{"id":43,"title":"Predictive Value of the Miscarriage Prediction Index for Early Miscarriage After Frozen Embryo Transfer","title_zh":"流产预测指数对冻融胚胎移植后早期流产的预测价值","url":"https://pubmed.ncbi.nlm.nih.gov/42992130","doi":"10.2147/ijwh.s619352","pmid":"42992130","journal":"Int J Womens Health","kind":"paper","lang":"en","published_at":"2026-11-01T00:00:00+00:00","fetched_at":"2026-11-08T03:43:52+00:00","authors":["Wang J","Song Z","Fang F","Shi X","Xing X","Pan Y","Liang R","Chen X","Lu Q"],"primary_topic":"art-clinical","topics":[{"slug":"art-clinical","score":5.0,"hits":["frozen embryo transfer","ongoing pregnancy"]},{"slug":"early-pregnancy","score":5.0,"hits":["early pregnancy","miscarriage"]},{"slug":"repro-aging","score":1.0,"hits":["maternal age"]}],"topic_score":5.0,"preference_score":5.0,"preference_labels":["可转化到 ART 实验室的发现"],"llm_score":72.0,"final_score":77.0,"score_dims":{"novelty":65,"rigor":78,"impact":65,"relevance":92,"translation":70},"recommend_reason":"样本量较大，且含外部队列验证，选题贴近冻融胚胎移植后早孕期管理；但MPI仅由激素动态比值构成，区分度中等（AUC约0.67–0.69），尚不足以单独用于临床决策，更适合作为风险分层的补充指标阅读。","keywords":["冻融胚胎移植","早期流产","流产预测指数","血清激素","风险分层","队列研究"],"selected":1,"story_id":244,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该回顾性队列纳入两家生殖中心1337例冻融胚胎移植后确认宫内妊娠的女性，基于早孕期血清激素动态变化计算流产预测指数（MPI，反映滋养细胞活性与雌激素支持的平衡），随访至妊娠12周，评估MPI与早期流产风险的关联及年龄差异。结果显示，MPI升高与早期流产风险增加、持续妊娠概率降低显著相关，且呈非线性关系，超过特定阈值后风险明显上升；MPI区分度中等，开发队列AUC为0.670（95%CI 0.627–0.719），外部队列为0.688（95%CI 0.630–0.747）。该关联在35岁以下女性中更强；MPI在年龄之外可提供额外预测信息。结论认为，MPI升高可能反映早期内分泌失衡与妊娠不稳定，按年龄分层解读有助于个体化风险分层与早期识别。","summary":"PURPOSE: To evaluate whether the Miscarriage Prediction Index (MPI), a novel ratio derived from early pregnancy hormonal changes, can identify women at increased risk of early miscarriage after frozen embryo transfer. METHODS: This retrospective cohort study included 1337 women with confirmed intrauterine pregnancies following frozen embryo transfer at two reproductive centers. Serum hormone levels were measured during early pregnancy, and the Miscarriage Prediction Index (MPI), reflecting the balance between trophoblastic activity and estrogenic support, was calculated from dynamic hormonal changes. Participants were followed through 12 weeks of gestation. Statistical analyses assessed the association between MPI and early miscarriage risk and explored age-related differences. RESULTS: Higher MPI values were significantly associated with an increased risk of early miscarriage and reduced likelihood of ongoing pregnancy. The relationship between MPI and miscarriage risk was nonlinear, with risk rising markedly beyond specific threshold values. MPI showed modest discriminatory performance, with an AUC of 0.670 (95% CI, 0.627-0.719) in the development cohort and 0.688 (95% CI, 0.630-0.747) in the external cohort. The association was stronger in women younger than 35 years, while MPI demonstrated modest and consistent predictive performance in both development and external cohorts and provided additional predictive information beyond maternal age alone. CONCLUSIONS: Elevated MPI is associated with early miscarriage risk after frozen embryo transfer and may reflect early endocrine imbalance and pregnancy instability. Age-specific MPI may better interpret MPI values and support more individualized risk stratification, early identification miscarriage, and monitoring among women, which may provide a potential window for timely clinical assessment and intervention.","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}}