Early pregnancy loss rate in first-time fresh cycles of low prognosis patients according to the POSEIDON criteria: a single-center data analysis.

Backgrounds: The study was designed to analyze early pregnancy loss rates in first-time fresh embryo transfer cycles in low prognosis patients according to the POSEIDON criteria.

Methods: This was a retrospective cohort study, including patients with positive human chorionic gonadotropin after first fresh cycles in the Reproductive Center of Henan Province People's Hospital from June 2018 to February 2023. A total of 2392 cycles were included in this study, which were divided into 4 groups according to the POSEIDON criteria. The general condition, laboratory indexes, and early pregnancy loss rates of patients were compared in each group and the prediction model was constructed in POSEIDON group 4.

Results: The early pregnancy loss rate ranked from high to low in order of Group D (32.82%), Group B (23.31%), Group C (15.34%), and Group A (13.68%). After adjusting confounding factors, multivariate logistic regression analysis revealed that the early pregnancy loss rate was significantly higher in groups B and D than in groups A and C (all P < 0.05). The comparison between Group A and Group C, as well as between Group B and Group D, showed no statistical differences (both P > 0.05). Group D was randomly divided into training and validation cohorts according to 7:3. The prediction model was constructed based on risk factors. The AUC of the training cohort was 0.761(95% CI: 0.680-0.841), and the AUC of the validation cohort was 0.604(95% CI: 0.440-0.767).

Conclusions: Patients in POSEIDON group 4 have the highest early pregnancy loss rate, followed by group 2, while patients in groups 3 and 1 have the lowest rate in first-time fresh cycles. The prediction model was successfully established which can predict the occurrence of early pregnancy loss in first-time fresh cycles in POSEIDON group 4.