Comprehensive approach to the management of patients with endometriosis‑associated infertility using the fertility index

DOI

https://dx.doi.org/10.18565/aig.2024.107

Chekeneva N.A., Dumanovskaya M.R., Chuprynin V.D., Asaturova A.V., Buralkina N.A.
1) Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia

Endometriosis is one of the common diseases associated with female infertility. Inability to conceive affects from 30 to 50% of women with endometriosis. The data of comparative studies on the potential effect of surgical treatment for deep endometriosis on spontaneous pregnancy rates and in vitro fertilization outcomes are not numerous and controversial. According to the ESHRE guidelines (2022), there are no data of comparative studies on the effectiveness of surgical treatment for deep endometriosis to improve fertility. In addition, the reproductive prognosis of patients with endometriosis has not been assessed by any classification until recently. The Endometriosis Fertility Index (EFI), proposed by G.D. Adamson and D.J. Pasta in 2010, is a reliable tool for predicting the postoperative spontaneous pregnancy rate in patients with endometriosis. According to the ESHRE guidelines (2022), the decision for surgical intervention for patients with endometriosis and infertility should be based on the presence of pain symptoms, the age and preference of the patient, previous surgical interventions, the presence of other infertility factors, the state of ovarian reserve, and the value of EFI.
Conclusion: The issue of choosing the EFI threshold value for determining the postoperative treatment tactics and optimal period for the assisted reproduction in patients with different values of this criterion remains relevant. Moreover, given the high risks of endometriosis recurrence, especially severe forms of the disease, the question of postoperative management of patients planning pregnancy continues to be important.

Authors’ contributions: Chekeneva N.A., Buralkina N.A. – development of the concept and design of the study;
Chekeneva N.A. – review of publications, analysis of the material on the issue, writing the manuscript; Asaturova A.V. –
writing and editing the article; Buralkina N.A., Chuprynin V.D., Dumanovskaya M.R. – editing the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: The study was carried out without sponsorship.
For citation: Chekeneva N.A., Dumanovskaya M.R., Chuprynin V.D., Asaturova A.V., Buralkina N.A. Comprehensive approach to the management of patients with endometriosis-associated infertility using the fertility index.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (9): 48-54 (in Russian)
https://dx.doi.org/10.18565/aig.2024.107

endometriosis fertility index

EFI

pregnancy

reproductive outcomes

infertility

anti-relapse therapy

Full text (in Russian)

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Received 26.04.2024

Accepted 31.07.2024

Natalya A. Chekeneva, obstetrician-gynecologist, doctor of ultrasound diagnostics, Sechenov Center for Motherhood and Childhood, Clinic of Childhood Diseases, Medical and Diagnostic Department, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), 119435, Russia, Moscow, Bolshaya Pirogovskaya str., 19-1, 4ekeneva@gmail.com, https://orcid.org/0009-0008-6645-6648
Madina R. Dumanovskaya, PhD, Senior Researcher at the Department of Gynecological Endocrinology, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, +7(916)737-40-54, dumanovskaya@gmail.com, https://orcid.org/0000-0001-7286-6047
Vladimir D. Chuprynin, Ph.D., Head of the Surgical Department, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, v_chuprynin@oparina4.ru, https://orcid.org/0000-0002-2997-9019
Aleksandra V. Asaturova, Dr. Med. Sci., Head of the Department of Anatomic Pathology, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, a_asaturova@oparina4.ru, https://orcid.org/0000-0001-8739-5209
Natalya A. Buralkina, Dr. Med. Sci., Senior Researcher at the Department of Surgery, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, 117997, Moscow, Ac. Oparin str., 4, natalyaburalkina@yandex.ru, https://orcid.org/0000-0001-5109-6725
Corresponding author: Natalya A. Buralkina, natalyaburalkina@yandex.ru

Comprehensive approach to the management of patients with endometriosis‑associated infertility using the fertility index

Chekeneva N.A., Dumanovskaya M.R., Chuprynin V.D., Asaturova A.V., Buralkina N.A.

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