波塞冬组3人群的临床研究进展——波塞冬组3人群临床特征分析
Clinical Research Progress of POSEIDON Group 3 Population—Analysis of the Clinical Characteristics of the POSEIDON Group 3 Population
DOI: 10.12677/acm.2025.1541211, PDF,   
作者: 孙安邈*#, 张雅璇*：山东大学妇儿与生殖健康研究院/山东大学附属生殖医院，山东 济南
关键词: 波塞冬标准；卵巢低反应；辅助生殖技术；POSEIDON Stratification； Poor Ovarian Response； Assisted Reproductive Technology
摘要: 波塞冬标准(Patient-Oriented Strategies Encompassing Individualized Oocyte Number, POSEIDON)是将反应卵巢状态的质量和数量指标结合后对卵巢低反应人群(Poor Ovarian Response, POR)进行分组的方式。在此标准下，波塞冬组3人群被定义为：患者年龄 < 35岁且AFC ˂ 5枚，AMH ˂ 1.2 ng/mL。既往研究普遍认同年龄增大是导致卵巢储备降低最关键的因素，但波塞冬组3人群却表现出年轻但卵巢储备功能低下的特点，辅助生殖技术(Assisted Reproductive Technology, ART)助孕结局不佳。因此通过对该人群的治疗前人群特征、治疗周期特征、妊娠并发症等方面进行综述，以期更好的满足波塞冬组3患者的生育需求，达到更好的ART效果。
Abstract: Patient-Oriented Strategies Encompassing Individualized Oocyte Number (POSEIDON) is a classification method that combines both quality and quantity indicators reflecting ovarian response to categorize women with poor ovarian response (POR). Under this standard, the POSEIDON Group 3 is defined as patients who are under 35 years of age, with an antral follicle count (AFC) of less than 5 and an anti-müllerian hormone (AMH) level of less than 1.2 ng/mL. Previous researches generally agree that advancing age is the most critical factor leading to decreased ovarian reserve; however, the POSEIDON group 3 demonstrates a unique profile of being younger yet having compromised ovarian reserve, resulting in poor outcomes in assisted reproductive technology (ART). Therefore, this review aims to summarize the pre-treatment characteristics, treatment cycle features, and pregnancy outcomes and complications of this population in order to better meet the reproductive needs of POSEIDON group 3 patients and improve ART success rates.
文章引用：孙安邈, 张雅璇. 波塞冬组3人群的临床研究进展——波塞冬组3人群临床特征分析[J]. 临床医学进展, 2025, 15(4): 2544-2550. https://doi.org/10.12677/acm.2025.1541211

参考文献

[1] Alviggi, C., Andersen, C.Y., Buehler, K., Conforti, A., De Placido, G., Esteves, S.C., et al. (2016) A New More Detailed Stratification of Low Responders to Ovarian Stimulation: From a Poor Ovarian Response to a Low Prognosis Concept. Fertility and Sterility, 105, 1452-1453. [Google Scholar] [CrossRef] [PubMed]
[2] Esteves, S.C., Yarali, H., Vuong, L.N., Carvalho, J.F., Özbek, İ.Y., Polat, M., et al. (2021) Low Prognosis by the POSEIDON Criteria in Women Undergoing Assisted Reproductive Technology: A Multicenter and Multinational Prevalence Study of over 13,000 Patients. Frontiers in Endocrinology, 12, Article ID: 630550. [Google Scholar] [CrossRef] [PubMed]
[3] 刘东明, 陈立雪, 杨硕, 等. 波塞冬分类指标对预期低预后人群促排卵体外受精/卵胞质内单精子注射早期治疗结局的预测价值研究[J]. 中华生殖与避孕杂志, 2021, 41(4): 300-306.
