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. 2024 May 31;17(1):117.
doi: 10.1186/s13048-024-01443-y.

What is the optimal number of embryos to transfer for POSEIDON group 1 and group 2? A retrospective study

Rang Liu #  1   2 , Qiuju Zhang #  1 , Lan Geng  1 , Huiqing He  1   2 , Chang Xu  3 , Jiali Feng  1 , Miaoling Song  1 , Yanpei Cao  1 , Tianren Wang  4 , Xi Xia  5
Affiliations

What is the optimal number of embryos to transfer for POSEIDON group 1 and group 2? A retrospective study

Rang Liu et al. J Ovarian Res. .

Abstract

Background: The 2016 Patient-Oriented Strategy Encompassing IndividualizeD Oocyte Number (POSEIDON) criteria redefined the poor responders as low prognosis patients. The embryo transfer strategy for POSEIDON patients remained to be addressed. This study aimed to investigate the optimized number of embryos to transfer for unexpected low-prognosis patients (POSEIDON Group 1 and Group 2) with blastocyst transfer in their first frozen cycle.

Methods: A retrospective cohort study of 2970 patients who underwent frozen-thawed embryo transfer (FET) between January 2018 and December 2021. Patients from POSEIDON Group 1 (N = 219) and Group 2 (N = 135) who underwent blastocyst transfer in their first FET cycles were included and divided into the elective single embryo transfer (eSET) group and the double embryo transfer (DET) group.

Results: For POSEIDON Group 1, the live birth rate per embryo transfer of the DET group was slightly higher than the eSET group (52.17% vs 46.15%, OR 0.786, 95% CI 0.462-1.337, P = 0.374; adjusted OR (aOR) 0.622, 95% CI 0.340-1.140, P = 0.124), while a significant increase of 20.00% in the multiple birth rate was shown. For Group 2, higher live birth rates were observed in the DET group compared to the eSET group (38.46% vs 20.48%, OR 0.412, 95% CI 0.190-0.892, P = 0.024; aOR 0.358, 95% CI 0.155-0.828, P = 0.016). The difference in the multiple birth rate was 20.00% without statistical significance. Univariate and multivariate analyses revealed that age (OR 0.759, 95% CI .624-0.922, P = 0.006 and OR 0.751, 95% CI 0.605-0.932, P = 0.009) and the number of transferred embryos (OR 0.412, 95% CI 0.190-0.892, P = 0.024 and OR 0.367, 95% CI 0.161-0.840, P = 0.018) were significant variables for the live birth rate in POSEIDON Group 2.

Conclusions: The findings in the present study showed that eSET was preferred in the first frozen cycle for POSEIDON Group 1 to avoid unnecessary risks. Double embryo transfer strategy could be considered to improve the success rate for POSEIDON Group 2 with caution. Further stratification by age is needed for a more scientific discussion about the embryo transfer strategy for POSEIDON patients.

Keywords: Embryo transfer strategy; Live birth rate; Low prognosis; Multiple birth rate; POSEIDON criteria.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The flowchart of the study design
Fig. 2
Fig. 2
The primary outcomes of POSEIDON Group 1 and 2 with different transferred embryo numbers. eSET = elective single embryo transfer; DET = double embryo transfer
See this image and copyright information in PMC

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