ArticleCureus2025
Clinical Outcomes of High-Dose Follitropin Delta in POSEIDON (Patient-Oriented Strategies Encompassing Individualized Oocyte Number) Group 4: An Exploratory Case Series on Follicular Efficiency and Embryo Development.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background Patients classified as Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number (POSEIDON) Group 4 represent a particularly challenging population in assisted reproductive technology (ART), due to advanced age and diminished ovarian reserve. While follitropin delta allows individualized dosing based on body weight and anti-Müllerian hormone (AMH) levels, its standard use in Japan is limited to 12 μg/day. The efficacy of higher off-label doses in this group remains insufficiently studied. Methods This retrospective case series included seven women aged ≥35 years with antral follicle count (AFC) <5 or AMH <1.2 ng/mL, treated at a single clinic between 2022 and 2024. All patients underwent controlled ovarian stimulation (COS) using a gonadotropin-releasing hormone (GnRH) antagonist protocol and received daily follitropin delta at doses of 15 μg. Key outcomes included follicular development, controlled ovarian stimulation (COS) and oocyte pick-up performance, embryological outcomes, and ovarian hyperstimulation syndrome (OHSS) incidence. Results The mean age of the participants was 44.0 years, and the mean AMH was 0.70 ng/mL. The average number of oocytes retrieved was 5.71, with all patients achieving follicle-to-oocyte index (FOI) ≥1.00 (mean 1.52). The mean follicular output rate (FORT) was 1.41. Good-quality blastocysts were obtained in five of seven cases (71.4%). None of the patients had OHSS despite relatively high gonadotropin exposure. No patient discontinued treatment, and the stimulation was well tolerated by all. Conclusion High-dose follitropin delta may represent a feasible and safe option for selected POSEIDON Group 4 patients. However, these findings are preliminary and derived from a small case series without a control group. Further prospective studies are required to confirm efficacy and long-term reproductive outcomes.
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