Background
Methods
Study setting and patients
PPOS and frozen-embryo transfer protocols
Statistical analysis
Results
Patient demographics and baseline characteristics
Group | POSEIDON group | Control group | P value | |||
---|---|---|---|---|---|---|
Group1 | Group2 | Group3 | Group4 | Group5 | ||
Younger unexpected poor responders | Older unexpected poor responders | Younger expected poor responders | Older expected poor responders | |||
Patients (n) | 4470 | 2270 | 1110 | 1095 | 8753 | |
Age of female | 30.21 ± 2.76a | 38.01 ± 2.83b | 30.32 ± 2.71a,d | 39.37 ± 3.38c | 30.44 ± 3.85d | <0.05 |
Percentage of age | a | b | c | d | e | <0.05 |
≤ 30 | 2234 (50.0%) | 0 (0.0%) | 541 (48.7%) | 0 (0.0%) | 4760 (54.4%) | |
> 30, ≤35 | 2236 (50.0%) | 494 (21.8%) | 569 (51.3%) | 141 (12.9%) | 3103 (35.5%) | |
> 35, ≤40 | 0 (0.0%) | 1360 (59.9%) | 0 (0.0%) | 564 (51.5%) | 796 (9.1%) | |
> 40 | 0 (0.0%) | 416 (18.3%) | 0 (0.0%) | 390 (35.6%) | 94 (1.1%) | |
AFC | 11.17 ± 5.77a | 8.99 ± 4.09b | 2.19 ± 1.65c | 2.51 ± 1.32c | 15.24 ± 6.21d | <0.05 |
Percentage of AFC | a | b | c | c | d | <0.05 |
< 4 | 0 (0.0%) | 0 (0.0%) | 750 (67.6%) | 776 (70.9%) | 0 (0.0%) | |
≥ 4, < 10 | 2185 (48.9%) | 1502 (66.2%) | 360 (32.4%) | 319 (29.1%) | 1444 (16.5%) | |
≥ 10 | 2285 (51.1%) | 768 (33.8%) | 0 (0.0%) | 0 (0.0%) | 7309 (83.5%) | |
Oocytes retrieved in the first cycle (n) | 5.97 ± 2.31a | 5.27 ± 2.34b | 7.07 ± 6.67c | 3.29 ± 3.05d | 16.84 ± 6.57e | <0.05 |
Type of infertility | a | b | c | d | e | <0.05 |
Primary | 2673 (59.8%) | 848 (37.4%) | 713 (64.2%) | 383 (35.0%) | 5059 (57.8%) | |
Secondary | 1797 (40.2%) | 1422 (62.6%) | 397 (35.8%) | 712 (65.0%) | 3694 (42.2%) | |
Main etiology | a | b | c | d | e | <0.05 |
Female | 460 (10.3%) | 240 (10.6%) | 94 (8.5%) | 69 (6.3%) | 1076 (12.3%) | |
Male | 2945 (65.9%) | 1401 (61.7%) | 770 (69.4%) | 741 (67.7%) | 5567 (63.6%) | |
Combined | 539 (12.0%) | 236 (10.4%) | 126 (11.3%) | 132 (12.0%) | 1059 (12.1%) | |
Others | 526 (11.8%) | 393 (17.3%) | 120 (10.8%) | 153 (14.0%) | 1051 (12.0%) | |
Duration of infertility (years) | 2.93 ± 2.42a | 4.08 ± 3.96b | 3.14 ± 2.46c | 4.32 ± 4.56d | 3.01 ± 2.70a,c | <0.05 |
Female BMI (kg/m2) | 22.00 ± 4.74a | 22.26 ± 3.07b | 21.78 ± 5.87a,c | 22.16 ± 2.88a,b | 21.64 ± 3.31c | <0.05 |
Year of treatment | a | b | c | d | e | <0.05 |
2013–2014 | 1160 (26.0%) | 526 (23.2%) | 309 (27.8%) | 304 (27.8%) | 2248 (25.7%) | |
2015 | 859 (19.2%) | 375 (16.5%) | 258 (23.2%) | 180 (16.4%) | 1821 (20.8%) | |
