Prediction model construction of the infertility risk of patients with endometriosis in childbearing age based on their clinical characteristics
Objective:To construct a prediction model of infertility risk of patients with endometriosis(EMS)in child-bearing age based on their clinical characteristics,and to provide guidance for clinical prevention and treatment of the infertility of the patients caused by EMS.Methods:A total of 200 patients with EMS in childbearing age were selected and were divided into infertility group(92 cases with secondary infertility)and control group(108 cases without second-ary infertility)according to whether the secondary infertility occurred or not from July 2021 to July 2023.The clinical characteristic data of the patients in the two groups were collected to screen the independent predictors of the infertility risk of the patients with EMS in childbearing age,and the prediction model was constructed based on their clinical characteristics.Results:There were significant differences in the age,the duration of menstruation,the EMS dura-tion,the location of EMS lesions,the revised-American fertility society(r-AFS)stage,the score of endometriosis fertility index(EFI),and the rates of the complication of the gynecologic inflammation,luteal dysfunction,hyperpro-lactinemia and cervical stenosis of the patients between the two groups(P＜0.05).Eight factors,including the age,the EMS duration,the r-AFS stage and EFI score of EMS,the complicating with gynecological inflammation,the luteal dysfunction,the hyperprolactinemia and cervical stenosis of the patients were initially found by Lasso regression analy-sis.Logistic regression analysis showed that the age(OR=4.828,95％CI 1.629-14.312),the EMS duration(OR=3.909,95％CI 1.405-10.873),the r-AFS stage of EMS(OR=6.983,95％CI 2.386-20.439),the complicating with gy-necological inflammation(OR=4.212,95％CI 1.774-15.675),the luteal dysfunction(OR=6.127,95％CI 2.051-18.306),the hyperprolactinemia(OR=5.896,95％CI 2.140-16.245)and the cervical stenosis(OR=4.952,95％CI 1.813-13.528)of the patients with EMS in childbearing age were the independent risk factors of their infertility risk,and the EFI score(OR=0.526,95％CI 0.316-0.877)of EMS of the patients was a independent protective factor of their infertility risk(P＜0.05).Receiver operator characteristic(ROC)curve analysis showed that the area under the curve(AUC)of the age,the EMS duration,the r-AFS stage and the EFI score of EMS,the complicating with gynecological inflammation,the luteal dysfunction,the hyperprolactinemia,or the cervical stenosis of the patients with EMS in childbearing age for predicting their infertility risk was all above 0.6.The prediction model was constructed according to the above independent factors,and the fitting degree was good,with the calibration degree of 0.854 and the consistency index of 0.906.ROC curve analysis showed that the AUC,the sensitivity and the specificity of the prediction model for the infertility risk of the patients with EMS in childbearing age were 0.932(95％CI 0.882-0.984),93.5％and 90.7％.Conclusion:The predictive value of the prediction model structured based on the age,the EMS duration,the r-AFS stage and the EFI score of EMS,the complicating with gynecological inflammation,the luteal dysfunction,the hyperp-rolactinemia,or the cervical stenosis of the patients with EMS in childbearing age for their infertility risk is reliable,and which can provide guidance information for clinical prevention and treatment of infertility of patients with EMS in childbearing age.
EndometriosisInfertilityClinical featuresPrediction modelPredictive value
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