[4] Weall, B.M., Al-Samerria, S., Conceicao, J., Yovich, J.L. and Almahbobi, G. (2015) A Direct Action for GH in Improvement of Oocyte Quality in Poor-Responder Patients. Reproduction, 149, 147-154. [Google Scholar] [CrossRef] [PubMed]
[5] Steiner, A.Z. and Jukic, A.M.Z. (2016) Impact of Female Age and Nulligravidity on Fecundity in an Older Reproductive Age Cohort. Fertility and Sterility, 105, 1584-1588.e1. [Google Scholar] [CrossRef] [PubMed]
[6] Li, Y., Li, X., Yang, X., Cai, S., Lu, G., Lin, G., et al. (2019) Cumulative Live Birth Rates in Low Prognosis Patients According to the POSEIDON Criteria: An Analysis of 26,697 Cycles of in Vitro Fertilization/Intracytoplasmic Sperm Injection. Frontiers in Endocrinology, 10, Article No. 642. [Google Scholar] [CrossRef] [PubMed]
[7] Shi, W., Zhou, H., Tian, L., Zhao, Z., Zhang, W. and Shi, J. (2019) Cumulative Live Birth Rates of Good and Low Prognosis Patients According to POSEIDON Criteria: A Single Center Analysis of 18,455 Treatment Cycles. Frontiers in Endocrinology, 10, Article No. 409. [Google Scholar] [CrossRef] [PubMed]
[8] Liu, L., Cai, B., Zhang, X., Huang, J. and Zhou, C. (2022) Euploid Blastocyst Rates in Patients from POSEIDON Groups 3 and 4 Using Propensity Score Matching. Reproductive BioMedicine Online, 45, 374-383. [Google Scholar] [CrossRef] [PubMed]
[9] Silvestris, E., de Pergola, G., Rosania, R. and Loverro, G. (2018) Obesity as Disruptor of the Female Fertility. Reproductive Biology and Endocrinology, 16, Article No. 22. [Google Scholar] [CrossRef] [PubMed]
[10] Jaswa, E.G., Rios, J.S., Cedars, M.I., Santoro, N.F., Pavone, M.E.G., Legro, R.S., et al. (2020) Increased Body Mass Index Is Associated with a Nondilutional Reduction in Antimüllerian Hormone. The Journal of Clinical Endocrinology & Metabolism, 105, 3234-3242. [Google Scholar] [CrossRef] [PubMed]
[11] Moslehi, N., Shab-Bidar, S., Ramezani Tehrani, F., Mirmiran, P. and Azizi, F. (2018) Is Ovarian Reserve Associated with Body Mass Index and Obesity in Reproductive Aged Women? A Meta-Analysis. Menopause, 25, 1046-1055. [Google Scholar] [CrossRef] [PubMed]
[12] Yang, R., Zhang, C., Chen, L., Wang, Y., Li, R., Liu, P., et al. (2020) Cumulative Live Birth Rate of Low Prognosis Patients with POSEIDON Stratification: A Single-Centre Data Analysis. Reproductive BioMedicine Online, 41, 834-844. [Google Scholar] [CrossRef] [PubMed]
[13] Chinta, P., Antonisamy, B., Mangalaraj, A.M., Kunjummen, A.T. and Kamath, M.S. (2021) POSEIDON Classification and the Proposed Treatment Options for Groups 1 and 2: Time to Revisit? A Retrospective Analysis of 1425 ART Cycles. Human Reproduction Open, 2021, hoaa070. [Google Scholar] [CrossRef] [PubMed]
[14] Malchau, S.S., Henningsen, A.A., Forman, J., Loft, A., Nyboe Andersen, A. and Pinborg, A. (2018) Cumulative Live Birth Rate Prognosis Based on the Number of Aspirated Oocytes in Previous ART Cycles. Human Reproduction, 34, 171-180. [Google Scholar] [CrossRef] [PubMed]
