Differential Efficacy of Antagonist Regimens Based on the Poseidon Criteria in Populations with Poor Ovarian Response

WANG Lin

doi:10.3969/j.issn.1004-437X.2026.06.016

Abstract：Objective To explore the application value of the antagonist protocol in patients with poor ovarian response(POR).Methods A retrospective analysis was performed on 807 POR patients who met the Bologna criteria and received the antagonist protocol at Nanyang Central Hospital from January 2022 to June 2024.According to the POSEIDON criteria,patients were divided into four groups:group A(age＜35 years,AFC ≥5,AMH ≥1.2 μg·L-1,312 cases),group B(age ≥35 years,AFC ≥5,AMH ≥1.2 μg·L-1,145 cases),group C(age＜35 years,AFC＜5,AMH＜1.2 μg·L-1,116 cases),and group D(age ≥35 years,AFC＜5,AMH＜1.2 μg·L-1,234 cases).The gonadotropin(Gn)dosage,hormone levels on the trigger day,and pregnancy outcomes were compared among the four groups.Results Total Gn dosage followed a descending trend from group D to group A(P＜0.05),though no significant difference was observed in the duration of Gn administration(P＞0.05).The levels of estradiol(E2)and luteining hormone(LH)on the trigger day were highest in group A and lowest in group D(P＜0.05),the progesterone(P)level showed no significant difference among groups(P＞0.05).The number of retrieved oocytes,MII oocytes,high-quality embryos,and blastocysts formed in group A and group B were significantly higher than those in group C and group D(P＜0.05).After 6 months of follow-up,biochemical and clinical pregnancy rates in groups A and B were higher than those in groups C and D(P＜0.05).The abortion rates in group B and group D were higher than those in group A and group C(P＜0.05).Conclusion For patients in group A and B with preserved ovarian function,the antagonist protocol can achieve favorable pregnancy outcomes while reducing Gn dosage and treatment costs.For patients in groups C and D with poor ovarian response,it is difficult to obtain satisfactory pregnancy outcomes.Therefore,individualized treatment strategies should be considered based on patient characteristics to accumulate high-quality embryos for transfer,thereby improving both pregnancy and live birth rates.