生育指数评分预测卵巢型子宫内膜异位症术后自然妊娠价值

The value of fertility index score after operation of the women with ovarian endometriosis for predicting their natural pregnancy

目的:分析生育指数评分(EFI)对卵巢型子宫内膜异位症(EMT)患者术后自然妊娠的评估价值。方法:选取2015年1月-2017年10月因卵巢EMT在本院行腹腔镜手术治疗的不孕症患者264例,术后行EFI评分并随访3年,分析术后妊娠率的影响因素以及EFI评分的预测价值。结果:术后妊娠率与EFI评分呈正相关(P<0.001)。术后EFI评分>5分者术后6个月内妊娠率最高为39.4%。EFI评分ROC曲线下面积(AUC)为0.836(95%CI 0.7160.935,P<0.001),EFI评分预测术后1年内妊娠的临界值是6.7分,敏感度为74.4%,特异度为87.0%。结论:卵巢型EMT患者腹腔镜术后自然妊娠率与EFI评分呈正相关性,术后6个月为受孕最佳时机。若术后评分EFI≥6.7分可期待治疗,术后1年内自然妊娠率较高;若术后EFI评分<6.7分,且术后1年内未自然妊娠建议行辅助生殖。

Objective: To analyze the value of fertility index(FI) score after operation of the women with ovarian endometriosis for predicting their natural pregnancy. Methods: 264 infertility women due to ovarian endometriosis had treated by laparoscopic surgery from 2015 to 2017 were collected. The postoperative FI scores of these women were conducted, and these women were followed up for 3 years. The influence factors of postoperative pregnancy rate of these women and the predictive value of EFI score for postoperative pregnancy rate of these women were analyzed. Results: Postoperative pregnancy rate of the women was positively correlated with their FI score(P<0.001). The pregnancy rate of the women with FI score > 5 within 6 months after operation was 39.4%, which was the highest. The area under the ROC curve(AUC) of FI score for predicting postoperative pregnancy was 0.836(95%CI: 0.716-0.935, P<0.001). The cutoff value of EFI score for predicting pregnancy within 1 year after operation was 6.7 points, which’s sensitivity and specificity were 74.4% and 87.0%. Conclusion: Natural pregnancy rate after laparoscopic surgery of the women with ovarian endometriosis was positively correlated with their FI score. 6 months after surgery of women with ovarian endometriosis is the best time to pregnancy. The women with postoperative FI score ≥6.7 points, the postoperative natural pregnancy rate is the highest. If the women with postoperative FI score <6.0 points has not natural pregnancy within 1 year after operation, it suggest that they should be given assisted reproduction.