Comparison of Cumulative Live Birth Rate (CLBR) According to Patient  Oriented Strategies Encompassing Individualized Oocyte Number  (POSEIDON) Stratification Among Low Prognosis Women Undergoing  IVF-ICSI Cycles

Reeta  Bansiwal; Reeta  Mahey; Neena  Malhotra; Neeta   Singh; Monika   Saini; Ashok  Bhatt; Nilima  Nilima; Kalaivani   Mani; Rohitha  Cheluvaraju; Monika  Rajput; Neerja  Bhatla

doi:10.18502/jri.v24i2.12497

Reeta Bansiwal Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Reeta Mahey Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Neena Malhotra Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Neeta Singh Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Monika Saini Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Ashok Bhatt Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Nilima Nilima Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Kalaivani Mani Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Rohitha Cheluvaraju Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Monika Rajput Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
Neerja Bhatla Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India

DOI: https://doi.org/10.18502/jri.v24i2.12497

Keywords: Cumulative live birth rate, Infertility, IVF, Low prognosis women, POSEIDON criteria.

Abstract

Background: The purpose of the current study was to evaluate patient-oriented strategies encompassing individualized oocyte number (POSEIDON) criteria, validate stratification of low prognosis women, and prognosticate their reproductive potential in terms of cumulative live birth rate (CLBR) in Indian women.

Methods: Out of 4048 women who underwent IVF/ICSI, 3287 women met the criteria for final evaluation of CLBR. They criteria were divided into (a) group 1a as cases with <4 oocytes retrieved and 1b with 4-9 oocytes retrieved; (b) group 2a as cases with <4 oocytes retrieved and 2b with 4-9 oocytes retrieved; (c) group 3 (<35 years, AMH <1.2 ng/ml, AFC <5); and (d) group 4 (≥35 years, AMH <1.2 ng/ml, AFC <5). Non-POSEIDON group was sub-divided into normo-responders (10-20 oocytes) and hyper-responder (>20 oocytes).

Results: Overall CLBR was two-fold lower in POSEIDON group as compared to non-POSEIDON group (p<0.001). For every one-year increase in the age, the odds of CLBR decreased by 4% (OR 0.96, CI 0.93-0.99) in POSEIDON group and by 5% (OR 0.95, CI 0.92-0.98) in non-POSEIDON group. For every unit increase in number of oocytes retrieved, the odds of CLBR increased by 1.22 times (OR1.22, CI 1.16-1.28) in POSEIDON group and by 1.08 times (OR 1.08, CI 1.05-1.11) in non-POSEIDON group. Among POSEIDON groups, the highest values in CLBR belonged to group 1b followed by 3, 2b, 4, 1a, and 2a.

Conclusion: POSEIDON stratification of low-prognosis women undergoing IVF may be considered valid to prognosticate and counsel women undergoing IVF. Prospective studies will strengthen its validity among different ethnic populations.