EFI在预测中重度内异症相关不孕术后非ART妊娠结局的价值分析

目的 探究子宫内膜异位症生育指数(EFI)在预测中重度(Ⅲ~Ⅳ期)内异症相关不孕术后非辅助生殖技术(ART)妊娠结局的价值.方法 选取新疆医科大学附属中医医院在2013年12月至2014年12月期间收治的、符合纳入标准的中重度内异症者60例,均行腹腔镜治疗.分析患者术后不同时期非ART妊娠率情况;随访2年,分析促排卵、EFI评分等与非ART妊娠率的相关性;绘制EFI的ROC曲线,判断其预测价值.结果 随访2年,术后非ART总妊娠率为55.00%(33/66);术后半年、1年、2年的非ART妊娠率分别为36.67%(22/60)、15.00%(9/60)、3.33%(2/60),差异具有统计学意义(χ2=38.23,P<0.01);非ART妊娠率与促排卵治疗、EFI评分有关(χ2值分别为10.09、27.81,均P<0.01);EFI评分的ROC曲线下面积为0.70,其约登指数最大值、特异度、敏感度分别为5.9、72.41%(21/29)、30.00%(12/40).结论 EFI能较好的预测中重度内异症相关不孕术后非ART妊娠结局.

Value of EFI in predicting non ART pregnancy outcomes after operation in patients with moderate to severe endometriosis

Objective To analyze the value of endometriosis fertility index (EFI) in predicting non ART pregnancy outcomes after operation in patients with moderate to severe endometriosis (Ⅲ-Ⅳstage).Methods Sixty patients with endometriosis admitted in Affiliated Hospital of Traditional Chinese Medicine in Xinjiang Medical University from December 2013 to December 2014 were collected into clinical data.All patients were treated with laparoscopy.Non ART pregnancy rate in different time after operation was analyzed.They were followed up for 2 years to analyze the correlation of non ART with ovulation rate and EFI score.The ROC curve of EFI was plotted to determine the diagnostic value.Results After 2 years of follow-up, total non ART pregnancy rate was 55.00% (33/66).The non ART pregnancy rate was 36.67% (22/60), 15.00% (9/60) and 3.33% (2/60), respectively in half, 1 and 2 years, and there was statistically difference at different periods (χ2=38.23, P<0.01).Non ART pregnancy rate was related to ovulation induction therapy and EFI score (χ2 value was 10.09 and 27.81, respectively, both P<0.01).The area under ROC curve of EFI score was 0.70.The maximum value of Youden''s index, specificity and sensitivity was 5.9, 72.41% (21/29) and 30.00% (12/40), respectively.Conclusion EFI can predict non ART pregnancy outcomes in patients with endometriosis.