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.