Construction of A Prediction Model for Natural Pregnancy Failure after Laparoscopic Surgery in Patients with Ovarian Endometriosis Cysts

WANG Mian; GAO Qi; WEN FengXiang

doi:10.16458/j.cnki.1007-0893.2025.23.007

Abstract：Objective To analyze the influencing factors of natural pregnancy failure after laparoscopic surgery in patients with ovarian endometriosis cysts and construct a prediction model.Methods A total of 246 patients with ovarian cysts admitted to Nanyang Central Hospital from April 2022 to April 2024 were selected as the research subjects.They were followed up for one year after surgery and divided into a failure group(95 cases)and a success group based on whether they achieved natural pregnancy.Univariate and multivariate analyses were conducted to identify the independent risk factors for natural pregnancy failure after laparoscopic surgery and construct a prediction model.Results There were statistically significant differences in age,infertility type,cyst diameter,revised American Fertility Society(r-AFS)stage,the number of uterine cavity operations,endometriosis fertility index(EFI)score,and the treatment situation with gonadotropin-releasing hormone agonists between the two groups(P<0.05).Logistic multivariate analysis showed that age≥35 years,primary infertility,cyst diameter 3-5 cm or>5 cm,r-AFS stage Ⅲ-Ⅳ,uterine cavity operation≥2 times,EFI score≤4 points,and no postoperative use of GnRH-a treatment were independent risk factors for natural pregnancy failure after laparoscopic surgery(P<0.05).Based on the results of multivariate analysis,the prediction model for natural pregnancy failure after laparoscopic surgery was fitted as Logit(P)=-6.694+0.680×age+0.882×primary infertility+0.822×cyst diameter+0.740×r-AFS stage+0.627×uterine cavity operation+0.655×EFI score+0.836×no postoperative use of GnRH-a treatment.Receiver operating characteristic(ROC)curve analysis showed that the area under the curve for predicting natural pregnancy failure after laparoscopic surgery was 0.932,with a sensitivity of 0.924,and a specificity of 0.818.Conclusion Patients with age≥35 years,primary infertility,cyst diameter(3-5 cm,>5 cm),r-AFS stage Ⅲ-Ⅳ,uterine cavity operation≥2 times,EFI score≤4 points,and no postoperative use of GnRH-a treatment are more likely to experience natural pregnancy failure.The prediction model established by combining these factors can identify high-risk groups for natural pregnancy failure after surgery.