Poor ovarian response classification systems in the clinical setting - time for an update?

Area of Science:

• Reproductive Endocrinology
• Infertility Research
• Assisted Reproductive Technology

Background:

• Poor ovarian response (POR) is a significant obstacle in achieving successful outcomes with assisted reproductive technology (ART).
• Accurate prediction and classification of POR are crucial for effective patient management and treatment planning.

Purpose of the Study:

• To comprehensively review the existing classification systems for POR, including the Bologna criteria and the POSEIDON classification.
• To evaluate the strengths, weaknesses, and predictive performance of these systems.
• To explore potential improvements and future directions for defining POR.

Main Methods:

• Literature review of the Bologna criteria and POSEIDON classification systems.
• Analysis of studies evaluating the predictive accuracy of these criteria for ART outcomes.
• Discussion of the limitations inherent in current POR definitions.

Main Results:

• The Bologna criteria and POSEIDON classification systems have demonstrated effectiveness in predicting the likelihood of achieving euploid embryos for transfer.
• These systems serve as valuable tools for patient counseling.
• Identified limitations include failure to account for underlying conditions, arbitrary cutoffs, and oocyte maturity assessment.

Conclusions:

• Current POR classification systems are useful but require refinement to enhance their clinical utility.
• There is a need to develop more nuanced and accurate methods for predicting ovarian response.
• The future of POR classification may involve moving beyond all-or-nothing thresholds towards more personalized approaches.