IMR Press / CEOG / Volume 51 / Issue 4 / DOI: 10.31083/j.ceog5104098
Open Access Original Research
A New Nomogram to Predict Spontaneous Pregnancy after Laparoscopy Combining Hysteroscopy in Women with Minimal to Mild Endometriosis-Associated Infertility
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1 Department of Reproductive Medicine, West China Second University Hospital of Sichuan University, 610000 Chengdu, Sichuan, China
2 Key Laboratory of Birth Defects and Related Disease of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital of Sichuan University, 610000 Chengdu, Sichuan, China
*Correspondence: weihuang64@163.com (Wei Huang)
Clin. Exp. Obstet. Gynecol. 2024, 51(4), 98; https://doi.org/10.31083/j.ceog5104098
Submitted: 29 October 2023 | Revised: 24 December 2023 | Accepted: 15 January 2024 | Published: 17 April 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Endometriosis is common in reproductive age women, which contributes to infertility. This study aims to build a model including antimüllerian hormone (AMH) to predict spontaneous pregnancy within one year after laparoscopy combined with hysteroscopy in women with minimal to mild endometriosis-associated infertility. Methods: There were 220 women included in the study, and a generalized linear model was constructed. The women enrolled in the study were experienced symptoms of endometriosis, and underwent combined laparoscopy and hysteroscopy between January and September 2016. All participants were diagnosed with minimal to mild endometriosis following surgery. Results: The predictive power (sensitivity, specificity, area under the curve (AUC)) of the model for spontaneous pregnancy rate after surgery was measured and compared with the endometriosis fertility index (EFI). The AUC for prediction model of postoperative spontaneous pregnancy was 0.697 (95% confidence interval (95% CI): 0.626–0.768). The best cut-off point was 0.629 (sensitivity: 78.4%; specificity: 54.5%). While the AUC for EFI as the spontaneous pregnancy predictor was 0.573 (95% CI: 0.498–0.648). The best cut-off point was 7.5 (sensitivity: 42.3%; specificity: 74.8%). Conclusions: We suggest that laparoscopy combined with hysteroscopy may offer better fertility outcomes to patients with minimal to mild endometriosis-associated infertility. The nomogram visualized the points of variate in the generalized linear model may provide a simple and convenient method for clinicians in making decisions for individual patients.

Keywords
antimüllerian hormone
laparoscopy combined with hysteroscopy
minimal to mild endometriosis
spontaneous pregnancy
prediction model
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