Prediction of Live Birth Rate After ICSI/IVF Cycles in Patients with Polycystic Ovary Syndrome Using a Clinical Prediction Model and Nomogram

Abstract Background: Achievement of a live birth is the marker of success in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatments. For patients with polycystic ovary syndrome (PCOS) who are undergoing these treatments, some predictive models and nomograms have been published. However, further development of these models is required for their useful application in clinical settings.Method: To establish and validate a clinical prediction model and nomogram to predict a live birth rate in women with PCOS undergoing IVF/ICSI. Records on 1193 patients underwent their first IVF/ICSI cycles for PCOS infertility from January 2014 to December 2019.The nomogram was built by a training cohort of 835 patients and tested on a validation cohort of 358 patients. Results: Female age, duration of infertility, total gonadotropin dose, the day of embryo transfer, no. of transferred embryos and the serum testosterone (T) level in PCOS groups were significantly associated with live birth rate. The predictive model was built by female age, duration of infertility, total gonadotropin dose, the day of embryo transfer, no. of transferred embryos, no. of retrieved oocytes, the serum T level, the serum progesterone (P) level, type of fecundation and endometrial thickness on embryo transfer day. The area under the curve (AUC) of the PCOS-specific predictive model in the training cohort was 0.72(95% CI, 0.68-0.76) and the AUC for the validation cohort was 0.63 (95% CI, 0.56-0.69).Conclusions: Our clinical prediction model and nomogram graphically demonstrated the risk factors that were associated with IVF/ICSI live birth rates in patients with PCOS. These findings offer improved clinical guidance for clinicians and patients.