REVIEW  HOT TOPICS IN FEMALE INFERTILITY 

Panminerva Medica 2019 March;61(1):24-9

DOI: 10.23736/S0031-0808.18.03511-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Novel approaches for diagnosis and management of low prognosis patients in assisted reproductive technology: the POSEIDON concept

Alessandro CONFORTI ¹ ✉, Sandro C. ESTEVES ², Silvia PICARELLI ¹, Giuseppe IORIO ¹, Erika RANIA ³, Fulvio ZULLO ¹, Giuseppe DE PLACIDO ¹, Carlo ALVIGGI ^{1, 4}

¹ Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy; ² Andrology and Human Reproduction Clinic ANDROFERT, Campinas, Brazil; ³ National Research Council, Institute for Experimental Endocrinology and Oncology (IEOS), Naples, Italy; ⁴ Unit of Obstetrics and Gynecology, Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy

The management of patients with a poor ovarian response (POR) to ovarian stimulation represents a challenging issue in reproductive medicine. Apart from economic burdens, the patient with POR has poor prognosis in assisted reproductive technology (ART), which represents a common cause of drop-out from treatment. To introduce a more nuanced picture of POR, the POSEIDON group developed novel criteria to identify and classify patients with low prognosis who undergo ART. The primary goal of POSEIDON criteria is to offer clinicians a pragmatic system to guide therapeutic management with the mindset to obtain the number of oocytes needed for improving ART success. A novel marker of ART success, namely, the ability to obtain the number of oocytes required for achieving at least one euploid embryo for transfer in each patient, is aligned with the POSEIDON criteria. A novel prediction model (ART Calculator) is developed to help clinicians estimate the POSEIDON marker of success. Furthermore, the POSEIDON criteria can also be used to identify more homogeneous populations to test in interventional trials.

KEY WORDS: Reproductive techniques, assisted - Ovulation induction - Prognosis