scholarly journals Novel Physiology and Definition of Poor Ovarian Response; Clinical Recommendations

2020 ◽  
Vol 21 (6) ◽  
pp. 2110
Author(s):  
Antoine Abu-Musa ◽  
Thor Haahr ◽  
Peter Humaidan
Keyword(s):  
Assisted Reproduction ◽  
Ovarian Stimulation ◽  
Clinical Management ◽  
Management Strategies ◽  
Ovarian Response ◽  
Poor Ovarian Response ◽  
Bologna Criteria ◽  
Recent Classification ◽  
Definition Of ◽  
The Impact

Poor ovarian response (POR) to controlled ovarian stimulation (OS) presents a major challenge in assisted reproduction. The Bologna criteria represented the first serious attempt to set clear criteria for the definition of POR. However, the Bologna criteria were questioned because of the persistent heterogeneity among POR patients and the inability to provide management strategies. Based on these facts, a more recent classification, the POSEIDON (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) classification, was developed to provide a homogeneous and refined definition of POR that significantly reduces the heterogeneity of the Bologna criteria definition of POR and helps in the clinical handling and counseling of patients. In this review, we discuss the impact of the POSEIDON classification on the clinical management of patients with POR.

scholarly journals Update on the management of poor ovarian response in IVF: the shift from Bologna criteria to the Poseidon concept

2020 ◽  
Vol 14 ◽  
pp. 263349412094148
Author(s):  
Panagiotis Drakopoulos ◽  
Erlisa Bardhi ◽  
Liese Boudry ◽  
Alberto Vaiarelli ◽  
Antonis Makrigiannakis ◽  
...  
Keyword(s):  
Ovarian Stimulation ◽  
Clinical Management ◽  
Ovarian Response ◽  
Medical Community ◽  
Future Prospects ◽  
Poor Ovarian Response ◽  
Subsequent Evolution ◽  
Bologna Criteria ◽  
Assisted Reproduction Technology ◽  
Poor Ovarian Responders

Despite the considerate progress to which assisted reproduction technology (ART) has been subject since 1978, some issues remain unresolved. Notably, the clinical management of patients with a poor ovarian response is still a challenge in everyday practice, frustrating to both the patient and the fertility expert. Poor ovarian responders (PORs) embody 9–24% of patients undergoing ovarian stimulation, meaning that up to one in four patients conceals a poor reproductive prognosis. The last decade has witnessed the attempts of the medical community to standardize diagnosis of POR with the developing of the Bologna Criteria and the subsequent evolution of the low prognosis patient elaborated in the POSEIDON classification. The aim of this article is to summarize all evidence concerning etiology and management of poor ovarian response, including the most recent advances and future prospects in this regard.

Relative importance of the different components of the Bologna criteria for predicting poor ovarian response in assisted reproduction

Maturitas ◽  
2017 ◽  
Vol 100 ◽  
pp. 170 ◽  
Author(s):  
Hang Wun Raymond Li ◽  
Tak Ming Cheung ◽  
William Shu Biu Yeung ◽  
Pak Chung Ho ◽  
Ernest Hung Yu Ng
Keyword(s):  
Assisted Reproduction ◽  
Ovarian Response ◽  
Relative Importance ◽  
Poor Ovarian Response ◽  
Bologna Criteria

scholarly journals The revised definition of pulmonary hypertension: exploring the impact on patient management

2019 ◽  
Vol 21 (Supplement_K) ◽  
pp. K4-K8 ◽  
Author(s):  
Gérald Simonneau ◽  
Marius M Hoeper
Keyword(s):  
Pulmonary Hypertension ◽  
Scientific Evidence ◽  
Management Strategies ◽  
Pulmonary Vascular Disease ◽  
Close Monitoring ◽  
Mean Pulmonary Arterial Pressure ◽  
Increased Risk ◽  
Patient Groups ◽  
Definition Of ◽  
The Impact

