Sathyapalan Thozhukat, Dickerson Emily H, Maguiness Stephen M, Robinson John, Dakroury Youssra H Z, Atkin Stephen L
Department of Academic Endocrinology, Diabetes and Metabolism, Hull York Medical School, Hull, UK.
Hull IVF Unit, Hull Women and Children's Hospital, Kingston-upon-Hull, UK.
BMJ Open Diabetes Res Care. 2017 May 27;5(1):e000387. doi: 10.1136/bmjdrc-2017-000387. eCollection 2017.
The free androgen index (FAI) calculated using total testosterone measured by immunoassay does not correlate with oocyte fertilization rates; however, there is considerable cross-reactivity for testosterone with other androgens by immunoassay that is not found using isotope dilution liquid chromatography-tandem mass spectrometry (LC/MS/MS).
This study was done to determine relationship between total testosterone and androstenedione measured by LC/MS/MS and fertilization rates.
49 infertile women without polycystic ovary syndrome were recruited preceding an in vitro fertilization (IVF) cycle. Serum testosterone and androstenedione were measured by LC/MS/MS and correlated with IVF parameters non-insulin resistant compared with insulin resistant (homeostatic model assessment >2.5) women.
For non-insulin resistant women, total testosterone FAI and androstenedione did not correlate with oocyte fertilization rates. In insulin-resistant women, there was a negative correlation between both testosterone and FAI and fertilization rates (r=-0.62, p<0.03) and r=-0.73, p=0.02, respectively). There was a positive correlation between androstenedione and fertilization rates (r=0.87, p<0.01).
For insulin-resistant women, increases in testosterone and FAI were associated with reduced fertilization rates and androstenedione was associated with increased fertilization rates when measured by LC/MS/MS that should be considered to be the measurement method of choice.
使用免疫测定法测得的总睾酮计算得出的游离雄激素指数（FAI）与卵母细胞受精率不相关；然而，免疫测定法中睾酮与其他雄激素存在相当程度的交叉反应，而同位素稀释液相色谱 - 串联质谱法（LC/MS/MS）则未发现这种情况。
本研究旨在确定通过LC/MS/MS测定的总睾酮和雄烯二酮与受精率之间的关系。
在体外受精（IVF）周期前招募了49名无多囊卵巢综合征的不孕女性。通过LC/MS/MS测定血清睾酮和雄烯二酮，并将其与非胰岛素抵抗女性（与胰岛素抵抗女性相比，稳态模型评估>2.5）的IVF参数进行关联。
对于非胰岛素抵抗女性，总睾酮FAI和雄烯二酮与卵母细胞受精率不相关。在胰岛素抵抗女性中，睾酮和FAI与受精率均呈负相关（r分别为 -0.62，p<0.03和r = -0.73，p = 0.02）。雄烯二酮与受精率呈正相关（r = 0.87，p<0.01）。
对于胰岛素抵抗女性，当通过LC/MS/MS测量时，睾酮和FAI的升高与受精率降低相关，而雄烯二酮与受精率升高相关，LC/MS/MS应被视为首选的测量方法。
