ESHRE Bologna Criteria (Poor Ovarian Response)
The ESHRE Bologna criteria for poor ovarian response (Ferraretti and colleagues 2011).
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Age
- 41 years
- ANY OTHER RISK FACTOR for poor ovarian response
- No
- A previous cycle yielding 3 or fewer oocytes AFTER A CONVENTIONAL STIMULATION…
- Yes
- Episodes of poor response after MAXIMAL stimulation
- 0 episodes
- Antral follicle count
- 12 follicles
- YOUR CENTER'S antral follicle count cutoff
- 7 follicles
- AMH
- 2.5 ng/mL
- YOUR CENTER'S AMH cutoff
- 1.1 ng/mL
Result: Poor ovarian responder
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Override
- TWO episodes of poor response after MAXIMAL stimulation suffice ALONE, in the ABSENCE of advanced age and an abnormal reserve test. Counting to 2 and stopping is wrong.
- Cut-offs
- PUBLISHED AS RANGES, NOT NUMBERS: AFC under 5 TO 7, AMH under 0.5 TO 1.1 ng/mL. The consensus does not pick one.
- Consequence
- An AFC of 6 is abnormal under a cutoff of 7 and normal under 5. The SAME patient is or is not a poor responder. Both cutoffs are required inputs; neither is defaulted.
- Criterion 1
- NOT A NUMBER - it admits "any other risk factor for POR", an open-ended clause with no list.
- Criterion 2
- CONDITIONAL ON THE PROTOCOL. A mild or minimal-stimulation cycle does not count.
- Criterion 3
- ONE criterion satisfied by EITHER marker - AFC and AMH do not add.
- Scope
- A definition, not a treatment decision. Does not set a protocol or dose; not a reason to decline treatment or advise donor oocytes.
- Successor
- POSEIDON was proposed because these criteria group women with very different prognoses.
What you enter
- Age.
- ANY OTHER RISK FACTOR for poor ovarian response.
- A previous cycle yielding 3 or fewer oocytes AFTER A CONVENTIONAL STIMULATION PROTOCOL.
- Episodes of poor response after MAXIMAL stimulation.
- Antral follicle count.
- YOUR CENTER'S antral follicle count cutoff.
- AMH.
- YOUR CENTER'S AMH cutoff.
Full field descriptions
- Age. 40 or over satisfies the first half of criterion 1.
- ANY OTHER RISK FACTOR for poor ovarian response. An open-ended clause with no list attached; it satisfies criterion 1 on its own, at any age.
- A previous cycle yielding 3 or fewer oocytes AFTER A CONVENTIONAL STIMULATION PROTOCOL. A mild or minimal-stimulation cycle does NOT count.
- Episodes of poor response after MAXIMAL stimulation. 2 or more qualify the patient ON THEIR OWN, but only in the ABSENCE of advanced age and of an abnormal ovarian reserve test.
- YOUR CENTER'S antral follicle count cutoff. REQUIRED AND NOT DEFAULTED: the consensus publishes a RANGE of 5 to 7, not a number.
- YOUR CENTER'S AMH cutoff. REQUIRED AND NOT DEFAULTED: the consensus publishes a RANGE of 0.5 to 1.1 ng/mL, not a number.
How this is calculated
- Rule
- At least 2 of 3: advanced age 40+ OR any other risk factor; previous 3 or fewer oocytes after a CONVENTIONAL protocol; abnormal ovarian reserve test.
Ferraretti AP, La Marca A, Fauser BCJM, et al. ESHRE consensus on the definition of "poor response" to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011;26(7):1616-1624. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.