The Construction of A Predictive Model for Clinical Pregnancy Outcome in Frozen-thawed Embryo Transfer Cycles in Women with Advanced Maternal Age

Junqiang WANG; Ying CHEN; Fengchen GAO; Wenxiu ZHAO; Shuxuan CAO; Yixi LI; Limei HE; Zexing YANG

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Junqiang WANG, Ying CHEN, Fengchen GAO, Wenxiu ZHAO, Shuxuan CAO, Yixi LI, Limei HE, Zexing YANG. The Construction of A Predictive Model for Clinical Pregnancy Outcome in Frozen-thawed Embryo Transfer Cycles in Women with Advanced Maternal Age[J]. Journal of Kunming Medical University.

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The Construction of A Predictive Model for Clinical Pregnancy Outcome in Frozen-thawed Embryo Transfer Cycles in Women with Advanced Maternal Age

1.
School of Public Health，Kunming Medical University，Kunming Yunnan 650500
2.
Department of Reproductive Genetics，The First Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032，China

Received Date: 2024-10-15
Available Online: 2025-08-12

Abstract

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.
- Frozen-thawed embryo transfer,
- Clinical pregnancy,
- Advanced maternal age,
- Predictors of outcome,
- Predictive model

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References(32)

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