{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T02:20:54Z","timestamp":1779243654110,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>\n                    Pregnancy loss after frozen embryo transfer (FET) remains an under\u2010recognized complication in assisted reproductive technology (ART), particularly in non\u2010Western settings. Existing prediction models rarely capture evolving hazards over gestation or externally validated. To address this, we developed and externally validated a parametric time\u2010to\u2010event model to predict the dynamic risks of pregnancy loss following FET using a large real\u2010world Chinese cohort. The model incorporated routinely available clinical variables, including maternal demographics, progesterone concentration, endometrium thickness, and endometrium preparation protocols. A Gompertz distribution model captured the time\u2010dependent hazard trajectory. Model performance was externally validated in two temporal cohorts, as well as in older women (\u226540\u2009years) and ethnic minority subgroups. Clinical utility was assessed by decision\u2010curve analysis (DCA). Among 21,242 conceptions, 17.6% resulted in miscarriage or stillbirth, with risks peaking in the first trimester. Maternal age showed a nonlinear effect: compared with reference age 32, hazard increased by 67% at age 40 and more than doubled by age 45. Higher weight accelerated risk over time. Protective factors included greater endometrial thickness, higher progesterone levels, and use of\n                    <jats:italic>mild\u2010<\/jats:italic>\n                    (hazard ratio, HR 0.80, 95% CI: 0.753\u20130862),\n                    <jats:italic>late\u2010<\/jats:italic>\n                    (HR 0.90, 95% CI: 0.798\u20130.951), or\n                    <jats:italic>modified\u2010late stimulation<\/jats:italic>\n                    (HR 0.80, 95% CI: 0.732\u20130.863) protocols. DCA indicated that model\u2010guided risk\u2010stratification strategies offered clear net benefit in older women across a broader range of risk threshold. This validated, time\u2010resolved model supports individualized risk\u2010stratification strategies and informed treatment decisions in FET\u2010based ART across diverse clinical settings in China.\n                  <\/jats:p>","DOI":"10.1002\/cpt.70174","type":"journal-article","created":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T16:30:38Z","timestamp":1766334638000},"page":"1317-1330","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Population Time\u2010to\u2010Event Modeling of Pregnancy Loss Risk Following Frozen Embryo Transfer: A Real\u2010World Study in Chinese Women"],"prefix":"10.1002","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8346-2934","authenticated-orcid":false,"given":"Wen Yao","family":"Mak","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmaceutical Sciences Fudan University  Shanghai China"},{"name":"Clinical Research Centre (Penang General Hospital), Institute for Clinical Research, National Institute of Health  Penang Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9617-8844","authenticated-orcid":false,"given":"Muyesaier","family":"Alifu","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmaceutical Sciences Fudan University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7589-5768","authenticated-orcid":false,"given":"Aole","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmaceutical Sciences Fudan University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3709-1866","authenticated-orcid":false,"given":"Ning","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmaceutical Sciences Fudan University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5795-1550","authenticated-orcid":false,"given":"Qingfeng","family":"He","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmaceutical Sciences Fudan University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3295-619X","authenticated-orcid":false,"given":"Xiao","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmaceutical Sciences Fudan University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9041-9689","authenticated-orcid":false,"given":"Xiaoyan","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Assisted Reproduction, Shanghai Ninth People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8683-2603","authenticated-orcid":false,"given":"Xiaoqiang","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmaceutical Sciences Fudan University  Shanghai China"},{"name":"Quzhou Fudan Institute  Quzhou China"},{"name":"State Key Laboratory of Advanced Drug Formulations for Overcoming Delivery Barriers  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,21]]},"reference":[{"key":"e_1_2_11_1_1","unstructured":"World Health Organization.1 in 6 people globally affected by infertility: WHO<https:\/\/www.who.int\/news\/item\/04\u201004\u20102023\u20101\u2010in\u20106\u2010people\u2010globally\u2010affected\u2010by\u2010infertility> (2023). 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