Abide Yayla C, Ozkaya E, Kayatas Eser S, Sanverdi I, Devranoglu B, Kutlu T
Zeynep Kamil Women and Children's Health Training and Research Hospital, Uskudar, Istanbul, Turkey.
Ir J Med Sci. 2018 May;187(2):409-415. doi: 10.1007/s11845-017-1665-1. Epub 2017 Jul 25.
The purpose of this study was to assess the predictive value of basal serum testosterone (T) and dehydroepiandrosterone sulfate (DHEAS) levels during follicular phase for ovarian response and outcome in intracytoplasmic sperm injection (ICSI) cycles of women with diminished ovarian reserve.
We prospectively gathered data of basal serum androgen levels and ICSI cycle characteristics of 120 women with diminished ovarian reserve. Association of basal serum T and DHEAS levels with ovarian response was analyzed.
Basal T and DHEAS levels were similar between pregnant and non-pregnant cases (P > 0.05). There were significant differences between groups with and without successful embryo implantation in terms of serum follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), gonadotropin starting and total dose, and peak estradiol level (P < 0.05). There were 58 (49.2%) cases who did not reach to the embryo transfer stage due to several reasons including cancelation of stimulation due to unresponsiveness (n = 26, 21.7%), no oocyte at oocyte pickup (n = 11, 9.2%), no mature oocyte (n = 6, 5%), and failure of fertilization or embryo development (n = 15, 12.5%). Basal androgen levels were not significant predictors for any of the cycle outcome. AMH level was a significant predictor for failure of fertilization or embryo development (AUC 0.722, P = 0.01) and cancelation of stimulation (AUC 0.801, P < 0.001). FSH was a significant predictor for cancelation of stimulation (AUC 0.774, P < 0.001).
In women with diminished ovarian reserve, basal T and DHEAS levels have no value in predicting any of the cycle outcome parameters.
本研究旨在评估卵泡期基础血清睾酮（T）和硫酸脱氢表雄酮（DHEAS）水平对卵巢储备功能减退女性在卵胞浆内单精子注射（ICSI）周期中卵巢反应及结局的预测价值。
我们前瞻性收集了120例卵巢储备功能减退女性的基础血清雄激素水平及ICSI周期特征数据。分析基础血清T和DHEAS水平与卵巢反应的相关性。
妊娠组和非妊娠组的基础T和DHEAS水平相似（P>0.05）。在血清卵泡刺激素（FSH）、抗苗勒管激素（AMH）、促性腺激素起始剂量和总剂量以及雌二醇峰值水平方面，有胚胎成功着床组和未成功着床组之间存在显著差异（P<0.05）。有58例（49.2%）因多种原因未达到胚胎移植阶段，包括因无反应而取消刺激（n = 26，21.7%）、取卵时未获得卵母细胞（n = 11，9.2%）、无成熟卵母细胞（n = 6，5%）以及受精或胚胎发育失败（n = 15，12.5%）。基础雄激素水平对任何周期结局均无显著预测价值。AMH水平是受精或胚胎发育失败（曲线下面积[AUC] 0.722，P = 0.01）和取消刺激（AUC 0.801，P<0.001）的显著预测指标。FSH是取消刺激的显著预测指标（AUC 0.774，P<0.001）。
对于卵巢储备功能减退的女性，基础T和DHEAS水平对任何周期结局参数均无预测价值。
