Use of Basal Serum Testosterone Level as Predictor for Poor Ovarian Response in Women with Unexplained Infertility Undergoing <i>In Vitro</i>Fertilization Cycle: Prospective Study

• 作者: Hayam Fathy Sarah Safwat Waleed M. Khalaf
• 来源期刊: 妇产科期刊(英文)
• 学科: 医学
• 关键词: TESTOSTERONE Induction OVARIAN Reserve Pregnancy
• 年，卷（期）: 2018,（14）
• 页码范围: 1520-1531
• 页数: 12页
• 分类号: R73

摘要

Background: Delayed pregnancy in women and marked increase in the numbers of older women who fail to respond to ovarian stimulation had been a significant issue. This study aims to assess the value of basal serum testosterone level as a predictor of ovarian response for induction of ovulation in women with unexplained infertility undergoing IVF (in vitro fertilization) cycle. Patients and Methods: A prospective study was conducted in Ain Shams University Maternity hospital Infertility Center during a period of time from October 2016 to June 2017. This study recruited 89 women. On day 2 or 3 of a spontaneous menstrual cycle of the included women within 3 months before fresh IVF cycle, basal hormonal (FSH, LH, estradiol, total testosterone) concentrations, AFC (antral follicle count) were performed. Using the Long-protocol for induction of ovulation, serial monitoring of ovarian response was assessed by transvaginal ultrasound. When the expected ovarian response was reached (at least three oocytes ≥ 17 mm), we gave trigger dose of HCG. Ultrasound guided oocyte aspiration was performed 34 - 36 hours later. Two to three days after oocyte aspiration, we transferred the embryos according to the patient’s age and the condition of embryos available. Biochemical pregnancy was considered if serum B-hCG test was positive at day 14 from embryo transfer, where all the data were correlated with serum testosterone level and ovarian response as 1 ry outcome. Results: There were significant positive correlations between testosterone and LH, Prolactin, AFC, Number of oocytes & Number of Embryos (0.014, 0.032, 0.023, 0.004, 0.033, p 0.001 respectively). Poor responders versus good responders as regards testosterone level (0.81 ± 0.47 versus 1.08 ± 0.45) Fertilized & pregnant cases had significantly higher testosterone than non-fertilized & non pregnant had (1.20 ± 0.45, 0.92 ± 0.47 p value 0.035, 0.021 respectively). Yet, testosterone had significant low diagnostic performance in prediction of poor response and pregnancy (A