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Prediction of risk factors for first trimester pregnancy loss in frozen-thawed good-quality embryo transfer cycles using machine learning algorithms

  • Assisted Reproduction Technologies
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Abstract

Purpose

Can the risk factors that cause first trimester pregnancy loss in good-quality frozen-thawed embryo transfer (FET) cycles be predicted using machine learning algorithms?

Methods

This is a retrospective cohort study conducted at Sisli Memorial Hospital, ART and Reproductive Genetics Center, between January 2011 and May 2021. A total of 3805 good-quality FET cycles were included in the study. First trimester pregnancy loss rates were evaluated according to female age, paternal age, body mass index (BMI), diagnosis of infertility, endometrial preparation protocols (natural/artificial), embryo quality (top/good), presence of polycystic ovarian syndrome (PCOS), history of recurrent pregnancy loss (RPL), recurrent implantation failure (RIF), severe male infertility, adenomyosis and endometriosis.

Results

The first trimester pregnancy loss rate was 18.2% (693/ 3805). The presence of RPL increased first trimester pregnancy loss (OR = 7.729, 95%CI = 5.908–10.142, P = 0.000). BMI, which is > 30, increased first trimester pregnancy loss compared to < 25 (OR = 1.418, 95%CI = 1.025–1.950, P = 0.033). Endometrial preparation with artificial cycle increased first trimester pregnancy loss compared to natural cycle (OR = 2.101, 95%CI = 1.630–2.723, P = 0.000). Female age, which is 35–37, increased first trimester pregnancy loss compared to < 30 (OR = 1.617, 95%CI = 1.120–2.316, P = 0.018), and female age, which is > 37, increased first trimester pregnancy loss compared to < 30 (OR = 2.286, 95%CI = 1.146–4,38, P = 0.016). The presence of PCOS increased first trimester pregnancy loss (OR = 1.693, 95%CI = 1.198–2.390, P = 0.002). The number of previous IVF cycles, which is > 3, increased first trimester pregnancy loss compared to < 3 (OR = 2.182, 95%CI = 1.708–2.790, P = 0.000).

Conclusions

History of RPL, RIF, advanced female age, presence of PCOS, and high BMI (> 30 kg/m2) were the factors that increased first trimester pregnancy loss.

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Authors and Affiliations

  1. Memorial Sisli Hospital IVF and Reproductive Genetics Centre, Piyalepasa Bulvarı, Okmeydanı, 35385, Istanbul, Turkey

    Gonul Ozer, Aysu Akca, Beril Yuksel, Ipek Duzguner & Semra Kahraman

  2. Faculty of Science and Letters Statistics Department, Mimar Sinan Fine Arts University, Bomonti Campus 34380, Istanbul, Turkey

    Ayca Cakmak Pehlivanli

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  1. Gonul Ozer
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Ozer, G., Akca, A., Yuksel, B. et al. Prediction of risk factors for first trimester pregnancy loss in frozen-thawed good-quality embryo transfer cycles using machine learning algorithms. J Assist Reprod Genet 40, 279–288 (2023). https://doi.org/10.1007/s10815-022-02645-3

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