{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:47:51Z","timestamp":1786121271592,"version":"build-2736575974"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To identify independent risk factors for fertilization failure (FF) during conventional\n                      <jats:italic>in vitro<\/jats:italic>\n                      fertilization (IVF) and to develop a predictive model for clinical risk stratification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 2,474 IVF cycles (173 FF cycles with fertilization rate &amp;lt;30% and 2,301 normal fertilization cycles with rate \u226530%) at a single center (2018\u20132023). Univariate and multivariate logistic regression analyses were performed to screen independent risk factors for FF. A combined predictive model was constructed using logistic binary regression, and its discriminative ability was assessed by the area under the ROC curve (AUC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Multivariate analysis identified four independent risk factors for FF: high proportion of primary infertility (OR\u00a0=\u00a02.19, 95% CI: 1.48\u20133.25), low proportion of tubal factor (OR\u00a0=\u00a00.60, 95% CI: 0.42\u20130.86), low normal sperm morphology rate (OR\u00a0=\u00a00.81, 95% CI: 0.73\u20130.91), and low sperm concentration after treatment (OR\u00a0=\u00a00.94, 95% CI: 0.91\u20130.97). The combined predictive model achieved an AUC of 74.6% (95% CI: 70.3%\u201378.9%), with an optimal cutoff of 0.185 (sensitivity 68.2%, specificity 71.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Primary infertility, absence of tubal factor, low normal sperm morphology, and low post-treatment sperm concentration are independent predictors of FF. This combined prediction model shows moderate discriminative power for fertilization failure risk stratification. However, its low positive predictive value (15.1%) restricts accurate identification of high-risk IVF patients. The model can only be used as an auxiliary counseling tool rather than a definitive reference for choosing conventional IVF or ICSI; prospective multicenter external validation is required before clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1880151","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:21:56Z","timestamp":1786076516000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Influencing factors of fertilization failure during in vitro fertilization"],"prefix":"10.3389","volume":"17","author":[{"given":"Hongzhi","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Reproductive Medicine, Maternity and Child Care Center of Qinhuangdao","place":["Qinhuangdao, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajia","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, Maternity and Child Care Center of Qinhuangdao","place":["Qinhuangdao, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongrong","family":"Liu","sequence":"additional","affiliation":[{"name":"Children Protect Branch, Maternity and Child Care Center of Qinhuangdao","place":["Qinhuangdao, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, Maternity and Child Care Center of Qinhuangdao","place":["Qinhuangdao, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, Maternity and Child Care Center of 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