期刊
FRONTIERS IN ENDOCRINOLOGY
卷 10, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fendo.2019.00409
关键词
POSEIDON; cumulative live birth; implantation rate; miscarriage rate; low prognosis patient
资金
- General Projects of Social Development in Shaanxi Province [2018SF-247]
- Personnel Training Program of Northwest women and children's Hospital [2018ZD02]
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.
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