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Cohort studyCureus · 2026

Validation of Endometriosis Fertility Index for the Prediction of Non-Assisted Reproductive Technology (ART) Pregnancy in Women With Endometriosis-Associated Infertility: A Prospective Cohort Study.

Divya Mishra, Shantanu Shubham, Neena Malhotra

Obstetrics & GynecologyCohort study

Endometriosis Fertility Index score of 7 or higher is associated with much greater conception.

Validation of Endometriosis Fertility Index for the Prediction of Non-Assisted Reproductive Technology (ART) Pregnancy in Women With Endometriosis-Associated Infertility: A Prospective Cohort Study.

Divya Mishra et al. · Cureus · 2026

Background

Endometriosis is a common cause of infertility and affects reproductive outcomes through multiple mechanisms, including pelvic adhesions, altered pelvic anatomy, and inflammatory changes.

Purpose

This study aimed to validate the EFI for predicting non-assisted reproductive technology (ART) pregnancy outcomes after laparoscopic surgery in women with endometriosis-associated infertility and compare its predictive performance with the revised American Society for Reproductive Medicine (r-ASRM) classification.

Methods

Underwent individualized fertility management, including expectant management, ovulation induction, and intrauterine insemination (IUI) where indicated.

Results

women with an Endometriosis Fertility Index of 7 or higher had a much greater likelihood of getting pregnant

95.8%

Sensitivity

52.3%

Specificity

More results

The mean EFI score was 6.7 ± 1.6.

Women who achieved clinical pregnancy had significantly higher EFI scores than those who did not conceive (8.2 ± 1.2 versus 6.0 ± 1.3; p < 0.001).

Women with EFI scores of 9-10 demonstrated a 100% pregnancy rate within six months.

The cumulative probability of non-ART pregnancy at six months was 33.3%.

“

Conclusion · 1 of 2

EFI demonstrated strong predictive performance for non-ART pregnancy outcomes following laparoscopic surgery in women with endometriosis-associated infertility.

Conclusion · 2 of 2

The index may serve as a valuable clinical tool for individualized fertility counselling, prognostic assessment, and guiding decisions regarding expectant management versus early assisted reproductive intervention.

Post

Validation of Endometriosis Fertility Index for the Prediction of Non-Assisted Reproductive Technology (ART) Pregnancy in Women With Endometriosis-Associated Infertility: A Prospective Cohort Study.

Endometriosis Fertility Index score of 7 or higher is associated with much greater conception.

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