{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:56:33Z","timestamp":1790571393993,"version":"4.1.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"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:p>\n                    In women aged 35 years or younger with diminished ovarian reserve (DOR), we evaluated whether two pretreatment markers, anti-M\u00fcllerian hormone (AMH) and antral follicle count (AFC), can stratify the risk of poor ovarian response (POR) before stimulation. This retrospective cohort included IVF\/ICSI cycles from four centres in Zhejiang, China (2022\u20132025). Of 1,754 DOR-eligible cycles, 157 were removed in two\n                    <jats:italic>post-hoc<\/jats:italic>\n                    phenotype-cleaning exclusions (PCOS, n = 139; AMH \u22655 ng\/mL without PCOS, n = 18), leaving 1,597 cycles. POR was defined as \u22643 oocytes. Cycles were cross-classified by AFC \u22645 and AMH &amp;lt;0.5 ng\/mL, and a two-marker logistic model was fitted. POR occurred in 42.0% of cycles. Total AFC (adjusted OR 0.843) and ln (AMH) (OR 0.310) carried the main pretreatment signal; age and basal FSH added little. The two single-marker cells had similar observed POR rates (46.4% vs 49.6%; P\u00a0=\u00a00.56), but equivalence was not established. The AFC \u22645 boundary was reproduced in the seed-2024 70:30 split and was re-selected in 92.0% of 1,000 bootstrap samples when the cut-off was chosen in-bag and evaluated out-of-bag. The descriptive three-tier rates were 23.9%, 47.1%, and 78.8%; when all 1,754 eligible cycles were retained, the middle-tier rate fell to 39.5%. For the fixed two-marker specification, bootstrap optimism correction gave an AUC of 0.768; centre-held-out AUCs using verified record-level centre labels ranged from 0.725 to 0.800. AMH and AFC therefore provide moderate pretreatment risk stratification within this young DOR cohort, but the absolute tier risks remain sensitive to cohort definition and cut-off choice. External validation and recalibration are required before clinical use.\n                  <\/jats:p>","DOI":"10.3389\/fendo.2026.1968836","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:29:50Z","timestamp":1790569790000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pretreatment AMH\u2013AFC stratification of poor-ovarian-response risk in young women with diminished ovarian reserve: a multicentre retrospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Yanning","family":"Lv","sequence":"first","affiliation":[{"name":"Department of Reproductive Medicine, The First Affiliated Hospital of Lishui University, Lishui People's Hospital","place":["Lishui, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahao","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, The First Affiliated Hospital of Lishui University, Lishui People's Hospital","place":["Lishui, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, The First Affiliated Hospital of Wenzhou Medical University","place":["Wenzhou, Zhejiang,, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianying","family":"He","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, Jinhua People's Hospital","place":["Jinhua, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, Huzhou Maternal and Child Health Hospital","place":["Huzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honglian","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine, The First Affiliated Hospital of Lishui University, Lishui People's Hospital","place":["Lishui, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoac051","article-title":"Infertility prevalence and the methods of estimation from 1990 to 2021: a systematic review and meta-analysis","volume":"2022","author":"Cox","year":"2022","journal-title":"Hum Reprod Open"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.05.008","article-title":"Cumulative live-birth rates per total number of embryos needed to reach newborn in consecutive in vitro fertilization (IVF) cycles: a new approach to measuring the likelihood of IVF 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