Development and Validation of a Clinical Pregnancy Failure Prediction Model for Poor Ovarian Responders During IVF/ICSI.
Development and Validation of a Clinical Pregnancy Failure Prediction Model for Poor Ovarian Responders During IVF/ICSI.
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IVF/ICSI 期间卵巢反应不佳者的临床妊娠失败预测模型的开发和验证
DOI：
10.3389/fendo.2021.717288
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发表时间：
2021
影响因子：
5.2
通讯作者：
Xue Q
中科院分区：
文献类型：
--
作者：
Li F;Lu R;Zeng C;Li X;Xue Q
背景尽管辅助生殖技术（ART）取得了巨大进步，但卵巢反应不良（POR）仍然是生殖医学中最具挑战性的任务之一。我们开发的这个预测模型旨在预测体外受精/胞浆内单精子注射（IVF/ICSI）下卵巢反应不良者（POR）临床妊娠失败的个体概率。方法对2016年1月至2019年12月281例POR患者根据博洛尼亚标准绘制列线图，其中训练组179例，验证组102例。使用单变量和多变量逻辑回归分析来确定与临床妊娠失败相关的特征。列线图是根据回归系数构建的。使用校准和辨别来评估绩效。结果 年龄>35岁、体重指数（BMI）>24 kg/m2、碱性卵泡刺激素（FSH）>10 mIU/ml、碱性E2>60 pg/ml、人绒毛膜促性腺激素（hCG）日子宫内膜B型或C型、优质胚胎数<2个与POR患者妊娠失败相关。训练集的受试者工作特征曲线（AUC）下面积为0.786（95%置信区间（CI）：0.710-0.861），验证集的AUC为0.748（95% CI：0.668-0.827），在该列线图中显示出令人满意的拟合优度和辨别能力。结论 我们的列线图可以预测 IVF/ICSI 程序中胚胎移植前 POR 临床妊娠失败的概率，帮助从业人员做出适当的临床决策，并帮助不孕夫妇管理他们的期望。
Backgrounds Despite the great advances in assisted reproductive technology (ART), poor ovarian response (POR) is still one of the most challenging tasks in reproductive medicine. This predictive model we developed aims to predict the individual probability of clinical pregnancy failure for poor ovarian responders (PORs) under in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Methods The nomogram was developed in 281 patients with POR according to the Bologna criteria from January 2016 to December 2019, with 179 in the training group and 102 in the validation group. Univariate and multivariate logistic regression analyses were used to identify characteristics that were associated with clinical pregnancy failure. The nomogram was constructed based on regression coefficients. Performance was evaluated using both calibration and discrimination. Results Age >35 years, body mass index (BMI) >24 kg/m2, basic follicle-stimulating hormone (FSH) >10 mIU/ml, basic E2 >60 pg/ml, type B or C of endometrium on human chorionic gonadotropin (hCG) day, and the number of high-quality embryos <2 were associated with pregnancy failure of POR patients. The area under the receiver operating characteristic curve (AUC) of the training set is 0.786 (95% confidence interval (CI): 0.710–0.861), and AUC in the validation set is 0.748 (95% CI: 0.668–0.827), showing a satisfactory goodness of fit and discrimination ability in this nomogram. Conclusion Our nomogram can predict the probability of clinical pregnancy failure in PORs before embryo transfer in IVF/ICSI procedure, to help practitioners make appropriate clinical decisions and to help infertile couples manage their expectations.
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影响因子：
4
作者：
Gong Y;Li-Ling J;Xiong D;Wei J;Zhong T;Tan H
通讯作者：
Tan H
影响因子：
9.8
作者：
Jungheim ES;Moley KH
通讯作者：
Moley KH
影响因子：
5.4
作者：
Gao, L.;Li, M.;Yang, X.
通讯作者：
Yang, X.
影响因子：
4
作者：
Galey-Fontaine, J
通讯作者：
Galey-Fontaine, J
影响因子：
8.9
作者：
Chen, C. M.
通讯作者：
Chen, C. M.