Predictive value of endometriosis fertility index on the in vitro fertilization/intracytoplasmic sperm injection-embryo transfer outcome of patients with endometriosis

Zexuan Wu ,Dongzi Yang ,Yucheng Liang ,Caihua Li ,Haifan Lin ,Wenjun Wang ,Li Yu

doi:10.3760/cma.j.issn.2096-2916.2019.08.003

Abstract

Objective To investigate the predictive value of endometriosis fertility index (EFI) on the in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) outcome of patients with endometriosis (EMS). Methods Totally 231 patients with EMS in the Reproductive Center of Sun Yat-sen Memorial Hospital accepted IVF/ICSI-ET treatment between January 2011 and December 2014 were collected and retrospectively analyzed. Only their first cycle was included. EFI score was achieved according to the operation and general situation. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of EFI for the clinical pregnancy rate of fresh transplantation. Patients were divided into two groups according to the cut-off EFI of ROC curve for further analysis. Results The area under ROC curve (AUC) of EFI was 0.571 (P=0.066), with a cut-off value of 7.5. Both embryo implantation rate (IR) and live birth rate (LBR) were significantly higher in the EFI>7 group when compared with the EFI≤7 group (47.5% vs. 33.1%, P=0.001; 60.0% vs. 43.7%, P=0.013, respectively), while the clinical pregnancy rate (CPR) manifested a higher tendency in the EFI>7 group (64.8% vs. 52.4%, P=0.058). In patients performed super-long pituitary down-regulation protocol, the index including IR, CPR and LBR were significantly increased in those EFI>7 group than those EFI≤7 group. In patients performed long pituitary down-regulation protocol, there was no significant difference of IR, CPR and LBR between those EFI>7 group and those EFI≤7 group. Conclusion EFI score is of a certain predicting value for the clinical pregnancy outcome in fresh transplantation, especially for patients using super-long pituitary down-regulation protocol. Key words: Endometriosis; Fertilization in vitro; Embryo transfer; Endometriosis fertility index; Pregnancy outcome

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