EFI Calculator — Endometriosis Fertility Index

Revised ASRM Classification

Step 1

rASRM Endometriosis Score

Endometriosis Implants

Peritoneum

	None	<1 cm	1–3 cm	>3 cm
Superficial	0	1	2	4
Deep	0	2	4	6

Right Ovary

	None	<1 cm	1–3 cm	>3 cm
Superficial	0	1	2	4
Deep	0	4	16	20

Left Ovary

	None	<1 cm	1–3 cm	>3 cm
Superficial	0	1	2	4
Deep	0	4	16	20

Posterior Cul-de-sac Obliteration

None (0) Partial (4) Complete (40)

AFS Endometriosis Score (Implants) 0

EFI: <16 → 1 pt · ≥16 → 0 pts → 1 pt

Adhesions

Right Ovary Adhesions

	None	<⅓	⅓–⅔	>⅔
Filmy	0	1	2	4
Dense	0	4	8	16

Left Ovary Adhesions

	None	<⅓	⅓–⅔	>⅔
Filmy	0	1	2	4
Dense	0	4	8	16

Right Tube Adhesions

	None	<⅓	⅓–⅔	>⅔
Filmy	0	1	2	4
Dense	0	4	8	16

Fimbriated end completely enclosed? (overrides to 16)

Left Tube Adhesions

	None	<⅓	⅓–⅔	>⅔
Filmy	0	1	2	4
Dense	0	4	8	16

Fimbriated end completely enclosed? (overrides to 16)

Adhesion Subtotal 0

AFS Total Score (Implants + Adhesions) 0

EFI: <71 → 1 pt · ≥71 → 0 pts → 1 pt

rASRM Stage —

Endometriosis Fertility Index

Step 2

Least Function (LF) Score

Rate each structure at the conclusion of surgery: 4 = Normal, 3 = Mild dysfunction, 2 = Moderate dysfunction, 1 = Severe dysfunction, 0 = Absent/nonfunctional

	LEFT	RIGHT
Tube	0 1 2 3 4	0 1 2 3 4
Fimbria	0 1 2 3 4	0 1 2 3 4
Ovary	0 1 2 3 4	0 1 2 3 4

Left ovary absent Right ovary absent

With one ovary absent, the LF score doubles the lowest score on the remaining side.

Left (lowest) —

Right (lowest) —

LF Score (left lowest + right lowest) —

LF Score	Function	EFI Points
7–8	High	3 pts
4–6	Moderate	2 pts
1–3	Low	1 pt
0	None	0 pts

Step 3

Historical Factors

Age at Surgery

≤ 35 yrs (2 pts) 36–39 yrs (1 pt) ≥ 40 yrs (0 pts)

Length of Infertility

≤ 3 years (2 pts) > 3 years (0 pts)

Prior Pregnancy

Yes (1 pt) No (0 pts)

Historical Factor Subtotal — / 5

Step 4

EFI Score Summary

HISTORICAL FACTORS

Age— pts

Length of Infertility— pts

Prior Pregnancy— pts

Subtotal— / 5

SURGICAL FACTORS

LF Score (—)— / 3

AFS Endo Score (0)1 / 1

AFS Total Score (0)1 / 1

Subtotal— / 5

EFI TOTAL SCORE— / 10

rASRM Stage—

Estimated Non-ART Pregnancy Rates

EFI Score	Pregnant at 1 Year	Pregnant at 3 Years
9–10	67%	75%
7–8	39%	66%
6	30%	54%
5	27%	42%
4	15%	28%
0–3	10%	10%

Based on Adamson GD & Pasta DJ. Fertil Steril 2010;94(5):1609–15
and the revised AFS/rASRM Classification System.

This is a personal informational tool, not a medical device. It does not provide medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for clinical decision-making. The pregnancy rate estimates are population-level statistics from published research and may not reflect individual outcomes.