Abstract At the 6th World Symposium on Pulmonary Hypertension (PH), it was proposed that the mean pulmonary arterial pressure (mPAP) threshold used to define PH should be lowered from ≥25 mmHg to >20 mmHg. The rationale for this change is that the ≥25 mmHg threshold is arbitrary, whereas the revised threshold is based on scientific evidence. For the definition of all forms of pre-capillary PH, the inclusion of a pulmonary vascular resistance (PVR) ≥3 Wood Units was also proposed, placing greater emphasis on an elevated PVR to identify pulmonary vascular disease. Here, we discuss the possible impact of the revised definition of PH on future clinical management. This change may facilitate earlier PH detection, particularly in at-risk patient groups that are already undergoing screening programmes, e.g. those with systemic sclerosis or mutations associated with PH. As an mPAP above the upper limit of normal (>20 mmHg) but <25 mmHg is associated with increased risk of morbidity and mortality compared with a normal mPAP, early identification of patients in this group is important to enable close monitoring and timely treatment initiation once clinically indicated. Treatments currently approved for PH are not necessarily suitable for patients with an mPAP 21–24 mmHg, as the management of this group has not been widely examined. The revised definition may facilitate inclusion of these patients in prospective trials, allowing the evaluation of appropriate management strategies.

scholarly journals A new more detailed stratification of low responders to ovarian stimulation: from a poor ovarian response to a low prognosis concept

2016 ◽  
Vol 105 (6) ◽  
pp. 1452-1453 ◽  
Author(s):  
Carlo Alviggi ◽  
Claus Y. Andersen ◽  
Klaus Buehler ◽  
Alessandro Conforti ◽  
Giuseppe De Placido ◽  
...  
Keyword(s):  
Ovarian Stimulation ◽  
Ovarian Response ◽  
Poor Ovarian Response ◽  
Low Responders

scholarly journals Morphokinetic Characteristics and Developmental Potential of In Vitro Cultured Embryos from Natural Cycles in Patients with Poor Ovarian Response

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
N. Hojnik ◽  
V. Vlaisavljević ◽  
B. Kovačič
Keyword(s):  
Implantation Rate ◽  
Ovarian Response ◽  
Time Lapse ◽  
Poor Responder ◽  
Poor Responders ◽  
Poor Ovarian Response ◽  
Developmental Potential ◽  
The Impact ◽  
Natural Cycles

Background. Patients with poor ovarian response to ovarian hyperstimulation represent an interesting group for studying the impact of embryo cleavage irregularities on clinical outcome since all embryos, regardless of their quality, are usually transferred to the uterus. The aim of our study was to follow the morphokinetics of fertilized oocytes from natural cycles in poor responders. Methods. Zygotes from 53 cycles were cultured in vitro for 3 days. The morphokinetics of their development and transfer outcomes were retrospectively analyzed for the normally and irregularly cleaved embryos. Results. Of all embryos, 30.2% had single and 20.8% multiple cleavage irregularities with the following prevalence: developmental arrest 30.2%, direct cleavage to more than two cells 24.5%, chaotic cleavage 13.2%, and reverse cleavage 11.3%. These embryos had longer pronuclear phases, first cytokinesis, second embryo cell cycles, and less synchronized divisions. The transfer of normally developing embryos resulted in an implantation rate of 30.8% and a delivery rate of 23.1%, but irregularly cleaved embryos did not implant. Conclusions. The use of time-lapse microscopy in poor responder patients identified embryos with cleavage abnormalities that are related with no or extremely low implantation potential. Gained information about embryo quality is important for counselling patients about their expectations.

The association between poor ovarian response and thrombophilia in assisted reproduction

2013 ◽  
Vol 166 (1) ◽  
pp. 65-69 ◽  
Author(s):  
Johnny S. Younis ◽  
Moshe Ben-Ami ◽  
Ido Izhaki ◽  
Jimmy Jadaon ◽  
Benjamin Brenner ◽  
...  
Keyword(s):  
Assisted Reproduction ◽  
Ovarian Response ◽  
Poor Ovarian Response
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