Managing patients with impaired or poor ovarian response (POR) is a controversial issue. Number of oocytes retrieved has been adopted as a criterion of POR in most clinical trials, although the threshold number differs considerably between studies. To standardize the definition of POR, the European society of human reproduction and embryology (ESHRE) proposed a new standard, known as the Bologna criteria. Although these criteria were found to be useful for counseling purposes, their use in clinical trials has been questioned because they entail the risk of grouping women who differ significantly in biologic characteristics and prognosis in IVF. Furthermore, the Bologna Criteria did not address the clinical approaches for these types of patients. A Panel of experts (Patient-Oriented Strategies Encompassing Individualized Oocyte Number, the POSEIDON group) recently proposed new criteria that can help guide the physician in managing patients. A more nuanced definition of the ‘‘low prognosis’’ patient is being proposed. These criteria introduced other categories of patients with impaired response to controlled ovarian stimulation such as hypo and suboptimal responders and combines qualitative and quantitative parameters, namely the age expected aneuploidy rate, biomarkers (anti mullerian hormone) and functional markers (antral follicle count). Each low prognosis group requires specific evidence-based clinical algorithms that include every possible strategy before, during, and after procedures; a topic that will be discussed during the meeting. In this context, the number of oocytes necessary to obtain at least one euploid embryo for transfer in each patient group will be proposed.
The new POSEIDON criteria could help to improve management of patients exposed to assisted reproductive technologies, promote more specific approaches to patient with impaired prognosis to IVF, thereby offering better tools with which to maximize IVF success rates.