摘要
目的分析行体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)的继发性不孕患者临床妊娠是否成功的影响因素,并构建列线图预测模型。方法回顾性分析2020年1月至2023年12月于乌鲁木齐市妇幼保健院行IVF-ET的235例继发性不孕患者的临床资料,根据是否成功临床妊娠将其分为妊娠成功组(n=109)和妊娠失败组(n=126)。比较两组患者的一般资料、促排卵资料、胚胎资料,采用多因素Logistic回归分析筛选有统计学意义的指标,基于此构建列线图预测模型,绘制受试者操作特征曲线、校准曲线及决策分析曲线对模型的区分度、准确度和临床实用性进行验证。结果多因素Logistic回归分析结果显示,女方年龄、超重和肥胖均是导致临床妊娠失败的危险因素,抗米勒管激素(anti-Müllerian hormone,AMH)、促性腺激素(gonadotropins,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,其区分度中等,准确度和临床实用性均较好。结论对行IVF-ET的继发性不孕患者,女方年龄、超重和肥胖、AMH和Gn总量均对临床妊娠有一定影响,可通过构建的列线图预测模型预测其临床妊娠结局。
Objective To analyze the influencing factors of the success of clinical pregnancy in secondary infertility patients undergoing in vitro fertilization-embryo transfer(IVF-ET)and construct a nomogram prediction model.Methods A retrospective analysis was conducted on the clinical data of 235 patients with secondary infertility who underwent IVF-ET at Urumqi Maternal and Child Health Hospital from January 2020 to December 2023.They were divided into successful pregnancy group(n=109)and failed pregnancy group(n=126)based on whether clinical pregnancy was successful.The general information,ovulation induction data and embryo data of two groups of patients were compared.Multivariate Logistic regression analysis was used to screen out statistically significant indicators,and based on this,a nomogram prediction model was constructed.The receiver operating characteristic curve,calibration curve and decision analysis curve were drawn to verify the discrimination,accuracy and clinical practicability of the model.Results The results of multivariate Logistic regression analysis showed that the female’s age,overweight and obesity were all risk factors for clinical pregnancy failure,while anti-Müllerian hormone(AMH)and the total amount of gonadotropins(Gn)were protective factor for clinical pregnancy outcomes.On this basis,a nomogram prediction model was successfully constructed,which has a medium degree of discrimination,good accuracy and clinical practicability.Conclusion For secondary infertility patients undergoing IVF-ET,the female’s age,overweight and obesity,AMH,and the total amount of Gn have certain influences on clinical pregnancy.The clinical pregnancy outcome can be predicted through the constructed nomogram prediction model.
作者
魏乾坤
吴芸
徐新燕
魏梦珂
曾智萍
代宇宁
帕提曼·艾尼瓦尔
张晶
WEI Qiankun;WU Yun;XU Xinyan;WEI Mengke;ZENG Zhiping;DAI Yuning;PATIMAN Ainiwaer;ZHANG Jing(School of Medicine,Shihezi University,Shihezi 832000,Xinjiang,China;Department of Assisted Reproduction,Urumqi Maternal and Child Health Hospital,Urumqi 830000,Xinjiang,China;No.2 Department of Gynecology,Urumqi Maternal and Child Health Hospital,Urumqi 830000,Xinjiang,China;School of Public Health,Xinjiang Medical University,Urumqi 830000,Xinjiang,China;No.1 Department of Gynecology,Urumqi Maternal and Child Health Hospital,Xinjiang Clinical Research Center for Perinatal Diseases,Urumqi 830000,Xinjiang,China)
出处
《中国现代医生》
2025年第28期43-47,77,共6页
China Modern Doctor
关键词
继发性不孕
体外受精-胚胎移植
临床妊娠
列线图
预测
Secondary infertility
In vitro fertilization-embryo transfer
Clinical pregnancy
Nomogram
Prediction
