Endometriosis Fertility Index: A Non-Surgical Approach
Research type
Research Study
Full title
Endometriosis Fertility Index: A Non-Surgical Approach
IRAS ID
296622
Contact name
Tom Holland
Contact email
Sponsor organisation
Guys & St Thomas Hospital
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
One in ten women of reproductive age in the UK have endometriosis. Endometriosis is a chronic inflammatory condition that causes pelvic pain, ovarian cysts, scar tissue formation, and subsequent sub fertility. At present, endometriosis is diagnosed and graded in severity by keyhole surgery (laparoscopy). This is associated with a 2 in 1000 risk of serious complication and costs the NHS approximately £1000 per operation.
In 2008 a scoring system based on the severity of the disease at laparoscopy was developed – the Endometriosis Fertility Index (EFI). Both this study, and subsequent others found this was excellent at predicting spontaneous pregnancy rates in women with endometriosis. The value is that patients who would benefit from IVF can have it early, while those with a good chance of falling pregnant naturally can be reassured.
The aim of this project is to develop an endometriosis fertility index based purely on ultrasound rather than surgery. An internal ultrasound will be used to look for signs of endometriosis and grade it’s severity, while a procedure known as a HyCoSy (passing water through the cervix [neck of the womb] and observing on ultrasound if this water flows through the fallopian tubes indicating if they are open or blocked) will be performed. The benefit to this is that ultrasound is safer, less painful, quicker, easier to offer and cheaper when compared with surgery.
We plan to recruit 100 women scheduled for a laparoscopy to investigate endometriosis. Prior to surgery, an ultrasound EFI score will be assigned. A separate doctor, unaware of this result will perform the laparoscopy and assign a surgical EFI. We will assess if the ultrasound and surgical EFI match closely. If this is the case, women may avoid unnecessary surgery and make more informed decisions about fertility in the future. It may also result in significant NHS cost savings in the future
REC name
London - South East Research Ethics Committee
REC reference
21/LO/0903
Date of REC Opinion
17 Jan 2022
REC opinion
Further Information Favourable Opinion