Ferrier C, Boujenah J, Poncelet C, et al. - Given the utility of the Endometriosis Fertility Index (EFI) score in predicting the occurrence of a spontaneous pregnancy following surgery, researchers sought to evaluate its cost-effectiveness perspective via determining fertility outcomes, and costs of different care pathways for endometriosis-associated infertility after primary surgery, with a stratification on the EFI score. After surgery, comparison was performed between 163 women with immediate IVF-ICSI (strategy I) and 445 women who had natural conception attempts during a year (strategy II). After a year failure of natural conception attempts, comparison was performed between 133 women continuing natural conception attempts (strategy III) and 168 women who had delayed IVF-ICSI (strategy IV). Outcomes revealed induction of more pregnancies after IVF-ICSI cycles than natural procreation attempts after surgery. They indicated IVF-ICSI to be linked with susbstantial costs, compared with natural procreation with supplementary pregnancies costs ranging from 20,387 € to 59,461 €. They support the EFI score as efficient in assisting decision making between between different care pathways after surgery.