Development a nomogram to predict fertilisation rate of infertile males with borderline semen by using semen parameters combined with AMH and INHB.
Development a nomogram to predict fertilisation rate of infertile males with borderline semen by using semen parameters combined with AMH and INHB.
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作者：
Li J;Hu T;Wang Y;Fu Y;Wang F;Hu R
一些男性的精子质量处于临界状态，导致临床医生很难选择合适的受精方法。本研究旨在开发一种智能列线图，用于预测具有边缘精液的不育男性的受精率。 160名男性接受了体外受精（IVF），其中58名因受精失败而接受了挽救性ICSI（R-ICSI）（IVF受精率≤30%）。最小绝对收缩和选择算子 (LASSO) 回归分析确定精子浓度、渐进性活动精子 (PMS)、精浆抗苗勒氏管激素 (spAMH)、精浆抑制素 (spINHB)、血清 AMH (serAMH) 和血清 INHB (serINHB) 为显着预测因子。通过多变量逻辑回归绘制列线图。该列线图模型显示出良好的辨别力、校准和临床价值。列线图的受试者工作特征曲线 (AUC) 下面积为 0.762 (p < .001)。校准曲线和 Hosmer–Lemeshow 检验 (p = .5261) 显示列线图的预测与实际观察结果具有良好的一致性，决策曲线分析表明列线图在临床上有用。该列线图可能有助于预测受精率，主要集中于新的生物标志物 INHB 和 AMH。它可以帮助临床医生和实验室技术人员为精液边缘的男性患者选择合适的受精方法（IVF 或 ICSI）。
The sperm quality of some males is in a critical state, making it hard for clinicians to choose the suitable fertilisation methods. This study aimed to develop an intelligent nomogram for predicting fertilisation rate of infertile males with borderline semen. 160 males underwent in vitro fertilisation (IVF), 58 of whom received rescue ICSI (R‐ICSI) due to fertilisation failure (fertilisation rate of IVF ≤30%). A least absolute shrinkage and selection operator (LASSO) regression analysis identified sperm concentration, progressively motile spermatozoa (PMS), seminal plasma anti‐Müllerian hormone (spAMH), seminal plasma inhibin (spINHB), serum AMH (serAMH) and serum INHB (serINHB) as significant predictors. The nomogram was plotted by multivariable logistic regression. This nomogram‐illustrated model showed good discrimination, calibration and clinical value. The area under the receiver operating characteristic curve (AUC) of the nomogram was 0.762 (p < .001). Calibration curve and Hosmer–Lemeshow test (p = .5261) showed good consistency between the predictions of the nomogram and the actual observations, and decision curve analysis showed that the nomogram was clinically useful. This nomogram may be useful in predicting fertilisation rate, mainly focused on new biomarkers, INHB and AMH. It could assist clinicians and laboratory technicians select appropriate fertilisation methods (IVF or ICSI) for male patients with borderline semen.
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