Horowitz Eran, Mizrachi Yossi, Barber Elad, Shimshy Miriam, Levitas-Djerbi Talia, Finkelstein Maya, Shalev Amir, Farhi Jacob, Raziel Arieh, Esteves Sandro C, Weissman Ariel
In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Eur J Obstet Gynecol Reprod Biol. 2024 Apr;295:42-47. doi: 10.1016/j.ejogrb.2024.01.025. Epub 2024 Jan 23.
Planned oocyte cryopreservation (OC) is being increasingly utilized worldwide. However, some women cannot accumulate sufficient oocytes because of poor response to stimulation. The POSEIDON classification is a novel system to classify patients with 'expected' or 'unexpected' inappropriate ovarian response to exogenous gonadotropins. Our study aimed to examine the prevalence of POSEIDON patients among women undergoing planned OC.
We retrospectively reviewed the first cycles of 160 consecutive patients undergoing planned OC. Patients were classified into the four POSEIDON groups or as 'non-POSEIDON' based on age, AMH level and the number of oocytes retrieved. The primary outcome measure was the prevalence of POSEIDON patients.
Overall, 63 patients (39.4 %) were classified as POSEIDON patients, 12 in group 1, 12 in group 2, 8 in group 3, and 31 in group 4. Compared to non-POSEIDON patients, POSEIDON patients had increased basal FSH levels and reduced serum AMH levels and antral follicle counts, required higher FSH starting doses and increased gonadotropin requirements and reached lower peak serum estradiol levels. Additionally, POSEIDON patients had a lower number of oocytes retrieved (7.6 ± 3.1 vs.20.2 ± 9.9, p < 0.001) and vitrified (5.8 ± 2.9 vs.14.7 ± 6.8, p < 0.001) than non-POSEIDON counterparts, respectively.
We found a high prevalence of patients being classified as low prognosis according to the POSEIDON criteria among patients seeking planned OC. POSEIDON patients had increased gonadotropin requirements and a significantly lower number of oocytes retrieved and vitrified. This novel, unexpected finding adds clinically relevant information for counselling and management of patients undergoing planned OC.
计划性卵母细胞冷冻保存（OC）在全球范围内的应用日益广泛。然而，一些女性因对促排卵刺激反应不佳而无法积累足够的卵母细胞。POSEIDON分类是一种用于对对外源性促性腺激素有“预期”或“意外”不适当卵巢反应的患者进行分类的新系统。我们的研究旨在调查计划性OC女性中POSEIDON患者的患病率。
我们回顾性分析了160例连续接受计划性OC患者的首个周期。根据年龄、抗缪勒管激素（AMH）水平和回收的卵母细胞数量，将患者分为四个POSEIDON组或“非POSEIDON”组。主要结局指标是POSEIDON患者的患病率。
总体而言，63例患者（39.4%）被分类为POSEIDON患者，1组12例，2组12例，3组8例，4组31例。与非POSEIDON患者相比，POSEIDON患者的基础促卵泡激素（FSH）水平升高，血清AMH水平和窦卵泡计数降低，需要更高的FSH起始剂量，促性腺激素需求量增加，血清雌二醇峰值水平更低。此外，与非POSEIDON患者相比，POSEIDON患者回收的卵母细胞数量（7.6±3.1 vs.20.2±9.9，p<0.001）和玻璃化保存的卵母细胞数量（5.8±2.9 vs.14.7±6.8，p<0.001）均较少。
我们发现在寻求计划性OC的患者中，根据POSEIDON标准被分类为低预后的患者患病率较高。POSEIDON患者的促性腺激素需求量增加，回收和玻璃化保存的卵母细胞数量显著减少。这一新颖且意外的发现为计划性OC患者的咨询和管理增添了临床相关信息。
