波塞冬标准低预后患者的累积活产率分析

Objective: To investigate the characteristics and outcomes of low prognosis patients based on POSEIDON criteria undergoing in vitro fertilization and embryo transfer (IVF-ET) treatment. Methods: A retrospective cohort study was conducted to analyze the data of low prognosis patients undergoing IVF-ET in Reproductive Medicine Centre, the Northwest Women's & Children's Hospital between January 1, 2014 to January 31, 2018. The follow-up lasted at least one year. After strict exclusion criteria, 4120 complete fresh cycles were included in the analysis. According to POSEIDON criteria, there were 1092 cases in group A [ age<35 years, antral follicle count (AFC)≥5, number of oocytes retrieved in previous standard stimulation≤9 ], 480 cases in group B (age≥35 years, AFC≥5, number of oocytes retrieved in previous standard stimulation≤9), 1132 cases in group C (age<35 years, AFC<5), and 1416 cases in group D (age≥35 years, AFC<5). The baseline characteristics, embryonic development and cumulative live birth rates were compared among the groups. Results: The oocytes output rate ranked from high to low in order of group C (149.47%), group D (112.06%), group B (85.39%) and group A (81.81%) with significantly differences (all P=0.000 1). The non-usable embryo transplant rate ranked from high to low in order of group D (19.49%), group C (15.37%), group B (11.88%) and group A (10.90%) with significant differences (all P=0.000 1). The cumulative live birth rate ranked from high to low in order of group A (48.81%), group C (35.07%), group B (26.46%) and group D (14.55%) with significant differences (all P=0.000 1). Conclusion: POSEIDON criteria grouping method can predict the cumulative live birth rate of patients. The cumulative live birth rate was the highest in the young women with good ovarian reserve, followed by the young women with diminished ovarian reserve, then the advanced age women with good ovarian reserve, and the lowest in the advanced age women with diminished ovarian reserve.