Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Obstetrics and Gynecology, Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, China.
Front Endocrinol (Lausanne). 2021 Apr 30;12:606231. doi: 10.3389/fendo.2021.606231. eCollection 2021.
We designed a predictive reference model to evaluate how many stimulation cycles are needed for a patient to achieve an ideal live birth rate using assisted reproductive technology.
To develop a counseling tool for women who wish to undergo assisted reproductive technology (ART) treatment to predict the likelihood of live birth based on age and number of oocytes retrieved.
This was a 6-year population-based retrospective cohort analysis using individual patient ART data. Between 2012 and 2017, 17,948 women were analyzed from their single ovarian stimulation cycle until they had a live birth or had used all their embryos. All consecutive women between 20 and 49 years old undergoing their ovarian stimulation cycles for ART in our center were enrolled. The cumulative live birth rate (CLBR) was defined as the delivery of a live neonate born during fresh or subsequent frozen-thawed embryo transfer cycles. Only the first delivery was considered in the analysis. Binary logistic regression was performed to identify and adjust for factors known to affect the CLBR independently. A generalized additive model was used to build a predictive model of CLBR according to the woman's age and the number of oocytes retrieved.
An evidenced-based counseling tool was created to predict the probability of an individual woman having a live birth, based on her age and the number of oocytes retrieved in ART cycles. The model was verified by 10 times 10-fold cross-validation using the preprocessed data, and 100 area under the curve (AUC) values for receiver operating characteristic (ROC) curves were obtained on the test set. The mean AUC value was 0.7394. Our model predicts different CLBRs ranging from nearly 90% to less than 20% for women aged 20-49 years with at least 22 oocytes retrieved. The CLBRs of women aged 20-28 years were very similar, nearly on one trend line with a certain number of oocytes retrieved. Differences in the CLBR began to appear by the age of 29 years; these increased gradually in women aged >35 years.
A predictive model of the CLBR was designed to serve as a guide for physicians and for patients considering ART treatment. The number of oocytes needed to be retrieved to achieve a live birth depends on the woman's age.
我们设计了一个预测参考模型，以评估患者使用辅助生殖技术实现理想活产率需要多少个刺激周期。
为希望接受辅助生殖技术 (ART) 治疗的女性开发一种咨询工具，根据年龄和取卵数预测活产的可能性。
这是一项基于人群的回顾性队列分析，使用了个体患者的 ART 数据。在 2012 年至 2017 年期间，对我院中心接受卵巢刺激周期进行 ART 的 17948 名年龄在 20 至 49 岁的连续女性进行了分析。所有连续女性均进行卵巢刺激周期，直至活产或用尽所有胚胎。累积活产率 (CLBR) 定义为新鲜或随后冷冻解冻胚胎移植周期中分娩的活新生儿的分娩。在分析中仅考虑第一次分娩。采用二元逻辑回归识别并调整独立影响 CLBR 的因素。根据女性的年龄和取卵数，使用广义加性模型构建 CLBR 的预测模型。
根据年龄和 ART 周期中取卵数，为个体女性创建了一个基于证据的咨询工具，以预测其活产的可能性。该模型使用预处理数据通过 10 次 10 折交叉验证进行了验证，在测试集上获得了 100 个接收器操作特征 (ROC) 曲线的曲线下面积 (AUC) 值。平均 AUC 值为 0.7394。我们的模型预测了年龄在 20-49 岁、取卵数至少为 22 的女性的不同 CLBR，范围从近 90%到低于 20%。年龄在 20-28 岁的女性的 CLBR 非常相似，几乎与一定数量的取卵数呈一条趋势线。年龄在 29 岁以上的女性的 CLBR 差异开始出现，并且随着年龄的增长逐渐增加。
设计了 CLBR 的预测模型，作为医生和考虑接受 ART 治疗的患者的指南。实现活产所需的取卵数取决于女性的年龄。
