Nomogram for the cumulative live birth in women undergoing the first IVF cycle: Base on 26, 689 patients in China

Abstract

ObjectivePredictive models of the cumulative live birth (CLB) in women undergoing in vitro fertilization (IVF) treatment are limited. The aim of this study was to develop and validate a nomogram for the CLB in women undergoing the first IVF cycle.MethodsBased on a cross-sectional study in assisted reproduction center of Northwest Women’s and Children’s Hospital, 26,689 Chinese patients who underwent IVF treatment was used to develop and validate a prediction model for the CLB. Among those participants, 70% were randomly assigned to the training set (18,601 patients), while the remaining 30% were assigned to the validation set (8,088 patients). A nomogram was constructed based on the results of the multivariate logistic regression analysis. The model performance was evaluated using the C statistic and the calibration performance was assessed by Hosmer-Lemeshow (HL) χ2 statistics and calibration plots.ResultsMultivariate logistic regression analyses revealed that female age, female body mass index (BMI), tubal factor infertility, male infertility, uterine factor infertility, unexplained infertility, antral follicle count (AFC) and basal serum follicle stimulating hormone (FSH) were significant factors for CLB in women undergoing the first IVF cycle. An area under the receiver operating characteristic curve (AUC) in the prediction model was 0.676 (95% CI 0.668 to 0.684) in the training group. The validation set showed possibly helpful discrimination with an AUC of 0.672 (95% CI 0.660 to 0.684). Additionally, the prediction model had a good calibration (HL χ2 = 8.240, P=0.410).ConclusionsWe developed and validated a nomogram to predict CLB in women undergoing the first IVF cycle using a single center database in China. The validated nomogram to predict CLB could be a potential tool for IVF counselling.

Pretreatment prediction for IVF outcomes: generalized applicable model or centre-specific model?

“… Qiu et al (2019) reported an Xgoobst-based predictive model for the live birth following the first IVF cycle, showing an AUC of 0.73 in the validation cohort. Qu et al (2022) reported an AUC of 0.676 based on a larger cohort of 26 689 patients. Both studies are based on validations of random split data, rather than validations in a more recent cohort or other clinics/countries.…”

“…Our study also established ‘centre-specific models’ which were based on a single-centre dataset. While several IVF prediction models have been constructed for a similar purpose ( Cai et al , 2011 ; Qiu et al , 2019 ; Vogiatzi et al , 2019 ; Tarin et al , 2020 ; Chen et al , 2022 ; Qu et al , 2022 ; Wang et al , 2022 ), many of them included treatment parameters and intermediate outcomes such as oocyte yield and therefore could not predict the patients’ prognosis before treatment ( Cai et al 2011 ; Vogiatzi et al , 2019 ; Chen et al , 2022 ; Wang et al , 2022 ). A few recent studies reported pretreatment models comparable to ours.…”

“…National-wide registry data and models based on them are not always available, especially for low- and middle-income countries where cost and efficacy are of significant concern ( Chiware et al , 2021 ). For regions where national-wide data were not available, prediction models based on local data including only one or a few clinics have been established ( Cai et al , 2011 ; Qiu et al , 2019 ; Vogiatzi et al , 2019 ; Tarin et al , 2020 ; Zhu et al , 2021 ; Chen et al , 2022 ; Qu et al , 2022 ; Wang et al , 2022 ). Although it is recommended that individual clinics first validate and recalibrate national-wide data-based models using their datasets before developing their clinic-specific prediction models ( McLernon et al , 2022 ), the centre-specific models are more specific to their patients and may include potentially important predictors that are not recorded in a national registry database.…”

Development and validation of a nomogram for predicting ongoing pregnancy in single vitrified-warmed blastocyst embryo transfer cycles

“…Maternal age, a widely recognized factor, negatively affects pregnancy outcomes in numerous prior studies (10,21,22). In a recent study, maternal aging significantly affected embryonic development from oocyte maturation to blastocyst formation (21).…”

Using UK/ASRM models and local model to predict the prognosis of IVF in China: a retrospective study.

“…National-wide registry data and models based on them are not always available, especially for low-and middle-income countries where cost and efficacy are of significant concern (6). For regions where nationalwide data were not available, prediction models based on local data including only one or a few clinics were established (7)(8)(9)(10)(11)(12)(13)(14). Although it is recommended that individual clinics may first validate and recalibrate national-wide data-based models using their datasets before developing their clinic-specific prediction models(4), the local models are more specific to their patients and may include potentially important predictors that are not recorded in a national registry database.…”