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预测行冻融胚胎移植的排卵女性活产的列线图。

Nomogram for predicting live birth in ovulatory women undergoing frozen-thawed embryo transfer.

机构信息

Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Qilu Hospital, Shandong University, Ji'nan, Shandong, 250012, P.R. China.

School of Computer Science and Technology, Shandong Jianzhu University, Jinan, Shandong, 250101, P.R. China.

出版信息

BMC Pregnancy Childbirth. 2024 Aug 27;24(1):559. doi: 10.1186/s12884-024-06759-7.

Abstract

BACKGROUND

Study objectives included the development of a practical nomogram for predicting live birth following frozen-thawed embryo transfers in ovulatory women.

METHODS

Totally, 2884 patients with regular menstrual cycles in our center were retrospectively enrolled. In an 8:2 ratio, we randomly assigned patients to training and validation cohorts. Then we identified risk factors by multivariate logistic regression and constructed nomogram. Finally, receiver operating characteristic curve analysis, calibration curve and decision curve analysis were performed to assess the calibration and discriminative ability of the nomogram.

RESULTS

We identified five variables which were related to live birth, including age, anti-Müllerian hormone (AMH), protocol of frozen-thawed embryo transfer (FET), stage of embryos and amount of high-quality embryos. We then constructed nomograms that predict the probabilities of live birth by using those five parameters. Receiver operating characteristic curve analysis (ROC) showed that the area under the curve (AUC) for live birth was 0.666 (95% CI: 0.644-0.688) in the training cohort. The AUC in the subsequent validation cohorts was 0.669 (95% CI, 0.625-0.713). The clinical practicability of this nomogram was demonstrated through calibration curve analysis and decision curve analysis.

CONCLUSIONS

Our nomogram provides a visual and simple tool in predicting live birth in ovulatory women who received FET. It could also provide advice and guidance for physicians and patients on decision-making during the FET procedure.

摘要

背景

研究目的包括开发一种实用的列线图,用于预测排卵妇女冷冻胚胎解冻移植后的活产。

方法

我们回顾性地纳入了 2884 名在我们中心有规律月经周期的患者。我们按 8:2 的比例将患者随机分配到训练队列和验证队列。然后,我们通过多变量逻辑回归确定风险因素,并构建列线图。最后,进行受试者工作特征曲线分析、校准曲线和决策曲线分析,以评估列线图的校准和判别能力。

结果

我们确定了五个与活产相关的变量,包括年龄、抗苗勒管激素(AMH)、冷冻胚胎解冻移植(FET)方案、胚胎阶段和高质量胚胎数量。然后,我们使用这五个参数构建了预测活产概率的列线图。受试者工作特征曲线分析(ROC)显示,训练队列中活产的曲线下面积(AUC)为 0.666(95%CI:0.644-0.688)。随后验证队列中的 AUC 为 0.669(95%CI,0.625-0.713)。校准曲线分析和决策曲线分析证明了该列线图的临床实用性。

结论

我们的列线图为接受 FET 的排卵妇女提供了一种预测活产的直观、简单的工具。它还可以为医生和患者在 FET 过程中的决策提供建议和指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/421c/11348591/f97ffb8e3544/12884_2024_6759_Fig1_HTML.jpg

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