昆明医科大学学报2025，Vol.46Issue(8)：51-57,7.DOI:10.12259/j.issn.2095-610X.S20250807
高龄女性冻融胚胎移植周期临床妊娠结局预测模型构建
The Construction of A Predictive Model for Clinical Pregnancy Outcome in Frozen-thawed Embryo Transfer Cycles in Women with Advanced Maternal Age
摘要
Abstract
Objective To construct a predictive model for clinical pregnancy outcomes in frozen-thawed embryo transfer(FET)cycles in women with advanced maternal age(age≥35 years)and to analyze its influencing factors.Methods A retrospective analysis was conducted on the clinical data of 2717 older patients who underwent FET treatment at the First Affiliated Hospital of Kunming Medical University from January 2018 to December 2023.These Patients were divided into a clinical pregnancy group(n=851)and a non-clinical pregnancy group(n=1866)based on whether the clinical pregnancy had occurred.The general characteristics and transplantation details of the two groups were compared,and a logistic regression analysis model was constructed.Results The clinical pregnancy rate(CPR)was 31.32%.The CPR for women aged 35-40 years(40.06%)was higher than that for women aged≥40 years(19.35%),with a statistically significant difference(χ2=133.371,P<0.05).The model results showed that the higher anti-Mullerian hormone(AMH)levels(OR=1.053,95%CI:1.012-1.095),the more high-quality blastocysts were transferred(OR=1.704,95%CI:1.143-2.542;OR=2.861,95%CI:1.921-4.262);the more high-quality blastocysts were transferred(OR=2.033,95%CI:1.077-3.836;OR=3.886,95%CI:2.035-7.420),the thicker the endometrial lining on the day of transfer(OR=1.150,95%CI:1.092-1.212)and it could increase the probability of clinical pregnancy.However,for women over 40 years of age(OR=0.551,95%CI:0.437-0.694)and secondary infertility(OR=0.704,95%CI:0.552-0.896),the probability of clinical pregnancy would be reduced;ROC curve analysis results showed that the AUC for predicting clinical pregnancy occurrence in the training set and validation set of the predictive model were 0.723(95%CI:0.699-0.748)and 0.726(95%CI:0.689-0.764),respectively,with cutoff values of 0.262 and 0.260 and the model fit was good(P>0.05).Conclusion Female age,AMH level,type of infertility,number of high-quality embryos(cleavage embryos,blastocysts)transferred,and endometrial thickness on the day of transfer are important factors affecting FET cycles in advanced maternal age women.The constructed prediction model based on these factors has a certain predictive ability for clinical pregnancy.关键词
冻融胚胎移植/临床妊娠/高龄/影响因素/预测模型Key words
Frozen-thawed embryo transfer/Clinical pregnancy/Advanced maternal age/Predictors of outcome/Predictive model分类
医药卫生引用本文复制引用
王军强,陈莹,高逢辰,赵文秀,曹舒璇,李依奚,和丽梅,杨泽星..高龄女性冻融胚胎移植周期临床妊娠结局预测模型构建[J].昆明医科大学学报,2025,46(8):51-57,7.基金项目
云南省中青年学术和技术带头人后备人才基金(202305AC160046) （202305AC160046）
云南省教育厅公共卫生与疾病防控重点实验室基金(2023ZD07) （2023ZD07）
昆明医科大学大学生创新训练项目(2024CYD321) （2024CYD321）
