Analysis of risk factors compromising embryo quality and quantity in patients with endometriosis.

PURPOSE: This study aims to analyze the clinical factors affecting embryo quality and quantity in endometriosis patients undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET), thereby providing a reference for the clinical prediction of embryonic development outcomes in this patient population.

METHODS

Univariate logistic regression was performed to select variables (P < 0.05), which were then entered into a multivariate logistic regression model to develop a predictive model for the likelihood of obtaining a sufficient number of high-quality embryos. A predictive nomogram was constructed based on the findings from the univariate and multivariate analyses. Restricted cubic splines were employed to identify potential non-linear relationships and threshold effects concerning ovarian reserve-related parameters.

RESULTS

The model demonstrated robust discriminative ability, with area under the curve values of 0.765 (95% CI: 0.749-0.769) in the training set and 0.776 (95% CI: 0.747-0.789) in the validation set. Subgroup analyses further revealed that endometriomas represent a pivotal phenotype adversely affecting both the yield of oocytes and the rate of high-quality embryos.

CONCLUSION

Anti-Müllerian Hormone level, Antral Follicle Count, the presence of bilateral endometriomas, and the utilization of gonadotropin-releasing hormone (GnRH) agonist pre-treatment serve as robust indicators for predicting oocyte yield in patients with endometriosis. The nomogram incorporating these factors provides a practical tool for the early prognostication of ovarian response, thereby offering valuable insights for formulating personalized treatment strategies. GnRH agonist administration demonstrates efficacy in improving clinical outcomes of IVF/ICSI cycles in these patients.