[15] Drakopoulos, P., Blockeel, C., Stoop, D., Camus, M., de Vos, M., Tournaye, H., et al. (2016) Conventional Ovarian Stimulation and Single Embryo Transfer for IVF/ICSI. How Many Oocytes Do We Need to Maximize Cumulative Live Birth Rates after Utilization of All Fresh and Frozen Embryos? Human Reproduction, 31, 370-376. [Google Scholar] [CrossRef] [PubMed]
[16] Chen, D., Shen, X., Wang, L. and Kuang, Y. (2022) Cumulative Live Birth Rates for Low-Prognosis Women over 5 Years or 9 Frozen-Thawed Embryo Transfer Cycles. BMC Pregnancy and Childbirth, 22, Article No. 233. [Google Scholar] [CrossRef] [PubMed]
[17] Xia, L., Zhou, X., Wang, X., Zhao, S., Wu, X., Xu, H., et al. (2024) The Role of Age and AMH on Cumulative Live Birth Rates over Multiple Frozen-Thawed Embryo Transfer Cycles: A Study Based on Low Prognosis Patients of POSEIDON 3 and 4 Groups. Reproductive Biology and Endocrinology, 22, Article No. 69. [Google Scholar] [CrossRef] [PubMed]
[18] Aldemir, O., Ozelci, R., Baser, E., Kaplanoglu, I., Dilbaz, S., Dilbaz, B., et al. (2020) Impact of Transferring a Poor Quality Embryo along with a Good Quality Embryo on Pregnancy Outcomes in IVF/ICSI Cycles: A Retrospective Study. Geburtshilfe und Frauenheilkunde, 80, 844-850. [Google Scholar] [CrossRef] [PubMed]
[19] Zhu, J., Lian, Y., Li, M., Chen, L., Liu, P. and Qiao, J. (2014) Does IVF Cleavage Stage Embryo Quality Affect Pregnancy Complications and Neonatal Outcomes in Singleton Gestations after Double Embryo Transfers? Journal of Assisted Reproduction and Genetics, 31, 1635-1641. [Google Scholar] [CrossRef] [PubMed]
[20] Li, F., Ye, T., Kong, H., Li, J., Hu, L., Jin, H., et al. (2020) Efficacies of Different Ovarian Hyperstimulation Protocols in Poor Ovarian Responders Classified by the POSEIDON Criteria. Aging, 12, 9354-9364. [Google Scholar] [CrossRef] [PubMed]
[21] Huang, M., Tzeng, S., Lee, C., Chen, H., Huang, C., Lee, T., et al. (2018) Gnrh Agonist Long Protocol versus Gnrh Antagonist Protocol for Various Aged Patients with Diminished Ovarian Reserve: A Retrospective Study. PLOS ONE, 13, e0207081. [Google Scholar] [CrossRef] [PubMed]
[22] Baart, E.B., Martini, E., Eijkemans, M.J., Van Opstal, D., Beckers, N.G.M., Verhoeff, A., et al. (2007) Milder Ovarian Stimulation for In-Vitro Fertilization Reduces Aneuploidy in the Human Preimplantation Embryo: A Randomized Controlled Trial. Human Reproduction, 22, 980-988. [Google Scholar] [CrossRef] [PubMed]
[23] Liu, X., Li, T., Wang, B., Xiao, X., Liang, X. and Huang, R. (2020) Mild Stimulation Protocol vs Conventional Controlled Ovarian Stimulation Protocol in Poor Ovarian Response Patients: A Prospective Randomized Controlled Trial. Archives of Gynecology and Obstetrics, 301, 1331-1339. [Google Scholar] [CrossRef] [PubMed]
[24] Morgia, F., Sbracia, M., Schimberni, M., Giallonardo, A., Piscitelli, C., Giannini, P., et al. (2004) A Controlled Trial of Natural Cycle versus Microdose Gonadotropin-Releasing Hormone Analog Flare Cycles in Poor Responders Undergoing in Vitro Fertilization. Fertility and Sterility, 81, 1542-1547. [Google Scholar] [CrossRef] [PubMed]
[25] 张俊韦, 杜明泽, 孙丽君, 等. 三种促排卵方案在波塞冬低预后患者中的累积活产率分析[J]. 中华生殖与避孕杂志, 2022, 42(2): 117-124.
