Predictive value of POSEIDON classification index for the early outcome of in vitro fertilization/intracytoplasmic sperm injection in the expected low prognosis population
10.3760/cma.j.cn101441-20200323-00153
- VernacularTitle:波塞冬分类指标对预期低预后人群促排卵体外受精/卵胞质内单精子注射早期治疗结局的预测价值研究
- Author:
Dongming LIU
1
;
Lixue CHEN
1
;
Shuo YANG
1
;
Caihong MA
1
;
Jie QIAO
1
;
Rong LI
1
Author Information
1. 北京大学第三医院妇产科生殖医学中心 国家妇产疾病临床医学研究中心（北京大学第三医院） 辅助生殖教育部重点实验室（北京大学） 北京市生殖内分泌与辅助生殖技术重点实验室 100191
- Publication Type:Journal Article
- Keywords:
Fertilization in vitro;
Ovarian reserve;
Ovulation induction;
Ovary, poor response;
Standards, POSEIDON
- From:
Chinese Journal of Reproduction and Contraception
2021;41(4):300-306
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive value of age, anti-Müllerian hormone (AMH) and antral follicle count (AFC) for the outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in the expected low prognosis population according to the POSEIDON criteria. Methods:This retrospective study was performed in patients who underwent IVF/ICSI and were expected low prognosis of ovarian stimulation from March 1, 2017 to December 31, 2018 in Reproductive Medicine Center, Department of Obstetrics and Gynecology, Peking University Third Hospital. According to three of the POSEIDON classification index, cycles were divided into 5 groups: group A (age<35 years, AFC<5 and AMH<1.2 μg/L), group B (age≥35 years, AFC<5 and AMH<1.2 μg/L), group C (AFC<5 and AMH≥1.2 μg/L), group D (age<35 years, AFC≥5 and AMH<1.2 μg/L) and group E (age≥35 years, AFC≥5 and AMH<1.2 μg/L). The ovarian stimulation and pregnancy outcomes were analyzed.Results:A total of 6745 IVF/ICSI cycles were included. The proportions of mini-stimulation and natural cycles in group A [15.8% (158/1000), 6.4% (64/1000)] and group B [28.1% (659/2342), 17.7% (414/2342)] were significantly higher than those in groups C, D and E [group C 6.4% (54/845), 1.1% (9/845); group D 5.8% (63/1077), 0.8% (9/1077); group E 11.0% (163/1481), 0.9% (14/1481), P<0.001]. The number of retrieved oocytes in groups A and B [4(2,6), 3(2,5)] was significantly lower than that in groups D and E [7(4,10), 6(3,8)] ( P<0.001). The clinical pregnancy rate [39.2% (200/510), 37.2% (272/731)], the implantation rate [28.4% (251/883), 26.7% (355/1332)], and the live birth rate [24.9% (127/510), 22.3% (163/731)] of young patients in groups A and D were significantly higher than those of older patients [group B: 21.5% (238/1109), 14.9% (266/1787), 10.4% (115/1109), group E: 23.5% (212/903), 15.4% (243/1581), 11.8% (107/903)] ( P<0.001). The cancellation rate of transplantation in groups A and B [49.0% (490/1000), 52.6% (1233/2342)] was significantly higher than that in the other groups [group C 34.1% (288/845), group D 32.1% (346/1077), group E 39.0% (578/1481), P<0.001], and among the cancellation reasons, the proportion of no embryos or no retrieved eggs in groups A and B was also higher. Conclusion:The POSEIDON criteria has a good predictive value on expected low prognosis patients. AMH, which is an objective index, represents a higher clinical pregnancy rate, while higher AFC indicate more retrieved eggs. In young patients with low ovarian reserve (POSEIDON group 3), clinical pregnancy rate per cycle is moderate, but due to a high cancellation rate because of no embryos or no retrieved eggs, live birth rate per egg retrieval cycle is still low.
