Nomogram to predict live birth in infertile women with adenomyosis undergoing IVF/ICSI treatment: a retrospective cohort study

Zhongyuan Li¹Wei Chen²Xiaohan Sun³Xueqing Zhao³Linlin Cui¹Jingmei Hu⁴Li Ge¹Wenting Wang¹Ping Zhang^1*

• ¹The Second Hospital of Shandong University, Jinan, China
• ²Shandong First Medical University, Tai'an, Shandong, China
• ³Shandong University, Jinan, Shandong Province, China
• ⁴Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China

The purpose of this study was to develop a nomogram to predict live birth outcomes for infertile women with adenomyosis undergoing IVF/ICSI treatment.: Data were collected from the Center for Reproductive Medicine, Shandong University, between January 2016 and December 2020. This study included 222 fresh embryo transfer (ET) cycles and 266 frozen embryo transfer (FET) cycles. Patients were divided into a modeling cohort and a validation cohort. In the modelling cohort, multivariable logistic regression was employed to generate the predictive model and construct the nomogram. The predictive model was subsequently validated and calibrated. Results: In total, 249 (51.0%) patients achieved clinical pregnancy, and 165 (33.8%) patients had a live birth. Predictive variables in the final model included mean initial uterine diameter, age, body mass index (BMI), type of infertility (primary or secondary), stage of transferred embryo, endometrial thickness, number of embryos transferred, and pregnancy type. The area under the receiver operating characteristic (ROC) curve for the final prediction model was 0.915 (95% confidence interval [CI]: 88.6%-94.3%) in the modeling cohort and 0.940 (95% CI: 90.3%-97.6%) in the validation cohort. The calibration curves and Hosmer-Lemeshow test (H-L test) demonstrated excellent consistency between predicted and actual live birth outcomes. Conclusions: This study established a well-calibrated predictive model capable of accurately forecasting live birth outcomes for infertile women with adenomyosis undergoing IVF/ICSI treatment.