Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California 94305, USA.
Fertil Steril. 2012 Jan;97(1):23-7.e1. doi: 10.1016/j.fertnstert.2011.10.020. Epub 2011 Nov 23.
To examine early pregnancy (EP) testosterone (T) after ovarian stimulation and its effect on singleton pregnancy outcomes.
Prospective cohort study.
University-based tertiary care center.
PATIENT(S): Subfertile women who conceived with or without fertility treatment.
INTERVENTION(S): Ovarian stimulation for assisted reproduction, collection of serum total T levels in early pregnancy, and pregnancy follow-up.
MAIN OUTCOME MEASURE(S): Rate of preterm delivery, low birth weight (LBW) (<2,500 g), and hypertensive disorders of pregnancy.
RESULT(S): EP serum samples were measured from 266 singleton pregnancies. The mean T level among spontaneous conceptions was 74.90 ng/dL (SD 48.35 ng/dL); 103 ng/mL was the 90th percentile. Mean EP T was increased among patients who underwent ovarian stimulation compared with nonstimulated control subjects. In patients undergoing IVF, T levels in EP were linearly correlated with the number of oocytes retrieved. When pregnancy outcomes in women with normal T were compared with women with elevated T (>90th percentile), we did not see an increased risk for preterm delivery, hypertensive disorders of pregnancy, LBW infants, or cesarean delivery (odds ratio ratios 1.43, 0.38, 1.39, and 0.85, respectively).
CONCLUSION(S): Elevations in EP T are associated with ovarian stimulation but do not appear to be associated with adverse pregnancy outcome. Further investigation to determine the etiology of increased maternal and neonatal morbidity among subfertile women is warranted.
研究卵巢刺激后早期妊娠（EP）的睾丸酮（T）及其对单胎妊娠结局的影响。
前瞻性队列研究。
大学附属三级保健中心。
受孕的不孕女性，包括接受或未接受生育治疗者。
卵巢刺激以辅助生殖，收集 EP 血清总 T 水平，并进行妊娠随访。
早产率、低出生体重（LBW）(<2500g)和妊娠高血压疾病的发生率。
共测量了 266 例单胎妊娠的 EP 血清样本。自发妊娠的平均 T 水平为 74.90ng/dL（SD 48.35ng/dL）；第 90 百分位数为 103ng/mL。与未接受刺激的对照组相比，接受卵巢刺激的患者 EP T 均值升高。在接受 IVF 的患者中，EP T 水平与获卵数呈线性相关。将 T 值正常的孕妇与 T 值升高（>第 90 百分位数）的孕妇的妊娠结局进行比较，我们并未发现早产、妊娠高血压疾病、LBW 婴儿或剖宫产的风险增加（比值比分别为 1.43、0.38、1.39 和 0.85）。
EP T 的升高与卵巢刺激有关，但似乎与不良妊娠结局无关。进一步研究不孕女性中母体和新生儿发病率增加的病因是必要的。
