目的通过对比研究,探讨子宫内膜异位症生育指数(EFI)对子宫内膜异位症(EMs)不孕妇女的腹腔镜术后自然妊娠率的预测意义。方法以该院2011年1月~2014年1月执行腹腔镜治疗的230例EMs相关不孕病患为研究对象,依照手术发现执行EFI评分,随访其妊娠情况和结局。对不同EFI分值的病患自然妊娠率进行比较,采用Kaplan-Meier生存分析法计算累积妊娠率并进行比较。结果 182例完成随访的病患的总妊娠率为56.04%(102/182)。EFI评分8~10分者的总妊娠率为54.90%(56/102),其中8、9、10分的妊娠率分别为53.66%(22/41)、51.06%(24/47)和64.29%(9/14),各分值间比较差异无统计学意义(P=0.216)。EFI 7分者的妊娠率为40.63%(13/32),低于8~10分者,差异有统计学意义(P=0.033);EFI 4~6分的妊娠率为20.93%(9/43),4、5、6分的妊娠率分别为22.22%(2/9)、21.43%(3/14)和20.00%(4/20),各分值间比较差异无统计学意义(P=0.655),显著低于7分者(P=0.000)。EFI 0~3分的妊娠率为0.00%(0/5)。术后不同时间的妊娠率差异有统计学意义(P=0.000)。r-AFS分期Ⅰ~Ⅳ期的妊娠率分别为Ⅰ期45.24%(19/42)、48.00%(24/50)、44.00%(22/50)45.00%(18/40),各期间差异无统计学意义(P=0.921)。结论 EFI能较好地预测接受腹腔镜手术的EMs相关不孕病患的术后生育力,值得临床推广运用。 Objective To compare the predictive value of endometriosis fertility index (EFI) for predicting spontaneous pregnancy after laparoscopic surgery in infertile women with endometriosis (EMs). Methods A total of 230 infertile patients with infertile EMs who underwent laparoscopy from January 2011 to January 2014 were enrolled in this study. EFI scores were observed according to the surgical findings and their pregnancy status and outcome were followed up. The natural pregnancy rates of patients with different EFI scores were compared, and the cumulative pregnancy rates were calculated using Kaplan-Meier survival analysis and compared. Results The total pregnancy rate of 182 patients completed follow-up was 56.04% (102/182). The total pregnancy rate was 54.90% (56/102) in patients with EFI score of 8-10. Among them, the pregnancy rates at 8, 9 and 10 points were 53.66% (22/41), 51.06% (24/47) and 64.29% (9/14). There was no significant difference between the scores (P = 0.216). The pregnancy rate of EFI 7 patients was 40.63% (13/32), and the difference was statistically significant below 8-10 (P = 0.033). The pregnancy rates of EFI 4-6 were 20.93% (9/43) ). The pregnancy rates of 4, 5 and 6 points were 22.22% (2/9), 21.43% (3/14) and 20.00% (4/20), respectively. There was no significant difference among the scores (P = 0.655), significantly lower than 7 points (P = 0.000). The pregnancy rate of 0 to 3 of EFI was 0.00% (0/5). The pregnancy rates at different time points after operation were significantly different (P = 0.000). The pregnancy rates of stages Ⅰ-Ⅳ of stage Ⅰ-Ⅳ were 45.24% (19/42), 48.00% (24/50) and 44.00% (22/50) 45.00% (18/40) respectively in the stage of r-AFS. Statistical significance (P = 0.921). Conclusions EFI can predict the post-partum fertility of EMs-related infertility patients undergoing laparoscopic surgery well and is worthy of clinical application.