Table 1_Age- and AMH-based prediction of mature oocyte yield in oncofertility is well calibrated overall, but substantial underestimation is more frequent in hematologic malignancies.docx

Analyses were performed overall and by cancer type. Threshold-based underestimation analyses and the incremental value of antral follicle count (AFC) were also explored.</p>Results<p>A total of 179 oocyte cryopreservation cycles performed in 167 women were included. The model showed good overall calibration using aggregated out-of-bootstrap predictions, with calibration-in-the-large of 0.00 (95% CI −0.08 to 0.09) and calibration slope of 0.98 (95% CI 0.80 to 1.15).

Mean prediction error was −0.10 MII (95% CI −0.97 to 0.80), indicating minimal average directional bias. Mean absolute error was 4.12 MII (95% CI 3.53 to 4.76), and root mean squared error was 5.94 MII (95% CI 4.92 to 7.00). Substantial underestimation, defined as observed MII yield exceeding predicted yield by more than 4 MII, was more frequent in hematologic malignancies than in solid tumors (31.8% [14/44] vs 12.6% [17/135]; risk difference +19.2 percentage points, 95% CI + 4.4 to +34.1; Fisher’s exact p=0.006).

This finding remained consistent in the one-cycle-per-woman sensitivity analysis. Adding AFC did not improve predictive performance in the complete-case analysis.</p>Conclusion<p>age and AMH are useful tools for counseling regarding the expected mature oocyte yield, including in our subset of oncofertility patients. As we found substantial underestimation of mature oocyte yield to be more frequent in hematologic malignancies, the results should be interpreted cautiously in this subgroup.</p>