[26] Montoya-Botero, P., Drakopoulos, P., González-Foruria, I. and Polyzos, N.P. (2021) Fresh and Cumulative Live Birth Rates in Mild versus Conventional Stimulation for IVF Cycles in Poor Ovarian Responders: A Systematic Review and Meta-Analysis. Human Reproduction Open, 2021, hoaa066. [Google Scholar] [CrossRef] [PubMed]
[27] Alviggi, C. and Conforti, A. (2022) Mild/Moderate versus Full Stimulation. Fertility and Sterility, 117, 664-668. [Google Scholar] [CrossRef] [PubMed]
[28] Magnus, M.C., Wilcox, A.J., Morken, N., Weinberg, C.R. and Håberg, S.E. (2019) Role of Maternal Age and Pregnancy History in Risk of Miscarriage: Prospective Register Based Study. BMJ, 364, l869. [Google Scholar] [CrossRef] [PubMed]
[29] Peuranpää, P., Hautamäki, H., Halttunen-Nieminen, M., Hydén-Granskog, C. and Tiitinen, A. (2020) Low Anti-Müllerian Hormone Level Is Not a Risk Factor for Early Pregnancy Loss in IVF/ICSI Treatment. Human Reproduction, 35, 504-515. [Google Scholar] [CrossRef] [PubMed]
[30] Tarasconi, B., Tadros, T., Ayoubi, J., Belloc, S., de Ziegler, D. and Fanchin, R. (2017) Serum Antimüllerian Hormone Levels Are Independently Related to Miscarriage Rates after in Vitro Fertilization-Embryo Transfer. Fertility and Sterility, 108, 518-524. [Google Scholar] [CrossRef] [PubMed]
[31] Busnelli, A., Somigliana, E., Cirillo, F. and Levi-Setti, P.E. (2021) Is Diminished Ovarian Reserve a Risk Factor for Miscarriage? Results of a Systematic Review and Meta-Analysis. Human Reproduction Update, 27, 973-988. [Google Scholar] [CrossRef] [PubMed]
[32] Bishop, L.A., Richter, K.S., Patounakis, G., Andriani, L., Moon, K. and Devine, K. (2017) Diminished Ovarian Reserve as Measured by Means of Baseline Follicle-Stimulating Hormone and Antral Follicle Count Is Not Associated with Pregnancy Loss in Younger in Vitro Fertilization Patients. Fertility and Sterility, 108, 980-987. [Google Scholar] [CrossRef] [PubMed]
[33] Leijdekkers, J.A., Eijkemans, M.J.C., van Tilborg, T.C., Oudshoorn, S.C., van Golde, R.J.T., Hoek, A., et al. (2019) Cumulative Live Birth Rates in Low-Prognosis Women. Human Reproduction, 34, 1030-1041. [Google Scholar] [CrossRef] [PubMed]
[34] 黄愈, 施文浩, 师娟子. 波塞冬标准低预后患者的累积活产率分析[J]. 中华生殖与避孕杂志, 2020, 40(5): 361-366.
[35] Esteves, S.C., Yarali, H., Vuong, L.N., Carvalho, J.F., Özbek, İ.Y., Polat, M., et al. (2021) Cumulative Delivery Rate per Aspiration IVF/ICSI Cycle in POSEIDON Patients: A Real-World Evidence Study of 9073 Patients. Human Reproduction, 36, 2157-2169. [Google Scholar] [CrossRef] [PubMed]
[36] Maheshwari, A., McLernon, D. and Bhattacharya, S. (2015) Cumulative Live Birth Rate: Time for a Consensus? Human Reproduction, 30, 2703-2707. [Google Scholar] [CrossRef] [PubMed]

为你推荐