Zhang Rui, Guo Yuanbing, Zhai Xiaonan, Wang Juan, Hao Xiaoyan, Yang Liu, Zhou Lei, Gao Jiawei, Liu Jiayun
Department of Clinical Laboratory Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Front Endocrinol (Lausanne). 2025 Jul 18;16:1544724. doi: 10.3389/fendo.2025.1544724. eCollection 2025.
Diagnosis and treatment of infertility and pregnancy loss are complicated by various factors. We aimed to develop a simpler, more efficient system for diagnosing infertility and pregnancy loss.
This study included 333 female patients with infertility and 319 female patients with pregnancy loss, as well as 327 healthy individuals for modeling; 1264 female patients with infertility and 1030 female patients with pregnancy loss, as well as 1059 healthy individuals for validating the models. The average age and basic information were matched between the groups. Three methods were used for screening 100+ clinical indicators, and five machine learning algorithms were used to develop and evaluate diagnostic models based on the most relevant indicators.
Multivariate analysis revealed significant differences in several factors between the patients and the control group. 25-hydroxy vitamin D3 (25OHVD3) was the factor exhibiting the most prominent difference, and most patients presented deficiency in the levels of this vitamin. 25OHVD3 is associated with blood lipids, hormones, thyroid function, human papillomavirus infection, hepatitis B infection, sedimentation rate, renal function, coagulation function, and amino acids in patients with infertility. The model for infertility diagnosis included eleven factors and exhibited area under the curve (AUC), sensitivity, and specificity values higher than 0.958, 86.52%, and 91.23%, respectively. The model for potential pregnancy loss was also developed using five machine learning algorithms and was based on 7 indicators. According to the results obtained from the testing set, the sensitivity was higher than 92.02%, the specificity was higher than 95.18%, the accuracy was higher than 94.34%, and the AUC was higher than 0.972.
The simplicity, good diagnostic performance, and high sensitivity of the models presented here may facilitate early detection, treatment, and prevention of infertility and pregnancy loss.
不孕症和流产的诊断与治疗受到多种因素的影响。我们旨在开发一种更简单、更高效的不孕症和流产诊断系统。
本研究纳入了333例不孕症女性患者、319例流产女性患者以及327名健康个体用于模型构建;1264例不孕症女性患者、1030例流产女性患者以及1059名健康个体用于模型验证。各组间平均年龄和基本信息相匹配。采用三种方法筛选100多项临床指标,并使用五种机器学习算法基于最相关指标开发和评估诊断模型。
多因素分析显示患者与对照组在几个因素上存在显著差异。25-羟基维生素D3(25OHVD3)是差异最为显著的因素,大多数患者该维生素水平缺乏。在不孕症患者中,25OHVD3与血脂、激素、甲状腺功能、人乳头瘤病毒感染、乙型肝炎感染、血沉、肾功能、凝血功能及氨基酸有关。不孕症诊断模型包括11个因素,其曲线下面积(AUC)、灵敏度和特异度值分别高于0.958、86.52%和91.23%。潜在流产模型也采用五种机器学习算法开发,基于7个指标。根据测试集结果,灵敏度高于92.02%,特异度高于95.18%,准确度高于94.34%,AUC高于0.972。
本文提出的模型具有简单性、良好的诊断性能和高灵敏度,可能有助于不孕症和流产的早期检测、治疗及预防。