Evidence map›Paper›PMID 39385174›Full record

ArticleReproductive biology and endocrinology : RB&E2024

Patients with low prognosis in ART: a Delphi consensus to identify potential clinical implications and measure the impact of POSEIDON criteria.

Carlo Alviggi, Peter Humaidan, Robert Fischer, Alessandro Conforti, Michael H Dahan, Antonio La Marca, Raoul Orvieto, Nikolaos P Polyzos, Matheus Roque, Sesh K Sunkara and 6 more

Abstract readConsensus Statement
In one paragraph

Article in Reproductive biology and endocrinology : RB&E, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Ten years of POSEIDON classification: a SOAR analysis.Reproductive biology and endocrinology : RB&E · 2026
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Carlo AlviggiDepartment of Public Health, University of Naples Federico II, Via Sergio Pansini, Naples, 80131, Italy.
Peter HumaidanThe Fertility Clinic, Faculty of Health, Skive Regional Hospital, Aarhus University, Aarhus C, Denmark.
Robert FischerFertility Centre Hamburg, Hamburg, Germany.
Alessandro ConfortiDepartment of Neuroscience, Reproductive Science and Odontomastology, University of Naples Federico II, Via Sergio Pansini, Naples, 80131, Italy.ORCID http://orcid.org/0000-0002-5676-0055
Michael H DahanDepartment of Obstetrics and Gynecology, McGill University, 888 De Maisonneuve Est., Montreal, QC, H2L 4S8, Canada.
Antonio La MarcaDepartment of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy.
Raoul OrvietoDepartment of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, 52621, Israel.
Nikolaos P PolyzosDexeus Fertility, Dexeus University Hospital, Barcelona, 08028, Spain.
Matheus RoqueDepartment of Reproductive Medicine, Mater Prime, São Paulo, Brazil.
Sesh K SunkaraKing's Fertility, King's College London, London, UK.
Filippo Maria UbaldiIVIRMA Global Research Alliance, GENERA, Clinica Valle Giulia, Rome, Italy.
Lan VuongDepartment of Obstetrics and Gynaecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Hakan YaraliAnatolia IVF and Women Health Centre, Ankara, Turkey.
Thomas D'HoogheMerck Healthcare KGaA, Darmstadt, Germany.
Salvatore LongobardiGlobal Clinical Development, Merck Serono S.p.A (an affiliate of Merck KGaA, Darmstadt 64293, Germany), Rome, 00176, Italy.
Sandro C EstevesANDROFERT, Andrology and Human Reproduction Clinic, Campinas, São Paulo, Brazil. s.esteves@androfert.com.br.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrently, there is no consensus on the optimal management of women with low prognosis in ART. In this Delphi consensus, a panel of international experts provided real-world clinical perspectives on a series of literature-supported consensus statements regarding the overall relevance of the POSEIDON criteria for women with low prognosis in ART.

methodsUsing a Delphi-consensus framework, twelve experts plus two Scientific Coordinators discussed and amended statements and supporting references proposed by the Scientific Coordinators (Round 1). Statements were distributed via an online survey to an extended panel of 53 experts, of whom 36 who voted anonymously on their level of agreement or disagreement with each statement using a six-point Likert-type scale (1 = Absolutely agree; 2 = More than agree; 3 = Agree; 4 = Disagree; 5 = More than disagree; 6 = Absolutely disagree) (Round 2). Consensus was reached if > 66% of participants agreed or disagreed.

resultsThe extended panel voted on seventeen statements and subcategorized them according to relevance. All but one statement reached consensus during the first round; the remaining statement reached consensus after rewording. Statements were categorized according to impact, low-prognosis validation, outcomes and patient management. The POSEIDON criteria are timely and clinically sound. The preferred success measure is cumulative live birth and key management strategies include the use of recombinant FSH preparations, supplementation with r-hLH, dose increases and oocyte/embryo accumulation through vitrification. Tools such as the ART Calculator and Follicle-to-Oocyte Index may be considered. Validation data from large, prospective studies in each POSEIDON group are now needed to corroborate existing retrospective data.

conclusionsThis Delphi consensus provides an overview of expert opinion on the clinical implications of the POSEIDON criteria for women with low prognosis to ovarian stimulation.

Indexed as

Embryo, MammalianOocytesOvulation InductionAdultAge FactorsCryopreservationDelphi TechniqueFemaleFollicle Stimulating Hormone, HumanHumansLive BirthLuteinizing HormonePrognosisRecombinant ProteinsSurveys and QuestionnairesTreatment OutcomeFollicle Stimulating Hormone, HumanLuteinizing HormoneRecombinant ProteinsAssisted reproductive technology (ART)Cumulative live birth rate (CLBR)Delphi consensusLow prognosisOvarian stimulationPOSEIDON Criteria

Identifiers

PMID39385174
PMCPMC11465546

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.