2016 | 1349 (30.2%) | 730 (32.2%) | 362 (32.6%) | 348 (31.8%) | 2188 (25.0%) | |
2017 | 683 (15.3%) | 353 (15.6%) | 111 (10.0%) | 172 (15.7%) | 1353 (15.5%) | |
2018 | 419 (9.4%) | 286 (12.6%) | 70 (6.3%) | 91 (8.3%) | 1143 (13.1%) | |
Gravidity | 0.71 ± 1.27a | 1.42 ± 1.53b | 0.62 ± 1.04c | 1.48 ± 1.52b | 0.74 ± 1.09a | <0.05 |
Parity | 0.06 ± 0.26a | 0.27 ± 0.48b | 0.05 ± 0.23a | 0.30 ± 0.51b | 0.08 ± 0.30c | <0.05 |
Ovarian stimulation characteristics and pregnancy outcomes
POSEIDON group | Control group | P-value | ||||
---|---|---|---|---|---|---|
Group1 | Group2 | Group3 | Group4 | Group5 | ||
Younger unexpected poor responders | Older unexpected poor responders | Younger expected poor responders | Older expected poor responders | |||
Patients (n) | 4470 | 2270 | 1110 | 1095 | 8753 | |
Oocyte retrieval cycles (n) | 1.33 ± 0.64a | 1.54 ± 0.89b | 1.55 ± 0.94b | 1.97 ± 1.33c | 1.11 ± 0.38d | <0.05 |
Retrieved oocytes (n) | 5.97 ± 2.31a | 5.27 ± 2.34b | 7.07 ± 6.67c | 3.29 ± 3.05d | 16.84 ± 6.57e | <0.05 |
Retrieved Oocytes / AFC (%) | 58.02% | 62.96% | 199.21% | 99.31% | 109.28% | <0.05 |
Cycles of 0 oocyte Retrieved (%) | 25 (0.4%)a | 12 (0.3%)a | 32 (1.9%)b | 51 (2.4%)b | 0 (0.0%)c | <0.05 |
Insemination method | a | b | c | d | e | <0.05 |
IVF | 2878 (64.6%) | 1486 (65.8%) | 781 (70.9%) | 752 (69.8%) | 5069 (58.0%) | |
ICSI | 988 (22.2%) | 572 (25.3%) | 235 (21.3%) | 290 (26.9%) | 2047 (23.4%) | |
IVF/ICSI | 587 (13.2%) | 201 (8.9%) | 86 (7.8%) | 36 (3.3%) | 1630 (18.6%) | |
2PN embryos per oocyte retrieval cycle (n) | 3.86 ± 2.08a | 3.44 ± 1.95b | 4.47 ± 4.26c | 2.16 ± 2.13d | 10.39 ± 5.09e | <0.05 |
Good quality embryos per oocyte retrieval cycle (n) | 2.15 ± 1.71a | 1.98 ± 1.55b | 2.38 ± 2.59c | 1.27 ± 1.39d | 5.32 ± 3.78e | <0.05 |
FET cycles (n) | 1.46 ± 0.81a | 1.58 ± 0.92b | 1.47 ± 0.78a,b | 1.54 ± 0.94a,b | 1.57 ± 0.88b | <0.05 |
Transplanted embryos (n) | 2.31 ± 1.61a | 2.50 ± 1.88b | 2.27 ± 1.70a | 2.01 ± 1.74c | 3.08 ± 1.88d | <0.05 |
CLBR over 2 years | ||||||
Optimistic(95%CI) | 0.76 (0.74–0.77)a | 0.55 (0.53–0.58)b | 0.67 (0.63–0.70)c | 0.36 (0.32–0.39)d | 0.76 (0.75–0.77)e | <0.001 |
Conservative(95%CI) | 0.64 (0.62–0.65)a | 0.42 (0.40–0.44)b | 0.55 (0.52–0.58)c | 0.26 (0.23–0.29)d | 0.70 (0.70–0.71)e | <0.001 |
CLBR over 5 years | ||||||
Optimistic(95%CI) | 0.81 (0.79–0.82)a | 0.60 (0.57–0.63)b | 0.75 (0.71–0.78)c | 0.41 (0.37–0.46)d | 0.79 (0.78–0.80)a | <0.001 |
Conservative(95%CI) | 0.66 (0.65–0.67)a | 0.44 (0.42–0.46)b | 0.58 (0.55–0.61)c | 0.27 (0.25–0.30)d | 0.72 (0.72–0.73)e | <0.001 |