A model for pregnancy rates after IVF-ET in patients with infertility and endometriosis

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This study developed a predictive model for IVF-ET pregnancy rates in infertile endometriosis patients, finding GnRH-a treatment, ASRM stage, and high-quality embryo number were significant factors.

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This retrospective study evaluated 158 infertile patients with endometriosis (158 IVF-ET cycles) after laparoscopic surgery, analyzing clinical factors associated with pregnancy and using them to build a multivariable predictive model. Using univariate comparisons followed by multivariate logistic regression, it found independent associations with successful pregnancy for post-operative GnRH-a treatment (OR 6.562), lower ASRM stage (OR 0.218), and a higher number of high-quality transferred embryos (OR 3.155), with model discrimination AUC 0.774 and good calibration by Hosmer-Lemeshow (p>0.05). Internal validation with bootstrapping showed consistency between predicted and observed pregnancy rates, but the paper’s evidence is limited to a retrospective design and internal validation rather than an external cohort. This paper is centrally about endometriosis — it develops and validates a model predicting pregnancy rates after IVF-ET in infertility patients with endometriosis based on post-operative and cycle-specific factors.

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Abstract

OBJECTIVE: The objective of the present study was to examine the clinical factors influencing the pregnancy rate of infertile patients with endometriosis and establish a predictive model. PATIENTS AND METHODS: This study included 158 patients (158 cycles) with infertility and endometriosis who underwent laparoscopic surgery, and in vitro fertilization and embryo transfer (IVF-ET) were evaluated retrospectively between January 2019 and December 2020. The clinical factors in the pregnant and non-pregnant group were analyzed by univariate analysis. Statistically significant variables were subsequently used for multivariate logistic regression to establish the prediction model. RESULTS: Multivariate logistic regression analyses showed that GnRH-a treatment after operation (OR, 6.562; 95% CI: 2.782-15.477; p<0.01), ASRM stage (OR, 0.218; 95% CI: 0.093-0.509; p<0.05), the number of high-quality transferred embryos (OR, 3.155; 95% CI: 1.647-6.047; p<0.05) were independently associated with successful pregnancy. The area under the curve (AUC) of the prediction model was 0.774 (95% CI: 0.700-0.847). According to Hosmer-Lemeshow, the model was well fitted (p>0.05). We applied the bootstrapping method to internal validation, and the result showed that the pregnancy rate predicted by the model and the real data were consistent. CONCLUSIONS: The models for predicting pregnancy rates after IVF-ET in infertility and endometriosis patients showed high accuracy. The effective methods to increase the number of high-quality embryos need further study.
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Objective

The objective of the present study was to examine the clinical factors influencing the pregnancy rate of infertile patients with endometriosis and establish a predictive model. PATIENTS AND METHODS: This study included 158 patients (158 cycles) with infertility and endometriosis who underwent laparoscopic surgery, and in vitro fertilization and embryo transfer (IVF-ET) were evaluated retrospectively between January 2019 and December 2020. The clinical factors in the pregnant and non-pregnant group were analyzed by univariate analysis. Statistically significant variables were subsequently used for multivariate logistic regression to establish the prediction model.

Results

Multivariate logistic regression analyses showed that GnRH-a treatment after operation (OR, 6.562; 95% CI: 2.782-15.477; p<0.01), ASRM stage (OR, 0.218; 95% CI: 0.093-0.509; p<0.05), the number of high-quality transferred embryos (OR, 3.155; 95% CI: 1.647-6.047; p<0.05) were independently associated with successful pregnancy. The area under the curve (AUC) of the prediction model was 0.774 (95% CI: 0.700-0.847). According to Hosmer-Lemeshow, the model was well fitted (p>0.05). We applied the bootstrapping method to internal validation, and the result showed that the pregnancy rate predicted by the model and the real data were consistent.

Conclusions

The models for predicting pregnancy rates after IVF-ET in infertility and endometriosis patients showed high accuracy. The effective methods to increase the number of high-quality embryos need further study. Free PDF DownloadThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License To cite this article F.-P. Huang, H.-L. Zhang, X. Xie, S.-R. Du, J.-S. Yi A model for pregnancy rates after IVF-ET in patients with infertility and endometriosis Eur Rev Med Pharmacol Sci Year: 2022 Vol. 26 - N. 19 Pages: 7188-7194 DOI: 10.26355/eurrev_202210_29908 Publication History Published online: 14 Oct 2022

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female

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europepmc
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openalex
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