The Use of A Combined Clinical Symptom and Biomarker-Based Model to Predict Risk of Developing Reproductive Conditions and Fertility Potential.

成功怀孕需要对排卵和月经周期、生活方式因素和稳定的激素水平进行复杂的计算。健康的生殖周期依赖于所有这些变量的精确同步。然而，在几乎30%的所有妇女中，这些因素的协调存在一定程度的不稳定性，可能会导致生殖周期中断，并导致随后的不孕症。关于怀孕所涉及的多因素变量的大部分数据主要来自对临床诊断为生育力低下人群的小规模研究。因此，还没有尝试受孕或患有非典型子宫内膜异位症的女性的数据很少。这些症状通常与其他常见疾病（例如，月经过多、肠易激综合征或间质性膀胱炎），在初级保健中进行鉴别诊断具有挑战性。此外，目前NICE在初级保健中常规妇科评估的指南限制了实验室检查和女性激素检测（生物标志物），并且作为当前诊断框架的结果，诊断通常被延迟，平均在最初表现出患有疾病后6- 12年。基于性别的护理问卷，旨在让妇女自我-结合更全面的生物标志物小组来确定他们自己的症状可以促进患者和医生之间的初步讨论，该研究项目的目的是根据患者自我识别的症状以及生物特征信息（激素、生殖和病史），开发一种临床预测模型。通过将这个模型应用于更广泛的人群，我们希望每个女性自己的症状和生物学可以用来表明她的生育和生殖健康的潜在风险。

Achieving a successful pregnancy requires a complex calculus of ovulation and menstrual cycles, lifestyle factors and stable hormone levels. A healthy reproductive cycle is reliant on precise synchronisation of all these variables. However, in almost 30% of all women, there is some varying degree of instability in the harmonisation of these factors that can cause a disruption to their reproductive cycle and lead to subsequent infertility.Much of the data concerning the multifactorial variables involved in pregnancy, has predominantly been generated from small scale studies on a clinically diagnosed subfertile population. Consequently, there is a paucity of data available from females who are yet to attempt conception or who present with atypical symptomology.These symptoms often overlap with those of other common conditions (e.g., heavy periods, irritable bowel syndrome or interstitial cystitis), making a differential diagnosis challenging in primary care. Moreover, current NICE guidelines for routine gynaecological evaluation in primary care limits laboratory tests and female hormone testing (biomarkers) and as a consequence of the current diagnostic framework diagnosis is often delayed, on average 6--12 years after initially presenting with symptoms.A patient-completed, symptom-based care questionnaire designed to allow women to self-identify their own symptoms in combination with a more comprehensive biomarker panel could facilitate the initial discussions between patients and physicians, with the potential to reduce diagnostic delay and encourage earlier treatment.The aim of this program of research is to develop a model of clinical prediction, based on both patient self-identified symptoms together with biometric information (hormones, reproductive and medical history). By applying this model to the wider population, we hope that each woman's own symptoms and biology can be used to indicate the potential risk to her fertility and reproductive health.