The Journal of Practical Medicine >

2025 , Vol. 41 >Issue 4: 580 - 588

DOI: https://doi.org/10.3969/j.issn.1006-5725.2025.04.018

Clinical Research

Analysis of clinical outcome of IVF/ICSI with dual⁃stimulation protocol in POSEIDON patients with low expected prognosis

  • Zhuolin YAO ,
  • Zhen LI ,
  • Caihua ZHANG ,
  • Mingmei ZHANG ,
  • Ruolin JIA ,
  • Yuan CAO ,
  • Yiping WANG ,
  • Yichun. GUAN
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  • Reproductive Center of the Third Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，He′nan，China

Received date: 2024-11-20

  Online published: 2025-02-28

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Abstract

Objective To compare the clinical outcomes of the clomiphene citrate（CC） dual stimulation protocol and the luteal phase ovarian stimulation protocol after natural cycle oocytes retrieved in POSEIDON patients with low expected prognosis. Methods The clinical data from patients who underwent in vitro fertilization （IVF） or intracytoplasmic sperm injection （ICSI） at the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from May 2016 to December 2023 were analyzed retrospectively. According to the POSEIDON criteria， including POSEIDON group 3 and group 4， which were treated with the CC dual stimulation protocol（the CC group） and the luteal-phase ovarian stimulation protocol after the natural cycle oocytes retrieval（the natural cycle group）. The basic data and clinical outcomes of the two ovulation protocols were analyzed， and the main observations included the number of oocytes retrieved， the cumulative clinical pregnancy rate and the cumulative live birth rate， and explored the impact of ovulation promotion regimens on clinical outcomes through binary logistic regression. Results On the whole，there was no significant difference in the total number of oocytes retrieved， cumulative clinical pregnancy rate and live birth rate between the CC group and the natural cycle group （all P >0.05）， And in POSEIDON group 4， the numbers of oocytes retrieved in the follicular phase of the CC group were higher than those in the natural cycle group， whereas the number of oocytes retrieved in the luteal phase of natural cycle group were higher， and the difference was statistically significant （P < 0.05）. After logistic regression analysis， the ovulation stimulation protocols did not affect the cumulative clinical pregnancy rate and live birth rate of POSEIDON 3 and 4 group （P > 0.05）. Conclusions For the POSEIDON patients with a low expected prognosis， the clinical effectiveness of the luteal phase ovarian stimulation protocol after natural cycle oocytes retrieved is not inferior to that of the CC dual stimulation protocol. In POSEIDON group 4， on the premise that the AMH levels of patients in the natural cycle group were lower than those in the CC group， who underwent natural cycle ovulation followed by luteal phase induction achieved similar clinical outcomes to those of the CC dual stimulation protocol group. Therefore， the luteal phase ovarian stimulation protocol after natural cycle oocytes retrieved should be more clinically recommended for POSEIDON group 4 patients.

Key words： double stimulation protocol; POSEIDON criteria; low prognosis; fertilization， in vitro; embryo transfer

Cite this article

Zhuolin YAO , Zhen LI , Caihua ZHANG , Mingmei ZHANG , Ruolin JIA , Yuan CAO , Yiping WANG , Yichun. GUAN . Analysis of clinical outcome of IVF/ICSI with dual⁃stimulation protocol in POSEIDON patients with low expected prognosis[J]. The Journal of Practical Medicine, 2025 , 41(4) : 580 -588 . DOI: 10.3969/j.issn.1006-5725.2025.04.018

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