Outcome of assisted reproductive technology in different subgroups of poor ovarian responders fulfilling the POSEIDON criteria

Background: The population of poor ovarian responders among patients undergoing in vitro fertilization (IVF) has been suggested to vary between 9 and 25%.Objective: Low success rates are common in women undergoing in vitro fertilization who respond poorly to ovarian hyperstimulation. Due to the heterogeneity of the populations, expressing a unique and shared definition is necessary in order to individualize infertility treatment. The main goal of this study was to evaluate the assisted reproductive technology outcome among various subgroups of poor responders defined by the POSEIDON (Patients-Oriented Strategies Encompassing IndividualizeD Oocyte Number) stratification.Materials and Methods: In this retrospective cohort study, the clinical and laboratory records of 245 poor responder women undergoing their first ovarian stimulation and fresh embryo transfer cycle were reviewed. Patients were categorized into 4 groups according to the POSEIDON classification.Results: The fertilization rate was comparable between groups (p> 0.05). Moreover, there was no difference in implantation rates between groups 1 and 2 and groups 3 and 4 (p> 0.05). In contrast, chemical and clinical pregnancy rates, as well as live birth, were significantly higher in group 1 and 2 compared to the groups 3 and 4 (p<0.05). As regards POSEIDON subgroup stratification, there were not significantly different between four subgroups of group 1 and 2 on the subject of ART outcomes (p> 0.05).Conclusion: Future studies should explore the most optimal treatment strategy for poor responders according to the POSEIDON stratification and suggested handling with live birth as primary end-point.

Keywords:

ART outcome , Poor responder , POSEIDON stratification , Individualized treatment