A 28-year-old with unexplained infertility for 2 years undergoes IVF. On day 3 of stimulation, her AFC (antral follicle count) was 4 and AMH was 0.8 ng/mL. She develops only 3 follicles on day 8. This represents which ovarian response category per POSEIDON (Patient-Oriented Strategies Encompassing IndividualizeD Oocyte Number) classification?
- A POSEIDON Group 1 (unexpected poor responder, good prognosis)
- B POSEIDON Group 2 (unexpected poor responder, poor prognosis)
- C POSEIDON Group 3 (expected poor responder, good prognosis)
- D POSEIDON Group 4 (expected poor responder, poor prognosis) ✓
Explanation
The POSEIDON classification of poor ovarian response categorises patients by: (a) expected vs. unexpected poor response and (b) ovarian reserve (good ≥35 years + AMH ≥1.2 ng/mL + AFC ≥5 vs. poor). Group 4 = expected poor responder (AMH <1.2 ng/mL, AFC <5) with age ≥35 years. Group 3 = expected poor responder but age <35 years (better prognosis). The patient has AMH 0.8 ng/mL and AFC 4 (both below threshold), and is 28 years old → Group 3 would apply if under 35. However, re-reading: AMH 0.8 and AFC 4 are both below the 'expected poor responder' threshold, and she is 28 (<35). Correct answer: POSEIDON Group 3 (expected poor responder, young, good prognosis).
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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