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Minimal ovarian stimulation is an alternative to conventional protocols for older women according to Poseidon’s stratification: a retrospective multicenter cohort study

  • Assisted Reproduction Technologies
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A Correction to this article was published on 30 April 2021

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Abstract

Objective

To investigate whether minimal ovarian stimulation (mOS) is as effective as conventional ovarian stimulation (cOS) for older women belonging to different groups according to the Poseidon criteria.

Material and methods

Observational retrospective multicentre cohort including women from Poseidon’s groups 2 and 4 that underwent in vitro fertilization (IVF). We performed a mixed-effects logistic regression model, adding as a random effect the patients and the stimulation cycle considering the dependence of data. Survival curves were employed as a measure of the cumulative live birth rate (CLBR). The primary outcomes were live birth rate per embryo transfer and CLBR per consecutive embryo transfer and oocyte consumed until a live birth was achieved.

Results

A total of 2002 patients underwent 3056 embryo transfers (mOS = 497 and cOS = 2559). The live birth rates per embryo transfer in mOS and cOS showed no significant difference in both Poseidon’s groups. Likewise, the logistic regression showed similar live birth rates between the two protocols in Poseidon’s groups 2 (OR 1.165, 95% CI 0.77–1.77; p = 0.710) and 4 (OR 1.264 95% CI 0.59–2.70; p = 0.387). However, the survival curves showed higher CLBR per oocyte in women that received mOS (Poseidon group 2: p < 0.001 and Poseidon group 4: p = 0.039).

Conclusions

Minimal ovarian stimulation is a good alternative to COS as a first-line treatment for patients belonging to Poseidon’s groups 2 and 4. The number of oocytes needed to achieve a live birth seems inferior in mOS strategy than cOS.

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Acknowledgements

We would like to thank the Clinical Directors of the participating IVI centers for their contribution to the data of the database analyzed. We would also like to thank Victor Lozoya Garcia for the support in the statistical analysis.

Funding

This study was funded by IVIRMA global. No additional external funding was received for this study.

Author information

Authors and Affiliations

  1. IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Avenida Fernando Abril Martorell, 106 - Torre A, Planta 1ª, 46026, Valencia, Spain

    Mauro Cozzolino, Juan Antonio Garcia-Velasco & Nicolás Garrido

  2. Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 310 Cedar St, New Haven, CT, 06510, USA

    Mauro Cozzolino

  3. Rey Juan Carlos University, Calle Tulipán, 28933, Móstoles, Madrid, Spain

    Mauro Cozzolino, Gustavo Nardini Cecchino & Juan Antonio Garcia-Velasco

  4. Department of Gynaecology, Federal University of São Paulo, São Paulo, Brazil

    Gustavo Nardini Cecchino

  5. Department of Reproductive Medicine, Mater Prime, São Paulo, Brazil

    Gustavo Nardini Cecchino

  6. IVI-RMA, Valencia, Spain

    Ernesto Bosch

  7. IVI-RMA, Madrid, Spain

    Juan Antonio Garcia-Velasco

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  1. Mauro Cozzolino
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  5. Nicolás Garrido
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Contributions

MC: study design, data analysis, interpretation, and manuscript writing. GNC: manuscript writing, interpretation, critical review, and final manuscript approval. EB and JAGV: critical review and final manuscript approval. NG: statistical analysis, critical review, and final manuscript approval.

Corresponding author

Correspondence to Mauro Cozzolino.

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Ethics approval

The study received ethical approval on 30 November 2018 by IVI Ethic Committee with the number 1810-FIVI-083-MC.

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The authors declare no competing interests.

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The original online version of this article was revised: Images of figures 2 and 3 were inverted.

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Cozzolino, M., Cecchino, G.N., Bosch, E. et al. Minimal ovarian stimulation is an alternative to conventional protocols for older women according to Poseidon’s stratification: a retrospective multicenter cohort study. J Assist Reprod Genet 38, 1799–1807 (2021). https://doi.org/10.1007/s10815-021-02185-2

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  • DOI: https://doi.org/10.1007/s10815-021-02185-2

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