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The Relationship of Serum Basal Testosterone Level with Pregnancy Outcomes and Ovarian Response

Author: WangChunLi
Tutor: ShaoXiaoGuang
School: Dalian Medical University
Course: Obstetrics and Gynaecology
Keywords: serum basal testosterone ovarian response ability pregnant in vitro fertilization
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Type: Master's thesis
Year: 2013
Downloads: 16
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Abstract


Objective:By a retrospective study,we evaluate the relationship of serum basaltestosterone (T) level of patients who have accepted controlled ovarian hyperstimulationwith ovarian response and in vitro fertilization (IVF) outcome. At present,there are nointegrating and definite standards to supplement androgen,we are trying to findoptimum serum basal testosterone level to supplement androgen.Methods: we analyzed data from DaLian Obstetrics and Gynecology HospitalCenter for Reproductive Medicine, a total of405stimulation IVF-ET cycles with longprotocol and212stimulation IVF-ET cycles with antagnist protocol.Patients,withoutpolycystic ovary syndrome,endometriosis,uterine malformation,other endocrinediseases and one or both who are chromosome abnormal. According to the scheme,theyare divided into long protocol and antagonist protocol groups, each group is furtherdivided into pregnancy and the non-pregnancy groups. We analyzed the relationship ofovarian response ability and pregcnany outcome of each group and based serumtestosterone level.Results: Correlation coefficient analysis,during long protocol group, age, GNinitial quantity, GN amount and serum testosterone, there are negative correlation. thenumber of eggs, embryos frozen number,embryo number and serum basal testosteroneexist positive correlation; Antagonists group,AFC, FC>14mm, the number of eggsand embryos frozen number and good embryo number and serum testosterone existpositive correlation。About basic characteristics and ovarian stimulation,pregnancygroup and the non-pregnancy with Long protocol, serum testosterone level,GN initialquantity, the number of eggs,FC>14mm,thickness of the lining of hCG day,embryosfrozen and good embryo number of patients are found differences. pregnancy group andthe non-pregnancy group with Antagonists,the serumbasal testosterone level, the number of eggs, FC>14mm,thickness of the liningof hCG day,embryos frozen andgood embryo numberof patients are differences。For both groups, the pregnancy outcomes in the ROC curve analysis,area under theROC of long protocol is0.642(0.5-0.7for moderate), indicating that prediction value ofthe serum testosterone level on the pregnancy outcome is moderate,area unde the ROCof antagonist protocol is0.629, indicating that prediction value of the serumtestosterone level on the pregnancy outcome is also moderate. The best boundary valueof based serum testosterone level in Long protocol group is0.2305ng/ml, bestboundary value in antagonist group is0.2215ng/ml. The sensitivity and specific degreeswere both above60%.Conclusion: The serum testosterone level can be used to predict ovarian responseability, also is used to predict the pregnancy outcome in patients whose ovarianfunction is good or bad. The serum testosterone level of Patients is greater than0.22ng/ml auxiliary help pregnancy, the pregnancy rate of them is higher. With auxiliaryhelp pregnant patients, patients,whose based serum testosterone level are low beforetreatment, serum testosterone levels should be increased to0.22ng/ml or more, so as toincrease the chance of conception.

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