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Background: The success of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in endometriosis patients varies widely, and predicting the likelihood of achieving a live birth remains a clinical challenge. This study aims to develop a predictive nomogram for assessing the cumulative live birth (CLB) rate following IVF/ICSI cycles among patients with endometriosis. Method: A retrospective cohort study was conducted to analyze the clinical data of 1457 patients with endometriosis after IVF/ICSI treatment from January 2017 to August 2022. The patients were divided into a training set (70%) and a validation set (30%) using a random number table. Univariate analysis and multifactorial logistic regression analysis were employed to identify relevant predictive factors affecting CLB rate. A predictive model was then established based on the identified factors. Results: Univariate analysis and multifactorial logistic regression analysis revealed that patients with concurrent adenomyosis had a decreased CLB rate (OR = 0.51, 95% CI: 0.31—0.82). As the duration of infertility increased, the CLB rate decreased (OR = 0.93, 95% CI: 0.88—0.99). Higher numbers of fertilized oocytes and high-quality embryos were associated with an increased likelihood of CLB. A nomogram predictive model for CLB rate, based on age, concurrent adenomyosis, duration of infertility, number of fertilization, and number of high-quality embryos, was developed. The area under the curve (AUC) for the training set and validation set was 0.823 (95% CI: 0.798–0.849) and 0.773 (95% CI: 0.729–0.818), respectively. The stratified analysis demonstrated the applicability of the model in the validation cohort. Conclusion: This predictive nomogram for CLB rate in patients with endometriosis provides valuable and precise information for personalized decision-making, which could be a visual and easily applied tool for IVF/ICSI counselling. [ABSTRACT FROM AUTHOR]

Owing to advances in genome sequencing, genome stability has become one of the most scrutinized cellular traits across the Tree of Life. Despite its centrality to all things biological, the mutation rate (per nucleotide site per generation) ranges over three orders of magnitude among species and several‐fold within individual phylogenetic lineages. Within all major organismal groups, mutation rates scale negatively with the effective population size of a species and with the amount of functional DNA in the genome. This relationship is most parsimoniously explained by the drift‐barrier hypothesis, which postulates that natural selection typically operates to reduce mutation rates until further improvement is thwarted by the power of random genetic drift. Despite this constraint, the molecular mechanisms underlying DNA replication fidelity and repair are free to wander, provided the performance of the entire system is maintained at the prevailing level. The evolutionary flexibility of the mutation rate bears on the resolution of several prior conundrums in phylogenetic and population‐genetic analysis and raises challenges for future applications in these areas. [ABSTRACT FROM AUTHOR]