Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 17:16:1591743.
doi: 10.3389/fendo.2025.1591743. eCollection 2025.

Gonadotropin dose selection for repeat IVF cycles in POSEIDON Groups 1 and 2

Hao Wei  1 , JinLiang Duan  1 , SiShi Wang  1 , BaoPing Zhu  1 , HaiLing Jiang  1
Affiliations

Gonadotropin dose selection for repeat IVF cycles in POSEIDON Groups 1 and 2

Hao Wei et al. Front Endocrinol (Lausanne). .

Abstract

Purpose: Investigating whether increasing the dose of gonadotropins (Gn) in the second in vitro fertilization (IVF) cycle using the antagonist protocol could improve the cumulative live birth rate (CLBR) in POSEIDON Groups 1 and 2.

Methods: This retrospective study included 343 patients from POSEIDON Groups 1 and 2 who underwent two consecutive cycles of ovarian stimulation with an antagonist protocol between May 2018 and September 2022. Patients were divided into an Additive group (those who increased the Gn dosage in the second cycle) and a Control group (those who maintained or decreased the Gn dosage), with a 1:2 propensity score matching analysis. The primary outcome was the CLBR.

Results: In the second IVF cycle, the Additive group had higher initial (191.8 vs 183.4, P=0.135) and total (2161.7 vs 1770.6, P=0.461) Gn doses compared to the Control group. The Additive group also had a higher average number of retrieved oocytes and Metaphase II (MII) oocytes, a higher two pronuclei (2PN) fertilization rate (3.3 vs 2.6, P=0.065), and higher blastocyst formation rates (44.9% vs 44.2%, P=0.937) compared to the Control group; however, these differences were not statistically significant. The Control group had a slightly higher CLBR (31.5% vs 28.9%, P=0.8), which was also not statistically significant.

Conclusions: For POSEIDON Groups 1 and 2, increasing the dose of Gn under the antagonist protocol increased treatment costs but did not improve the CLBR. Routine increase of Gn dose was not recommended.

Keywords: POSEIDON; antagonist protocol; cumulative live birth rate; gonadotropin dosage; in vitro fertilization.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart showing the selection of the study cohort. Additive group: increased the Gn dosage in the second cycle, Control group: maintained or decreased the Gn dosage in the second cycle.
See this image and copyright information in PMC

References

    1. Ferraretti AP, La Marca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli L. ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod (Oxford England). (2011) 26:1616–24. doi: 10.1093/humrep/der092, PMID: - DOI - PubMed
    1. Alviggi C, Andersen CY, Buehler K, Conforti A, De Placido G, Esteves SC, et al. A new more detailed stratification of low responders to ovarian stimulation: from a poor ovarian response to a low prognosis concept. Fertility sterility. (2016) 105:1452–3. doi: 10.1016/j.fertnstert.2016.02.005, PMID: - DOI - PubMed
    1. Esteves SC, Yarali H, Vuong LN, Carvalho JF, Özbek İY, Polat M, et al. Low prognosis by the POSEIDON criteria in women undergoing assisted reproductive technology: A multicenter and multinational prevalence study of over 13,000 patients. Front Endocrinol. (2021) 12:630550. doi: 10.3389/fendo.2021.630550, PMID: - DOI - PMC - PubMed
    1. Wang B, Liu W, Liu Y, Zhang W, Ren C, Guan Y. What does unexpected suboptimal response during ovarian stimulation suggest, an overlooked group? Front Endocrinol. (2021) 12:795254. doi: 10.3389/fendo.2021.795254, PMID: - DOI - PMC - PubMed
    1. Out HJ, Rutherford A, Fleming R, Tay CC, Trew G, Ledger W, et al. A randomized, double-blind, multicentre clinical trial comparing initial doses of 150 and 200 IU of recombinant FSH in women treated with the GnRH antagonist ganirelix for assisted reproduction. Hum Reprod (Oxford England). (2004) 19:90–5. doi: 10.1093/humrep/deh044, PMID: - DOI - PubMed

LinkOut - more resources