Si Manfei, Jiang Huahua, Zhao Yue, Qi Xinyu, Li Rong, Long Xiaoyu, Qiao Jie
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.
National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.
Diagnostics (Basel). 2023 May 31;13(11):1927. doi: 10.3390/diagnostics13111927.
Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility. A better understanding of factors associated with pregnancy outcomes and successful prediction of live birth after IVF/ICSI are important to guide clinical practice. This was a retrospective cohort study investigating live birth after the first fresh embryo transfer using the GnRH-ant protocol in patients with PCOS between 2017 and 2021 at the Reproductive Center of Peking University Third Hospital. A total of 1018 patients with PCOS were qualified for inclusion in this study. BMI, AMH level, initial FSH dosage, serum LH and progesterone levels on the hCG trigger day, and endometrial thickness were all independent predictors of live birth. However, age and infertility duration were not significant predictors. We developed a prediction model based on these variables. The predictive ability of the model was demonstrated well, with areas under the curve of 0.711 (95% CI, 0.672-0.751) and 0.713 (95% CI, 0.650-0.776) in the training cohort and validation cohort, respectively. Additionally, the calibration plot showed good agreement between the prediction and the observation ( = 0.270). The novel nomogram could be helpful for clinicians and patients in clinical decision-making and outcome evaluation.
多囊卵巢综合征（PCOS）是无排卵性不孕的主要原因。更好地了解与妊娠结局相关的因素以及成功预测体外受精/卵胞浆内单精子注射（IVF/ICSI）后的活产情况对于指导临床实践很重要。这是一项回顾性队列研究，调查了2017年至2021年期间北京大学第三医院生殖中心使用促性腺激素释放激素拮抗剂（GnRH-ant）方案进行首次新鲜胚胎移植后的活产情况。共有1018例PCOS患者符合本研究的纳入标准。体重指数（BMI）、抗缪勒管激素（AMH）水平、初始促卵泡生成素（FSH）剂量、人绒毛膜促性腺激素（hCG）触发日的血清促黄体生成素（LH）和孕酮水平以及子宫内膜厚度均为活产的独立预测因素。然而，年龄和不孕持续时间并非显著的预测因素。我们基于这些变量开发了一个预测模型。该模型的预测能力得到了很好的证明，在训练队列和验证队列中的曲线下面积分别为0.711（95%可信区间，0.672 - 0.751）和0.713（95%可信区间，0.650 - 0.776）。此外，校准图显示预测值与观察值之间具有良好的一致性（ = 0.270）。这种新型列线图可能有助于临床医生和患者进行临床决策和结局评估。
