ASRM2010: Endometriosis Fertility Index (EFI) predicts likelihood of natural conception in women with endometriosis

Denver, 27 October 2010

US researchers have developed an Endometriosis Fertility Index (EFI) using the functional status of women’s fallopian tubes, ovaries, and fimbria, to predict their chances of conceiving naturally.

Dr David Adamson

In this afternoon’s session, arranged by the Society of Reproductive Surgeons, Dr G David Adamson presented the Endometriosis Fertility Index (EFI), which is the first endometriosis staging system that has ever been validated, and thus shown to work.

Drs Adamson and Pasta developed the EFI using data from 579 infertile women with endometriosis who underwent hysteroscopy for surgical staging. Women’s fallopian tubes, ovaries, and fimbria were given a functional score by the surgeon.

In addition to clinical factors, patient age, years infertile, and pregnancy history (all predictive of natural conception) were accounted for while developing the EFI.

After validating the EFI in a cohort of 222 additional women with endometriosis, the team found good correlation between predicted and actual outcomes for all stages of endometriosis.  Specifically, patients with an EFI of 9-10 (indicating the highest potential for natural conception) had approximate estimated pregnancy rates of 55% and 74% at 12 and 36 months, respectively, while the rates for those with the lowest EFI (0-3) remained at just 10%.

“The EFI is a simple, robust, and validated clinical tool that predicts pregnancy rates for patients after endometriosis surgical staging. It provides reassurance to those patients with good prognoses and avoids wasted time and treatment for those with poor prognoses”

said Dr Adamson from Fertility Physicians of Northern California, who is also the current president of the World Endometriosis Research Foundation.

The Endometriosis Fertility Index has been published in the October 2010 issue of Fertility and Sterility.

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