The development of using nomogram to predict pregnancy outcomes of emergency oocyte freeze-thaw cycles

Abstract

Background: To study which characteristics of a pre-oocyte-retrieval patient can affect the pregnancy outcomes of emergency oocyte freeze-thaw cycles. Methods: Nomogram model performance was assessed by examining the discrimination and calibration in the development and validation cohorts. Discriminatory ability was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test and calibration plots. Data was collected from the Reproductive Center, Peking University Third Hospital of China. Nomogram model performance was assessed by examining the discrimination and calibration in the development and validation cohorts. Discriminatory ability was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test and calibration plots.Results: The predictors in the model of ‘no embryo to transfer’ are female age (OR= 1.099, 95% CI=1.003-1.205, P=0.044), duration of infertility(OR= 1.140, 95% CI=1.018-1.276, P=0.024), basal FSH level (OR= 1.205, 95% CI=1.051-1.382, P=0.0084), basal E2 level (OR=1.006, 95% CI=1.001-1.010, P=0.012) and sperm from MESA (OR=7.741, 95% CI=2.905-20.632, P<0.001). Upon assessing predictive ability, the AUC for this model was 0.799 (95% CI: 0.722–0.875, p＜0.001). The Hosmer-Lemeshow test (p=0.721) and calibration curve showed good calibration. The predictors in the cumulative live birth were the number of follicles on the day of hCG administration (OR= 1.088, 95% CI=1.030-1.149, P=0.002) and endometriosis (OR= 0.172, 95% CI=0.035-0.853, P=0.031). The AUC for this model was 0.724 (95% CI: 0.647–0.801, p＜0.001). The Hosmer-Lemeshow test (p=0.562) and calibration curve showed good calibration for the prediction of cumulative live birth. Conclusion: The predictors in the final multivariate logistic regression models found to be significantly associated with poor pregnancy outcomes were increasing female age, duration of infertility, basal FSH and E2 level, the number of follicles with a diameter greater than 10 mm on the day of hCG administration, endometriosis and sperm from microdissection testicular sperm extraction (MESA).