What is POSEIDON?
The POSEIDON group has introduced a new stratification system for classifying infertility patients with confirmed or expected low ovarian response to exogenous gonadotropins. Specifically, four subgroup categories have been created based on quantitative and qualitative parameters, namely, i. The age of the patient and the expected aneuploidy rate; ii. Ovarian biomarkers (i.e. AFC and AMH), and iii. The ovarian response of the patient provided a previous cycle of stimulation had been carried out. In the latter, a ‘suboptimal response’ was defined as the retrieval of four to nine oocytes despite adequate pre-stimulation ovarian parameters, as it is associated at any given age with a significantly lower live birth rate compared with normal responders, i.e., those with 10–15 oocytes. And a ‘poor response’ was defined as the retrieval of fewer than four oocytes despite adequate pre-stimulation ovarian parameters.
The management of patients with impaired ovarian reserve or poor ovarian response (POR) to exogenous gonadotropin stimulation has challenged reproductive specialists for a long time. Apart from our limited understanding of its pathophysiology, there is extensive heterogeneity in the definition of the poor responder patient as well as overall disappointing outcomes in assisted reproductive technology (ART) cycles.