Poor ovarian response (POR)

Women with a poor ovarian response to ovarian stimulation have few eggs retrieved (3 or fewer). This is in contrast to suboptimal ovarian response (4-9 eggs), normal ovarian response (10-15 eggs) and high ovarian response (>15 eggs).

According to the Bologna criteria, women with POR are defined as having at least 2 of the 3 criteria (Ferraretti and Gianaroli 2014):

1. Advanced age (>40)
2. Previous poor ovarian response (cycles canceled or 3 or less eggs retrieved)
3. Diminished ovarian reserve (<5 antral follicle count, <0.8 ng/ml or 5.4 pmol/L AMH)

If two aren’t met, having two previous episodes of POR (where 3 or less eggs were retrieved, or cycles canceled) would qualify as a poor responder.

Another way to classify POR patients is by the POSEIDON criteria (Roque et al. 2021):

• Group 1: <35 years old, AFC 5 or higher, AMH 1.2 ng/ml or higher.
• Group 2: 35 years or older, AFC 5 or higher, AMH 1.2 ng/ml or higher.
• Group 3: <35 years old, AFC <5, AMH <1.2 ng/ml.
• Group 4: 35 years or older, AFC <5, AMH <1.2 ng/ml.