Findings were consistent across reproductive-stage strata: estradiol and FSH remained differentiating markers (all <i>p</i> < 0.05), and the model maintained strong discrimination in both groups (AUC 0.988 in reproductive-age; 0.982 in menopausal).<h4>Conclusion</h4>An interpretable, high-performing model can aid early PFO risk stratification in females; performance was robust across reproductive-age and menopausal strata, and external validation especially in larger female cohorts is warranted. The gene discussed is BRD2; the disease is Patent foramen ovale.