External validation of the Endometriosis Fertility Index in a French population

The Endometriosis Fertility Index (EFI) predicted spontaneous pregnancy after surgery for endometriotic infertile women. Combining surgery and assisted reproductive technologies according to EFI led to a 78% pregnancy rate at 18 months.


Jeremy Boujenah, M.D., Claire Bonneau, M.D., Jean-Noel Hugues, M.D., Ph.D., Christophe Sifer, M.D., Christophe Poncelet, M.D., Ph.D.

Volume 104, Issue 1, Pages 119–123



To show an external validation of the Endometriosis Fertility Index (EFI) and to observe cumulated pregnancy rates after infertility management combining surgery and assisted reproductive technologies (ART).


Observational study from January 2004 to December 2012.


Tertiary-care university hospital and ART center.


Four hundred twelve infertile and endometriotic patients after laparoscopic surgery.


Surgical diagnosis and treatment followed by spontaneous fertility or ART management.

Main Outcome Measure(s):

Spontaneous pregnancy rates and cumulative (spontaneous and ART) pregnancy rates according to the EFI.


A significant relationship between EFI and spontaneous pregnancy rates was observed at 12 months (P=.001). The least function score and complete removal of endometriotic lesions and pelvic adhesions were significantly associated with spontaneous pregnancy (P=.006). Cumulative pregnancy rate at 18 months was 78.8%. ART benefits for pregnancy rates were higher for patients with poor EFI.


External validation of the EFI in a French population was demonstrated. Combining surgery for endometriosis and ART led to a 78.8% pregnancy rate at 18 months after surgery.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)00233-2/fulltext

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