A model for prediction of a twin live birth following in vitro fertilization-embryo transfer in women of advanced age.
- 1Reproductive Medicine Center, Henan Provincial People's Hospital, Zhengzhou, China.
- 2State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, China.
Abstract
Introduction
The aim of this study was to construct a model for prediction of the probability of a twin live birth in women of advanced age in vitro fertilization and embryo transfer cycles.Methods
This retrospective analysis included 10,089 transfer cycles from women aged ≥35 years, stratified by whether they had a live twin birth. Taking a twin live birth as the positive outcome (Y = 1) and cycles with a singleton or no live birth as the negative outcome (Y = 0). A multivariate logistic regression analyses was built based on candidate variables, followed by nomogram construction. The discrimination ability of the model was assessed by the area under the receiver-operating characteristic curve, with 500 bootstrap resamples for internal validation.Results
There were significant differences in age, endometrial thickness, number of usable embryos, number of embryos transferred, and embryo type between the groups (all P < 0.05). Multivariate logistic regression identified the following five predictors of a twin live birth: age (adjusted odds ratio [aOR] 0.69, 95% confidence interval [CI] 0.66-0.73, P < 0.001), endometrial thickness ≥7 mm (aOR 2.79, 95% CI 1.30-5.99, P = 0.009), blastocyst transfer (aOR 1.88, 95% CI 1.36-2.60, P < 0.001), two good quality embryos (aOR 2.20, 95% CI 1.71-2.82, P < 0.001), and two embryos transferred (aOR 19.45, 95% CI 11.57-32.69, P < 0.001). The nomogram built on these variables yielded an area under the curve of 0.8462. Bootstrap internal validation (500 resamples) produced a corrected area under the curve of 0.8443.Conclusions
The likelihood of a twin live birth correlated positively with two embryos transferred, two good quality embryos, blastocyst transfer, and endometrial thickness ≥7 mm, and correlated negatively with maternal age.
Related
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- Factors associated with tubal obstruction and development of a preliminary prediction model following laparoscopic tubal fenestration and embryo removal in patients with tubal pregnancy: a single-center exploratory study
BibTeX
@article{xu2026model,
title = {{A model for prediction of a twin live birth following in vitro fertilization-embryo transfer in women of advanced age.}},
author = {Siyue Xu and Ruolei Wang and Cuilian Zhang and Meng Li and Shaodi Zhang},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1789377},
url = {https://europepmc.org/article/MED/42948012},
note = {CC BY},
}
RIS
TY - JOUR
TI - A model for prediction of a twin live birth following in vitro fertilization-embryo transfer in women of advanced age.
AU - Siyue Xu
AU - Ruolei Wang
AU - Cuilian Zhang
AU - Meng Li
AU - Shaodi Zhang
PY - 2026
DA - 2026/10/13
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1789377
UR - https://europepmc.org/article/MED/42948012
AB - Introduction The aim of this study was to construct a model for prediction of the probability of a twin live birth in women of advanced age in vitro fertilization and embryo transfer cycles.Methods This retrospective analysis included 10,089 transfer cycles from women aged ≥35 years, stratified by whether they had a live twin birth. Taking a twin live birth as the positive outcome (Y = 1) and cycles with a singleton or no live birth as the negative outcome (Y = 0). A multivariate logistic regression analyses was built based on candidate variables, followed by nomogram construction. The discrimination ability of the model was assessed by the area under the receiver-operating characteristic curve, with 500 bootstrap resamples for internal validation.Results There were significant differences in age, endometrial thickness, number of usable embryos, number of embryos transferred, and embryo type between the groups (all P < 0.05). Multivariate logistic regression identified the following five predictors of a twin live birth: age (adjusted odds ratio [aOR] 0.69, 95% confidence interval [CI] 0.66-0.73, P < 0.001), endometrial thickness ≥7 mm (aOR 2.79, 95% CI 1.30-5.99, P = 0.009), blastocyst transfer (aOR 1.88, 95% CI 1.36-2.60, P < 0.001), two good quality embryos (aOR 2.20, 95% CI 1.71-2.82, P < 0.001), and two embryos transferred (aOR 19.45, 95% CI 11.57-32.69, P < 0.001). The nomogram built on these variables yielded an area under the curve of 0.8462. Bootstrap internal validation (500 resamples) produced a corrected area under the curve of 0.8443.Conclusions The likelihood of a twin live birth correlated positively with two embryos transferred, two good quality embryos, blastocyst transfer, and endometrial thickness ≥7 mm, and correlated negatively with maternal age.
SN - 2296-858X
ER -