{
    "abstract": "To externally validate the Endometriosis Fertility Index (EFI) and to assess cumulative spontaneous pregnancy rates in women with moderate to severe endometriosis following fertility-enhancing minimally invasive surgery.\nRetrospective cohort study.\nTertiary-care center for infertility treatment.\nWomen diagnosed with r-ASRM Stage III or IV endometriosis following fertility-sparing surgery between June 2013 and July 2023, and who desired for fertility.\nMinimally invasive laparoscopy.\nThe follow-up rate was 76.3\u00a0%, with a median duration of 15\u00a0months [Range (1-130\u00a0months)]. The mean age of women was 28.5\u00a0\u00b1\u00a03.8\u00a0years. Women with low EFI scores (0-3) had lower cumulative spontaneous pregnancy rates (11.4\u00a0% at six months, 17\u00a0% at three years) compared to those with higher EFI scores (7-8), who had significantly higher rates (35\u00a0% at six months, 84.5\u00a0% after three years) (P\u00a0<\u00a00.001). A similar trend was observed for overall pregnancy rates. Factors negatively correlated with spontaneous pregnancy included lower least function scores (P\u00a0<\u00a00.001), increasing maternal age (P = 0.003), rASRM scores of 16-40 vs.\u00a0\u2265\u00a071 (P\u00a0<\u00a00.001), lower antral follicle count (P = 0.02), and increasing paternal age (P\u00a0<\u00a00.001). Cystectomy (P = 0.001) was positively associated with spontaneous pregnancy post-surgery. Among the 518 women identified with moderate and severe endometriosis, 395 were followed up, out of which 370 attempted spontaneous conception for at least six months, resulting in a pregnancy rate of 37.3\u00a0% (138/370).\nThe current study demonstrated that EFI scores correlate with pregnancy rates, validating the scoring system in a South Asian population. Additionally, clinical factors such as low antral follicle count, and advanced paternal age may be considered to make informed clinical decisions post-surgery for women with advanced endometriosis who wish to conceive.",
    "authors": [
        {
            "affiliation": "Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, India.",
            "firstname": "Nivedita",
            "initials": "N",
            "lastname": "Gupta"
        },
        {
            "affiliation": "Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, India.",
            "firstname": "Treasa",
            "initials": "T",
            "lastname": "Joseph"
        },
        {
            "affiliation": "Department of Biostatistics, Christian Medical College, Vellore, India.",
            "firstname": "Reka",
            "initials": "R",
            "lastname": "Karuppusami"
        },
        {
            "affiliation": "Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, India.",
            "firstname": "Aleyamma T",
            "initials": "AT",
            "lastname": "Kunjummen"
        },
        {
            "affiliation": "Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, India. Electronic address: mohankamath@cmcvellore.ac.in.",
            "firstname": "Mohan S",
            "initials": "MS",
            "lastname": "Kamath"
        }
    ],
    "conclusions": "The current study demonstrated that EFI scores correlate with pregnancy rates, validating the scoring system in a South Asian population. Additionally, clinical factors such as low antral follicle count, and advanced paternal age may be considered to make informed clinical decisions post-surgery for women with advanced endometriosis who wish to conceive.",
    "copyrights": "Copyright \u00a9 2025 Elsevier B.V. All rights reserved.",
    "doi": "10.1016/j.ejogrb.2025.03.052",
    "journal": "European journal of obstetrics, gynecology, and reproductive biology",
    "keywords": [
        "Advanced endometriosis",
        "Endometriosis Fertility Index",
        "Infertility",
        "Live birth",
        "Predict",
        "Spontaneous conception"
    ],
    "methods": null,
    "publication_date": "2025-04-02",
    "pubmed_id": "40168751",
    "results": null,
    "title": "Predictive factors for spontaneous conception in women with moderate and severe endometriosis following operative laparoscopy: A cohort study.",
    "xml": "<Element 'PubmedArticle' at 0x7885065ebe70>"
}