目的：探讨子宫内膜异位症生育指数（EFI）对子宫内膜异位症（EMs）相关性不孕患者腹腔镜术后行宫腔内人工授精（IUI）助孕临床妊娠率的预测作用。方法：收集2008年1月-2014年4月在广州市第一人民医院生殖健康与不孕症专科就诊的75例EMs不孕患者125个IUI周期的资料，按照EFI评分标准计算EFI，利用受试者工作特征曲线（ROC曲线）分析EFI对IUI临床妊娠率的预测价值。结果：EFI评分预测IUI临床妊娠率的ROC曲线下面积为0.708±0.059，大于机会参考线下面积（P＜0.05）；诊断界值点为7分，敏感度为0.737，特异度为0.613；美国生育协会修订的EMs分期（r-AFS分期）预测IUI临床妊娠率的ROC曲线下面积为0.375±0.065（P＞0.05），不具有诊断意义。 EFI≤6分的周期患者IUI临床妊娠率为3.1%，EFI为7、8、9、10分的周期患者IUI临床妊娠率分别为10.5%、21.1%、27.8%、27.8%，EFI为8、9、10分的周期患者临床妊娠率高于EFI≤6分的周期，差异有统计学意义（P＜0.05）。结论：EFI可以有效预测EMs相关性不孕患者腹腔镜术后IUI的临床妊娠率，EFI≥8分的患者IUI临床妊娠率明显升高，可为EMs相关性不孕患者腹腔镜术后辅助生殖技术的选择提供参考依据。%Objective: To study the predictive value of the endometriosis fertility index (EFI) for the clinical pregnancy rate in intrauterine insemination (IUI) treatment cycles for endometriosis patients complicated with infertility. Methods:The clinical data of 75 endometriosis patients complicated with infertility after laparoscopic surgery undergoing 125 IUI cycles were analyzed. EFI score was calculated according to the endometriosis fertility index system, the ROC curve was used to assess the predictive value of EFI for the clinical pregnancy rate of IUI. Results:The areas under ROC curve of EFI and r-AFS were 0.708±0.059(P<0.05) and 0.375±0.065(P>0.05) respectively. The best point for diagnosis by EFI was 7, the sensitivity was 0.737 and the specificity was 0.613. The clinical pregnancy rate of EFI≤6, 7, 8, 9, 10 was 3.1%, 10.5%, 21.1%, 27.8%, 27.8%respectively. Compare to the group of EFI≤6, the clinical pregnancy rate of EFI=8, 9 and 10 was significantly higher(P<0.05). Conclusions:EFI can be used as a good and effective tool to predict pregnancy outcome in the endometriosis-associated infertile patients attempted to IUI after laparoscopic surgery, the clinical pregnancy rate was obviously increased among EFI≥8, which can provide an important basis for assisted reproductive technology treatment.
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