.
Zurück zum Zitat Zegers-Hochschild F et al (2009) The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009. Hum Reprod 24:2683–2687PubMedCrossRef Zegers-Hochschild F et al (2009) The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009. Hum Reprod 24:2683–2687PubMedCrossRef
30.
Zurück zum Zitat Brosens I, Gordts S, Benagiano G (2013) Endometriosis in adolescents is a hidden, progressive and severe disease that deserves attention, not just compassion. Hum Reprod 28:2026–2031PubMedPubMedCentralCrossRef Brosens I, Gordts S, Benagiano G (2013) Endometriosis in adolescents is a hidden, progressive and severe disease that deserves attention, not just compassion. Hum Reprod 28:2026–2031PubMedPubMedCentralCrossRef
31.
Zurück zum Zitat Hans Evers JL (2013) Is adolescent endometriosis a progressive disease that needs to be diagnosed and treated? Hum Reprod 28:2023PubMedCrossRef Hans Evers JL (2013) Is adolescent endometriosis a progressive disease that needs to be diagnosed and treated? Hum Reprod 28:2023PubMedCrossRef
32.
Zurück zum Zitat Aboulghar MA, Mansour RT, Serour GI (2002) Spontaneous intrauterine pregnancy following salpingectomy for a unilateral hydrosalpinx. Hum Reprod 17:1099–1100PubMedCrossRef Aboulghar MA, Mansour RT, Serour GI (2002) Spontaneous intrauterine pregnancy following salpingectomy for a unilateral hydrosalpinx. Hum Reprod 17:1099–1100PubMedCrossRef
33.
Zurück zum Zitat Ragni G et al (2005) Damage to ovarian reserve associated with laparoscopic excision of endometriomas: a quantitative rather than a qualitative injury. Am J Obstet Gynecol 193:1908–1914PubMedCrossRef Ragni G et al (2005) Damage to ovarian reserve associated with laparoscopic excision of endometriomas: a quantitative rather than a qualitative injury. Am J Obstet Gynecol 193:1908–1914PubMedCrossRef
34.
Zurück zum Zitat de Ziegler D et al (2010) Use of oral contraceptives in women with endometriosis before assisted reproduction treatment improves outcomes. Fertil Steril 94:2796–2799PubMedCrossRef de Ziegler D et al (2010) Use of oral contraceptives in women with endometriosis before assisted reproduction treatment improves outcomes. Fertil Steril 94:2796–2799PubMedCrossRef
35.
Zurück zum Zitat Orazov MR et al (2019) Oocyte quality in women with infertility associated endometriosis. Gynecol Endocrinol 35:24–26PubMedCrossRef Orazov MR et al (2019) Oocyte quality in women with infertility associated endometriosis. Gynecol Endocrinol 35:24–26PubMedCrossRef
36.
Zurück zum Zitat Jacobson TZ et al (2002) Laparoscopic surgery for subfertility associated with endometriosis. Cochrane Database Syst Rev 2002:CD001398 Jacobson TZ et al (2002) Laparoscopic surgery for subfertility associated with endometriosis. Cochrane Database Syst Rev 2002:CD001398
37.
Zurück zum Zitat Practice Committee of the American Society for Reproductive M (2012) Endometriosis and infertility: a committee opinion. Fertil Steril 98:591–598CrossRef Practice Committee of the American Society for Reproductive M (2012) Endometriosis and infertility: a committee opinion. Fertil Steril 98:591–598CrossRef
38.
Zurück zum Zitat Steiner AZ, Jukic AM (2016) Impact of female age and nulligravidity on fecundity in an older reproductive age cohort. Fertil Steril 105(1584–1588):e1581 Steiner AZ, Jukic AM (2016) Impact of female age and nulligravidity on fecundity in an older reproductive age cohort. Fertil Steril 105(1584–1588):e1581
39.
Zurück zum Zitat Faddy MJ et al (1992) Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause. Hum Reprod 7:1342–1346PubMedCrossRef Faddy MJ et al (1992) Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause. Hum Reprod 7:1342–1346PubMedCrossRef
41.
