Abstract
Objective: To investigate the characteristics and outcomes of low prognosis patients defined by POSEIDON criteria undergoing IVF treatment.Design: Retrospective cohort analysis.Setting: An IVF clinic in a public hospital.Patients: 18,455 fresh aspirated IVF cycles with subsequently frozen embryo transfer from Jan 2014 to Jan 2017 in a single IVF clinic were included in the analysis. The low prognosis patients were categorized into 4 groups based on POSEIDON criteria: group 1: age < 35, antral follicle count (AFC) ≥ 5, number of oocytes retrieved ≤ 9 in the previous cycle; group 2: age ≥ 35, AFC≥5, number of oocytes retrieved ≤ 9 in the previous cycle; group 3: age < 35, AFC < 5; group 4: age ≥ 35, AFC < 5. The non-low prognosis patients: group 5: AFC ≥ 5, previous number of oocytes retrieved > 9 oocytes; group 6: AFC ≥ 5, no previous ovarian stimulation.Intervention(s): None.Main Outcome Measure: The primary outcome was cumulative live birth rate (CLBR).Result(s): Taking group 1 as reference, the CLBR from young women in group 3 (35.5%, OR 0.9, 95% CI 0.7–1.2) was slightly lower than that in group 1 (44.6%, p = 0.615). The CLBR in group 2 (24.5%, OR 0.6, 95% CI 0.4–0.8, p = 0.004) and group 4 (12.7%, OR 0.4, 95% CI 0.3–0.6, p < 0.001) was significant lower than that in group 1. In non-poor prognosis patients, the CLBR from young women in group 5 (53.5% OR 1.3 95% CI 0.9, 1.7, p = 0.111) was a slight higher than the reference group 1 while the highest CLBR was originated from the first IVF patients with good ovarian reserve in group 6 (66.9%, OR 2.0, 95% CI 1.6, 2.4).Conclusion(s): The CLBRs and implantation rates in the young women (group 3) with diminished ovarian reserve was similar in those young women (group 1), and was significantly higher than in advanced age women with a fair ovarian reserve (group 2). Though patients in group 2 had better ovarian reserve, more oocytes and more embryos, the pregnancy outcome was inferior to that of group 3 patients with poorer ovarian reserve, fewer oocytes and fewer embryos.
Highlights
A novel system, the POSEIDON criteria, was developed to classify infertility patients with low prognosis undergoing assisted reproductive technology (ART) treatment [1]
Consistent with the trend of non-adjusted results, the cumulative live birth rate (CLBR) in group 3 was slightly lower and group 5 was slightly higher than CLBR in group 1 without significant statistical difference
The CLBR in group 2 was significantly lower than in group 1 and CLBR in group 4 was the lowest as compared to group 1
Summary
The POSEIDON criteria, was developed to classify infertility patients with low prognosis undergoing assisted reproductive technology (ART) treatment [1]. It is a useful system for the identification and classification of patients with impaired ovarian reserve or poor ovarian response (POR), providing guidance for the diagnosis and management of these patients [2]. Four subsets have been suggested based on quantitative and qualitative parameters including, age, ovarian reserve biomarkers, and ovarian response. Among the four groups based on the POSEIDON criteria, group 1 is undoubtedly the best prognostic group considering their younger age and normal ovarian reserve, while group 4 has the worst prognosis due to the advanced age and diminished ovarian reserve. There have been very few reports on the CLBRs of the four patient groups defined by the POSEIDON criteria
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
