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oai:figshare.com:article/34053189 2026-10-02T04:32:39Z category_388 portal_316 item_type_3 month_year_10_2026

Table 1_Age- and AMH-based prediction of mature oocyte yield in oncofertility is well calibrated overall, but substantial underestimation is more frequent in hematologic malignancies.docx Claudia Massarotti (9212384) Sara Stigliani (189731) Paola Scaruffi (189715) Fausta Sozzi (10752763) Andrea Amaroli (24654006) Paola Anserini (9468452) Oncology and Carcinogenesis not elsewhere classified cancer and fertility fertility preservation hematologic cancers oocytes cryopreservation solid tumors Introduction<p>age and ovarian reserve markers are commonly used in clinical practice to predict ovarian response to controlled stimulation for assisted reproductive techniques in infertile patients. In oncofertility, some reports suggest the predictive performance of these markers may be lower in specific subgroups. We evaluated the performance of a prespecified age + log(AMH) model for predicting metaphase-II (MII) oocyte yield in women undergoing oocyte cryopreservation before gonadotoxic treatment.</p>Methods<p>This retrospective single-center cohort study included consecutive oocyte cryopreservation cycles performed before gonadotoxic treatment between January 2015 and January 2025. MII yield was modelled using negative-binomial regression with age and log-transformed AMH as predictors. Regression coefficients were estimated in the current cohort. Model performance was assessed using calibration measures and patient-level bootstrap internal validation, with all cycles from the same woman kept together during resampling. Analyses were performed overall and by cancer type. Threshold-based underestimation analyses and the incremental value of antral follicle count (AFC) were also explored.</p>Results<p>A total of 179 oocyte cryopreservation cycles performed in 167 women were included. The model showed good overall calibration using aggregated out-of-bootstrap predictions, with calibration-in-the-large of 0.00 (95% CI −0.08 to 0.09) and calibration slope of 0.98 (95% CI 0.80 to 1.15). Mean prediction error was −0.10 MII (95% CI −0.97 to 0.80), indicating minimal average directional bias. Mean absolute error was 4.12 MII (95% CI 3.53 to 4.76), and root mean squared error was 5.94 MII (95% CI 4.92 to 7.00). Substantial underestimation, defined as observed MII yield exceeding predicted yield by more than 4 MII, was more frequent in hematologic malignancies than in solid tumors (31.8% [14/44] vs 12.6% [17/135]; risk difference +19.2 percentage points, 95% CI + 4.4 to +34.1; Fisher’s exact p=0.006). This finding remained consistent in the one-cycle-per-woman sensitivity analysis. Adding AFC did not improve predictive performance in the complete-case analysis.</p>Conclusion<p>age and AMH are useful tools for counseling regarding the expected mature oocyte yield, including in our subset of oncofertility patients. As we found substantial underestimation of mature oocyte yield to be more frequent in hematologic malignancies, the results should be interpreted cautiously in this subgroup.</p> 2026-10-02T04:32:39Z Dataset Dataset 10.3389/fonc.2026.1940599.s001 https://figshare.com/articles/dataset/Table_1_Age-_and_AMH-based_prediction_of_mature_oocyte_yield_in_oncofertility_is_well_calibrated_overall_but_substantial_underestimation_is_more_frequent_in_hematologic_malignancies_docx/34053189 CC BY 4.0