{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T11:11:49Z","timestamp":1789125109750,"version":"build-2803163510"},"reference-count":23,"publisher":"Bioscientifica","issue":"5","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":56,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Women with polycystic ovary syndrome (PCOS) exhibit diverse reproductive and metabolic phenotypes, complicating short-term pregnancy counseling. We developed and externally validated a pragmatic model to predict clinical pregnancy within 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study utilized data from Center A (development) and Center B (validation). Predictors included routinely available anthropometric, reproductive endocrine, metabolic, and treatment markers. We developed a multivariable logistic regression model, evaluating discrimination (AUC and precision\u2013recall), calibration (decile-based plots), and clinical utility via decision curve analysis (DCA). Clinical pregnancy, confirmed by ultrasonography, served as the reference standard. A web-based calculator was created for bedside risk estimation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the development cohort (n = 315; 167 pregnancies), the final model retained age, anti-M\u00fcllerian hormone (AMH), LH\/FSH ratio, assisted reproductive treatment, HOMA-IR, and homocysteine. The model demonstrated good discrimination (AUC = 0.813) and remained robust after internal validation (AUC = 0.800; AUPRC = 0.823). Calibration showed strong agreement between predicted and observed probabilities, despite minor deviations at higher risk levels. DCA indicated higher net benefit compared to \u2018treat-all\u2019 or \u2018treat-none\u2019 strategies across relevant thresholds. External validation confirmed acceptable discrimination (AUC = 0.759), with modest calibration attenuation (slope = 0.681; intercept = \u22120.019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This endocrine\u2013metabolic model provides individualized 12-month pregnancy predictions for women with PCOS, demonstrating validated discrimination and decision-analytic utility. While the web calculator facilitates clinical implementation, local recalibration is recommended to ensure accuracy across different populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/ec-26-0049","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T15:06:40Z","timestamp":1776697600000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":0,"title":["Development and external validation of a parsimonious endocrine\u2013metabolic model for 12-month pregnancy prediction in women with polycystic ovary syndrome (PCOS)"],"prefix":"10.1530","volume":"15","author":[{"given":"Sifu","family":"Ha","sequence":"first","affiliation":[{"name":"Reproductive Medicine Center, Dalian Women and Children\u2019s Medical Center (Group), Dalian, Liaoning, China 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