Haahr Thor, Dosouto Carlos, Alviggi Carlo, Esteves Sandro C, Humaidan Peter
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
The Fertility Clinic Skive, Skive Regional Hospital, Skive, Denmark.
Front Endocrinol (Lausanne). 2019 Sep 11;10:614. doi: 10.3389/fendo.2019.00614. eCollection 2019.
In the POSEIDON classification, patients belonging to groups 3 and 4 share the same common feature of a poor ovarian reserve which independently of age renders them at high risk of a poor reproductive outcome. Overall, POSEIDON groups 1-4 constitute approximately 47% of patients attending assisted reproductive technology (ART) treatment. With the increasing delay in childbearing, POSEIDON group 4 seems to increase in numbers now in some centers constituting more than 50% of the total POSEIDON population, whereas group 3 patients constitute approximately 10%. Both POSEIDON groups 3 and 4 patients require special attention as regards pre-treatment strategy, ovarian stimulation, adjuvant treatment, and ovulation trigger strategy in order to optimize the probability of having at least one euploid blastocyst for transfer. Although more evidence is needed, recent advances seem to have increased the reproductive outcomes in the poor prognosis patient. The key to success is individualization in all steps of ART treatment. Herein, we review the recent evidence for the management of POSEIDON groups 3 and 4.
在波塞冬分类中，3组和4组患者具有相同的共同特征，即卵巢储备功能差，这使得他们无论年龄大小，生殖结局不良的风险都很高。总体而言，波塞冬1 - 4组约占接受辅助生殖技术（ART）治疗患者的47%。随着生育延迟的增加，目前在一些中心，波塞冬4组患者数量似乎有所增加，占波塞冬总人群的比例超过50%，而3组患者约占10%。为了优化获得至少一个可移植整倍体囊胚的概率，波塞冬3组和4组患者在治疗前策略、卵巢刺激、辅助治疗和排卵触发策略方面都需要特别关注。尽管还需要更多证据，但最近的进展似乎提高了预后不良患者的生殖结局。成功的关键在于ART治疗所有步骤的个体化。在此，我们综述了波塞冬3组和4组管理的最新证据。
