Pregnancy-related Factors Of Infertility With Endometriosis After Surgery And Their Predictive Value

ObjectiveTo probe the correlating factors for the pregnancy outcome of the endometriosis-associated infertility after laparoscopic surgery and their predictive values. The aim is to provide a scientific basis for clinical treatment.MethodA retrospective analysis of the endometriosis-associated infertility from April2011to December2013after laparoscopic surgery including the history of infertility, the surgery data and the pregnancy outcome data. The data were analyzed by statistieal software SPSS19.0.Result1.A total of489cases were collected,57cases were lost,432cases were effective.290cases were with successful pregnancy outcome after surgery (143with natural pregnancy,138with IVF pregnancy,9with AIH cases pregnancy).The total pregnancy rate was67.1%and the natural pregnancy rate was40.4%2. Univariate analysis showed:age, infertility time, EFI score, AFC and the association with AM were statistically significant (P<0.05). Previous surgery, infertility types, EMT types, r-AFS stages, tubal obstruction, GnRH-a using,unilateral and bilateral ovarian lesions were not statistically significant (P>0.05). COX multivariate analysis shows:EFI score, AFC, ART using, the association with AM were statistically significant(P<0.05).3.EFI with total cumulative pregnancy rate analysis:the area under the curve is 0.662(P<0.05). the critical value is7points. The sensitivity is0.717,and the specificity is0.518. EFI natural pregnancy rate and cumulative analysis:the area under the curve is0.638(P<0.05). The predictive critical value is the same7points. The sensitivity is0.783, and the specificity is0.401.4.When the EFI score is less than5points, the application of ART can significantly improve the pregnancy rate after the operation and reduce the time to wate.5.AFC with total pregnancy rate analysisr:the area under the curve is0.662(P<0.05). The predictive critical value is9, and sensitivity is0.543,and the specificity is0.735. In the patients with the chocolate cyst, the area under the curve of0.694(P<0.05).The predictive critical value is9,too. The sensitivity is0.439and the specificity of0.908.conclusionl.As this study suggests:EFI score, AFC, ART,the adenomyosis are closely related postoperative pregnancy.2.The laparoscopic surgery can improve the pregnancy rate.3.Using EFI and APC can effectively predict the pregnancy outcomes. The cut-off of EFI is7.The cut-off of AFC is9.