A Nomogram To Predict The Cumulative Live Birth Rate for Patients with Low Prognosis According To The POSEIDON Criteria: A Retrospective Observational Cohort Study of 4,395 Patients in Chinese Population
Abstract Purpose A small number of risk prediction model have been previously reported to predict the infertility treatment success. While the studies of the risk prediction model for the patients with low prognosis are limited. This study aimed to construct and validate a nomogram for the prediction of cumulative live birth rate (CLBR) in patients with low prognosis from a single center database in Chinese population. Methods Clinical data of 4,395 patients with low prognosis, who received in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) therapy between 2014 and 2018, were retrieved and randomly divided into training (70%) and the external validation (30%) sets. Multivariate analysis with logistic regression model was conducted. Results Multivariate analyses showed that maternal age, body mass index (BMI), basal serum follicle-stimulating hormone (FSH) level, type of infertility, male factors, uterine factors, and usable embryos number at day 3 were risk factors for CLBR in patients with low prognosis. The area under the receiver operating characteristic curve (AUC) of the prediction model was 0.769 (95% confident interval (CI): 0.751, 0.787) in training set. The validation set presented good performance with an AUC of 0.749 (95% CI: 0.720, 0.778). In addition, Hosmer-Lemeshow chi-square value was 10.194 (P = 0.252). Conclusion We constructed and validated a nomogram for the prediction of CLBR in low prognosis patients with a single center database in Chinese population. The validated nomogram for the prediction of CLBR could be potentially applied in clinic for IVF counselling in patients with low prognosis.