通讯作者: 张晶, 147548574@qq.com

DOI：10.12201/bmr.202506.00074

Predictive modeling of IVF-ET clinical pregnancy in patients with secondary infertility

• 摘要：目的：分析参与体外受精-胚胎移植（in vitro fertilization and embryotransfer，IVF-ET）的继发性不孕患者临床妊娠是否成功的影响因素，并对个体风险进行预测。方法：回顾性分析2020年1月-2023年12月于乌鲁木齐市妇幼保健院进行IVF-ET的235例继发性不孕患者的胚胎移植档案资料，根据是否成功临床妊娠分为胚胎移植成功组（n=109）和胚胎移植失败组（n=126）。比较两组患者一般资料、促排卵资料、胚胎资料，进行多因素logistic回归分析（向前LR法）筛选出有统计学意义的指标，基于此构建列线图预测模型，绘制受试者工作特征（receiver operator characteristic，ROC）曲线、校准曲线以及决策分析（decision analysis，DCA）曲线对模型的区分度、准确度和临床实用性进行验证。结果：对于参与IVF-ET的继发性不孕患者，多因素logistic回归结果显示，女方年龄、超重和肥胖是导致临床妊娠失败的危险因素，AMH、Gn总量是临床妊娠结局的保护因素。在此基础上成功构建列线图预测模型，区分度、准确度和临床实用性均通过了验证。结论：对于参与IVF-ET的继发性不孕患者，女方年龄、超重和肥胖、AMH和Gn总量是临床妊娠的影响因素。可通过构建的列线图预测模型对参与IVF-ET的原发性不孕患者是否能成功临床妊娠进行预测，有待今后积累更多的样本和变量，对模型进行更新和调整。

  关键词： 继发性不孕；IVF-ET；临床妊娠；列线图；预测; ; ; ; 

   

  Abstract: Objective: To analyze the factors influencing whether clinical pregnancy is successful or not in secondary infertility patients involved in in vitro fertilization and embryotransfer (IVF-ET), and to predict individual risk. Methods: The embryo transfer files of 235 secondary infertility patients who underwent IVF-ET in Urumqi Maternal and Child Health Hospital from January 2020 to December 2023 were retrospectively analyzed, and divided into the successful embryo transfer group (n=109) and the failed embryo transfer group (n=126) according to whether they had a successful clinical pregnancy. Comparing the general data, ovulation promotion data and embryo data of the two groups, we performed multifactorial logistic regression analysis (forward LR method) to screen out statistically significant indicators, based on which we constructed the prediction model of the nomogram, and plotted the receiver operator characteristic (ROC) curve, the calibration curve, and the decision analysis (DCA) curve. （ROC curves, calibration curves and decision analysis (DCA) curves were plotted to verify the differentiation, accuracy and clinical utility of the model. Results: For secondary infertility patients involved in IVF-ET, multifactorial logistic regression showed that female age overweight and obesitywere risk factors for clinical pregnancy failure, and AMH and total Gn were the clinical pregnancy outcomes Protective factors. On this basis, the nomogram prediction model was successfully constructed, and the differentiation, accuracy and clinical utility were verified. Conclusion: For secondary infertile patients involved in IVF-ET, female age, overweight and obesity, AMH and total Gn are influential factors for clinical pregnancy. The constructed nomogram prediction model can be used to predict whether a successful clinical pregnancy can be achieved in patients with primary infertility participating in IVF-ET, pending the accumulation of more samples and variables to update and adjust the model in the future.

  Key words: Secondary infertility; IVF-ET; clinical pregnancy; nomogram; prediction

  提交时间：2025-06-24

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• 序号	提交日期	编号	操作
  1	2025-05-01	bmr.202506.00074V1	下载

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