Zurück zum Zitat American College of O, Gynecologists Committee on Gynecologic P, Practice C (2014) Female age-related fertility decline. Committee Opinion No. 589. Fertil Steril 101:633–634CrossRef American College of O, Gynecologists Committee on Gynecologic P, Practice C (2014) Female age-related fertility decline. Committee Opinion No. 589. Fertil Steril 101:633–634CrossRef
42.
Zurück zum Zitat Poseidon G et al (2016) A new more detailed stratification of low responders to ovarian stimulation: from a poor ovarian response to a low prognosis concept. Fertil Steril 105:1452–1453CrossRef Poseidon G et al (2016) A new more detailed stratification of low responders to ovarian stimulation: from a poor ovarian response to a low prognosis concept. Fertil Steril 105:1452–1453CrossRef
43.
Zurück zum Zitat Guerriero S et al (2016) Age-related differences in the sonographic characteristics of endometriomas. Hum Reprod 31:1723–1731PubMedCrossRef Guerriero S et al (2016) Age-related differences in the sonographic characteristics of endometriomas. Hum Reprod 31:1723–1731PubMedCrossRef
44.
Zurück zum Zitat Sanchez AM et al (2017) Is the oocyte quality affected by endometriosis? A review of the literature. J Ovar Res 10:43CrossRef Sanchez AM et al (2017) Is the oocyte quality affected by endometriosis? A review of the literature. J Ovar Res 10:43CrossRef
45.
Zurück zum Zitat Muzii L et al (2018) Antimullerian hormone is reduced in the presence of ovarian endometriomas: a systematic review and meta-analysis. Fertil Steril 110(932–940):e931 Muzii L et al (2018) Antimullerian hormone is reduced in the presence of ovarian endometriomas: a systematic review and meta-analysis. Fertil Steril 110(932–940):e931
46.
Zurück zum Zitat Abuzeid MI et al (2007) The prevalence of fimbrial pathology in patients with early stages of endometriosis. J Minim Invasive Gynecol 14:49–53PubMedCrossRef Abuzeid MI et al (2007) The prevalence of fimbrial pathology in patients with early stages of endometriosis. J Minim Invasive Gynecol 14:49–53PubMedCrossRef
47.
Zurück zum Zitat Zheng X, Han H, Guan J (2015) Clinical features of fallopian tube accessory ostium and outcomes after laparoscopic treatment. Int J Gynaecol Obstet 129:260–263PubMedCrossRef Zheng X, Han H, Guan J (2015) Clinical features of fallopian tube accessory ostium and outcomes after laparoscopic treatment. Int J Gynaecol Obstet 129:260–263PubMedCrossRef
48.
Zurück zum Zitat Peterson CM et al (2013) Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study. Am J Obstet Gynecol 208(451):e451–e411 Peterson CM et al (2013) Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study. Am J Obstet Gynecol 208(451):e451–e411
49.
Zurück zum Zitat Buck Louis GM et al (2016) Women’s Reproductive History before the diagnosis of incident endometriosis. J Women’s Health 25:1021–1029CrossRef Buck Louis GM et al (2016) Women’s Reproductive History before the diagnosis of incident endometriosis. J Women’s Health 25:1021–1029CrossRef
50.
Zurück zum Zitat Li X et al (2017b) Chemical remodeling cell surface glycans for immunotargeting of tumor cells. Carbohyd Res 452:25–34CrossRef Li X et al (2017b) Chemical remodeling cell surface glycans for immunotargeting of tumor cells. Carbohyd Res 452:25–34CrossRef
Metadaten
Titel
Modified endometriosis fertility index is more accurate to predict the non-ART pregnancy rate following surgery: a cohort of Chinese women
verfasst von
Jiaying Fan
Kang Qin
Kuanrong Li
Xiaojun Li
Qingsheng Huang
Yunsheng Liao
Huiying Liang
Jingying Xie
Yan Yang
Qingfeng Li
Publikationsdatum
16.11.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 5/2021
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-020-05871-1

Weitere Artikel der Ausgabe 5/2021

Archives of Gynecology and Obstetrics 5/2021 Zur Ausgabe

Gynecologic Endocrinology and Reproductive Medicine

Decreased expression of m6A demethylase FTO in ovarian aging

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.