Liu Lidan, Gan Qiuying, Yang Yihua, Liu Bo, Huang Qianyi, Li Mujun
Guangxi Reproductive Medical Center, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Reproductive Center, Nanning Maternity and Child Health Hospital, Nanning, China.
Front Endocrinol (Lausanne). 2024 Nov 22;15:1428086. doi: 10.3389/fendo.2024.1428086. eCollection 2024.
This study aimed to develop a predictive model for assessing clinical pregnancy probabilities in patients undergoing frozen-thawed cycles with single Day 6 blastocyst transfers.
We conducted a two-center retrospective cohort study analyzing 1,381 frozen-thawed single Day 6 blastocyst transfer cycles from June 2016 to December 2022. The primary outcome was the clinical pregnancy rate per cycle. Data were divided into training, testing, and validation groups in a 6:2:2 ratio. Univariate and LASSO regression analyses identified factors influencing clinical pregnancy, which were incorporated into a multiple regression model to predict outcomes. Model performance was assessed in terms of discrimination, calibration, and clinical utility.
Factors independently predicting clinical pregnancy included inner cell mass (ICM) grade, trophectoderm (TE) grade, Day 3 (D3) fragmentation, endometrium thickness, and male age at oocyte pick-up (OPU). The AUC values for the training, testing, and validation sets were 0.66, 0.65, and 0.60, respectively, indicating acceptable performance. Calibration curves demonstrated good predictive accuracy, with slopes of 0.988, 0.871, and 1.263 for the respective groups.
The developed nomogram accurately predicts clinical pregnancy probabilities in patients undergoing single Day 6 blastocyst transfers in frozen-thawed cycles, enhancing clinical decision-making by integrating crucial embryological and clinical parameters.
本研究旨在开发一种预测模型，用于评估接受第6天单囊胚冻融周期移植患者的临床妊娠概率。
我们进行了一项双中心回顾性队列研究，分析了2016年6月至2022年12月期间的1381个第6天单囊胚冻融周期移植。主要结局是每个周期的临床妊娠率。数据按6:2:2的比例分为训练组、测试组和验证组。单因素和LASSO回归分析确定影响临床妊娠的因素，并将其纳入多元回归模型以预测结局。从区分度、校准度和临床实用性方面评估模型性能。
独立预测临床妊娠的因素包括内细胞团（ICM）分级、滋养外胚层（TE）分级、第3天（D3）碎片率、子宫内膜厚度以及取卵时男性年龄。训练集、测试集和验证集的AUC值分别为0.66、0.65和0.60，表明模型性能可接受。校准曲线显示出良好的预测准确性，各分组的斜率分别为0.988、0.871和1.263。
所开发的列线图可准确预测接受第6天单囊胚冻融周期移植患者的临床妊娠概率，通过整合关键的胚胎学和临床参数增强临床决策。
