Abstract
It is well-known that poor ovarian reserve is a cause of infertility, poor response to gonadotrophin stimulation and poor success rate after in vitro fertilization (IVF) cycles. Some years ago a consensus was elaborated on precise criteria which can lead to a correct identification of poor responders (the Bologna criteria). More recently, the POSEIDON group has proposed a new stratified classification of patients with low prognosis, also with the aim of providing clinical indications for the management of these patients. A literature search was carried out for studies that investigated the ability of ovarian reserve markers, in particular AMH and AFC, to predict poor ovarian response in IVF cycles; secondly, studies regarding the Bologna criteria and their prognostic value were analyzed and available literature on POSEIDON classification was reported. The most recent markers of ovarian reserve (serum AMH and ultrasound AFC) have shown to provide a direct and accurate measurement of ovarian follicle pool. These markers have generally shown comparable predictive power for ovarian response and a number of retrieved oocytes in IVF cycles. “Abnormal ovarian reserve test” is a very important parameter both in the Bologna criteria and in the POSEIDON classification. Several studies have already been published about the reproductive outcome of patients defined as poor responders according to the ESHRE Bologna criteria: all of them agree on the poor IVF outcome and low pregnancy rate of these patients. Instead, being the POSEIDON classification of very recent publication, the efficacy of the POSEIDON approach in improving management and outcomes of POR patients has yet to be tested and validated with future prospective clinical trials. Prediction of poor response may help clinicians choose the stimulation protocol with the aim of gaining patient compliance and cost reduction, and many efforts have been made by researchers in this sense, including the formulation of the Bologna criteria and of the POSEIDON classification, in which the ovarian reserve markers (AMH and AFC) play a fundamental role.
Highlights
In the last decades, a high number of studies has been carried out on the possibility of measuring ovarian reserve through ovarian reserve markers
This review aims at analyzing the role of ovarian reserve markers (AMH and antral follicle count) in predicting poor response after controlled ovarian stimulation (COS) according to both classifications
Such variability could be explained by factors such as the low number of subjects included in some of these studies, the variability in the measuring methods used for the two markers and the different definitions of poor ovarian response adopted by the various authors, resulting in variations in the diagnostic performance of markers of ovarian reserve
Summary
A high number of studies has been carried out on the possibility of measuring ovarian reserve through ovarian reserve markers. Poor Ovarian Response Prediction and Management the ovarian reserve of a single woman allows clinicians to predict individual response to controlled ovarian stimulation (COS) in IVF cycles: if a patient has, for instance, a low ovarian reserve, she will probably achieve a poor ovarian response after COS. This condition is characterized by a low number of growing follicles and low serum estradiol levels after exogenous gonadotropin stimulation, resulting in a poor oocytes retrieval and, often, in a poor reproductive outcome [1,2,3,4,5]. We will discuss the ability of the Bologna criteria to predict a poor reproductive prognosis in these patients as well as the innovations introduced by the POSEIDON classification
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
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 call
