Development and validation of a nomogram for failure to collect oocytes in POSEIDON Groups 3 and 4 undergoing...

This study aimed to develop and validate a predictive model for failure to collect oocytes in the Patient-Oriented Strategies Encompassing Individualized Oocyte Number (POSEIDON) Groups 3 and 4 during their first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle. A retrospective analysis was conducted on patients in POSEIDON Groups 3 and 4 who underwent their first IVF/ICSI cycle at our center from January 2016 to December 2023. A total of 2,373 patients were randomly assigned to the training or validation cohort at a ratio of 6:4. Univariate analysis, the least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression analysis were used to identify the risk factors. It revealed that the anti-Müllerian hormone (AMH) concentration, controlled ovarian stimulation (COS) protocols, the number of follicles ≥ 14 mm on the day of trigger, and the change in estradiol level between the day before trigger and the trigger day (ΔE2) were the independent predictors. A nomogram was constructed accordingly. The areas under the receiver operating characteristic curves (ROC) of the training and the validation cohorts were 0.868 (95% CI: 0.835-0.902) and 0.860 (95% CI: 0.823-0.897), respectively. The calibration curve showed that the predicted risk of the model was in good agreement with the actual results. Decision curve analysis (DCA) demonstrated the clinical value of this nomogram. Our nomogram provides a practical and user-friendly tool for clinical decision-making.