{"id":292,"title":"[Predictive value of maternal age, AMH level, and number of PGT cycles for the acquisition of euploid blastocysts: Construction and validation of a Nomogram model]","title_zh":"母体年龄、AMH水平及PGT周期数对获得整倍体囊胚的预测价值：列线图模型的构建与验证","url":"https://pubmed.ncbi.nlm.nih.gov/42982430","doi":"10.3760/cma.j.cn511374-20260809-00360","pmid":"42982430","journal":"Zhonghua Yi Xue Yi Chuan Xue Za Zhi","kind":"paper","lang":"en","published_at":null,"fetched_at":"2026-11-08T03:44:04+00:00","authors":["Tan C","Wang X","Zou P","Fei J","Yu Y"],"primary_topic":"pgt","topics":[{"slug":"pgt","score":10.0,"hits":["euploid","pgt","pgt-a","preimplantation genetic"]},{"slug":"repro-endo","score":5.0,"hits":["amh","anti-müllerian"]},{"slug":"repro-aging","score":5.0,"hits":["advanced maternal age","maternal age"]},{"slug":"ai-compute","score":5.0,"hits":["nomogram","predictive model"]},{"slug":"early-embryo","score":4.0,"hits":["blastocysts"]},{"slug":"industry","score":4.0,"hits":["acquisition"]},{"slug":"repro-tox","score":1.0,"hits":["bmi"]}],"topic_score":10.0,"preference_score":0.0,"preference_labels":[],"llm_score":74.0,"final_score":74.0,"score_dims":{"novelty":55,"rigor":72,"impact":65,"relevance":95,"translation":82},"recommend_reason":"模型简洁且内部验证表现良好，列线图可直接辅助PGT-A前个体化咨询；但预测因素均为已知指标，单中心回顾性设计且缺乏外部验证，新颖性和证据等级有限。","keywords":["PGT-A","整倍体囊胚","AMH","母体年龄","列线图","预测模型"],"selected":1,"story_id":2,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-endo-genetics","source_name":"PubMed · 生殖内分泌/遗传/保存","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该回顾性研究纳入2022年6月至2025年6月单中心501个PGT-A治疗周期，按是否获得整倍体囊胚分为获得组447例与未获得组54例。多因素Logistic回归显示，母体年龄（OR=0.872）、AMH水平（OR=1.514）及既往PGT周期数（每增加1周期OR=0.392）为独立预测因素；父体BMI在敏感性分析后未纳入最终模型。简化模型AUC为0.828（95%CI 0.755-0.865），Hosmer-Lemeshow检验P=0.852，Bootstrap内部验证校准斜率接近1，并构建列线图用于临床可视化咨询。","summary":"OBJECTIVE: To identify independent predictive factors for the presence of euploid blastocysts during the preimplantation genetic testing for aneuploidy (PGT-A) cycle and to develop a clinical predictive model. METHODS: A retrospective analysis was conducted on the clinical data from 501 treatment cycles of PGT-A performed at the Department of Reproductive Medicine, Northern Theater Command General Hospital, between June 2022 and June 2025. Patients were divided into an acquisition group (n = 447) and a non-acquisition group (n = 54) based on whether euploid blastocysts were obtained. Independent predictive factors were identified using uni-variate and multivariate Logistic regression analyses; model fit and discrimination were evaluated using the Hosmer-Lemeshow test and ROC curves; internal validation was performed using the Bootstrap method (1 000 bootstrap samples); and a nomogram was constructed for clinical visualization. RESULTS: Multivariate Logistic regression analysis identified maternal age (OR = 0.872, P = 0.025), maternal anti-Müllerian hormone (AMH) level (OR = 1.514, P = 0.001), and number of PGT cycles (per additional cycle: OR = 0.392, P < 0.001) as independent predictors of obtaining euploid blastocysts. Sensitivity analysis revealed that the positive association between paternal BMI (OR = 1.116, P = 0.031) lost statistical significance after excluding extreme values (OR = 1.034, P = 0.618), and no nonlinear relationship was observed (square term P = 0.189), therefore paternal BMI was not included in the final model. The area under the curve (AUC) for the simplified model (including maternal age, AMH level, and number of PGT cycles) was 0.828 (95%CI: 0.755-0.865); the Hosmer-Lemeshow test yielded P = 0.852, and the calibrated slope after bootstrap adjustment was close to 1, indicating high model stability and low risk of overfitting. CONCLUSION: Advanced maternal age, decreased AMH levels, and an increased number of previous PGT cycles are independent risk factors for failure to obtain euploid blastocysts during a PGT-A cycle. The predictive model developed based on these three factors demonstrates good discrimination and calibration capabilities; the nomogram can serve as a reference for clinical personalized counseling.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}