Abstract: Objective: To assess the predictive value of fertility index in the pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET) after chocolate cyst removal in patients with endometriosis. Methods: From Jan. 1，2016 to Dec. 31, 2018, 93 infertility patients underwent the laparoscopic ovarian chocolate cyst removal and IVF-ET treatment after operation in our hospital. The clinical data were recorded. On the basis of pregnancy outcomes, the patients were divided into the non-pregnant group and the pregnant group. The basic data, AMH value and EFI score were compared between the two groups. The predictive value of EFI score for pregnancy outcome was evaluate by multivariate analysis and ROC curve. Results: There were significant differences in the AMH level and EFI score between the two groups (P＜0.05). EFI score is an independent factor affecting pregnancy outcome in those patients with similar basic data. The higher EFI score, the higher pregnancy rate. The area under curve (AUC) of the ROC curve of EFI was 0.709 (95%CI: 0.604-0.814). The critical value of this AUC was 5.5, with the sensitivity of 0.867 and the specificity of 0.521. The AUC of the ROC curve of EFI combined with postoperative AMH was 0.793 (95%CI: 0.626-0.833), and its critical value was 5.5, with the sensitivity of 0.867 and the specificity of 0.521. There were no differences in the specificity and the sensitivity between EFI score predicting alone and EFI score combined with postoperation AMH (P=0.125). Conclusions: EFI score can be used to predict the pregnancy outcome of IVF-ET after operation. When EFI score is greater than 5.5, the pregnancy rate of IVF-ET will increase significantly. Patients with low EFI score should be fully evaluated before IVF-ET treatment, and the strategy of ovarian stimulation for those patients should be carefully selected.

Key words: Endometriosis, Laparoscopes, Endometriosis fertility index , Fertilization in Vitro, Embryo Transfer, Forecasting