Modified endometriosis fertility index is more accurate to predict the non-ART pregnancy rate following surgery: a cohort of Chinese women
| Autor: | Kuanrong Li, Xiaojun Li, Yan Yang, Huiying Liang, Qingfeng Li, Jing-Ying Xie, Yunsheng Liao, Kang Qin, Qingsheng Huang, Jia-Ying Fan |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Laparoscopic surgery China medicine.medical_specialty Pregnancy Rate medicine.medical_treatment Population Endometriosis Reproductive technology Cohort Studies 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans education education.field_of_study 030219 obstetrics & reproductive medicine business.industry Proportional hazards model Obstetrics and Gynecology General Medicine medicine.disease Surgery Pregnancy rate Fertility 030220 oncology & carcinogenesis Cohort Female business |
| Zdroj: | Archives of Gynecology and Obstetrics. 303:1353-1361 |
| ISSN: | 1432-0711 0932-0067 |
| DOI: | 10.1007/s00404-020-05871-1 |
| Popis: | 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. 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. 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. 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. |
| Databáze: | OpenAIRE |
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