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Medicine Advances 2023, 1(4): 383-393 https://doi.org/10.1002/med4.41
Original Article | Open Access | Issue | Published: 18 December 2023

Dynamic serum testosterone concentration may predict in vitro fertilization yield during ovarian stimulation by a gonadotrophin‐releasing hormone agonist long protocol in women with normal ovarian reserve

Show Author's Information Yang Zhao1,,  Xuedan Jiao2,  Jiawen Xu1,  Chu Chu1,  Yacong Cao2,  Huiyu Xu3,  Wenming Xu4,  Xiaomiao Zhao1 ( )
Department of Reproductive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medicine Science, Southern Medical University, Guangzhou, China
Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University, Guangzhou, China
Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China

Xuedan Jiao contributed equally to the work and should be considered as the co‐first author.

Keywords:
pregnancy, controlled ovarian stimulation, in vitro fertilization, long protocol, total testosterone
Cite this article:
Zhao Y, Jiao X, Xu J, et al. Dynamic serum testosterone concentration may predict in vitro fertilization yield during ovarian stimulation by a gonadotrophin‐releasing hormone agonist long protocol in women with normal ovarian reserve. Medicine Advances, 2023, 1(4): 383-393. https://doi.org/10.1002/med4.41
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Abstract Full text Electronic supplementary material About this article
Objective

To determine whether dynamic changes in serum total testosterone (TT) levels during controlled ovarian stimulation (COS) by a GnRH‐a (gonadotrophin‐releasing hormone agonist) long protocol may predict pregnancy in women with normal ovarian reserve in in vitro fertilization.

Methods

The TT measurements were added to routine hormone tests during COS. The TT dynamic changes, clinical pregnancy rate, and quality of oocytes and embryos of 109 patients were analyzed.

Results

Compared with the non‐pregnancy group, in the pregnancy group the TT level on Gn initial day (TTinitial‐d) increased sharply when the dominant follicle reached a diameter 10–12 mm [TTfΦ (10–12)‐d] and on human chorionic gonadotrophin (HCG) day (TTHCG‐d), also the ratios of TTfΦ (10–12)‐d to TTinitial‐d (1.23 ± 0.37 vs. 1.10 ± 0.58, p = 0.040) and TTHCG‐d to TTinitial‐d (2.32 ± 1.26 vs. 2.00 ± 1.43, p = 0.019) increased notably. Of the 2 TT ratios, the first tertile limit was regarded as the threshold of high TT ratios (1.00, 1.45). High tertiles had higher pregnancy rates than low tertiles (82.86% vs. 42.11%, p = 0.006; 71.43% vs. 44.83%, p = 0.040). The 2 TT ratios were positively associated with the number of metaphase Ⅱ oocytes and good‐quality embryos.

Conclusion

Of COS in a long GnRH‐a protocol with optimized outcome, serum TT kinetics appears to be characterized by sharp rises at the early and late stages of follicle growth. The ratios of TTΦ (10–12)‐d to TTinitial‐d and TTHCG‐d to TTinitial‐d may be predictors for pregnancy and qualitative outcomes of oocytes and embryos.


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Abstract
Full text
Outline
Electronic supplementary material
About this article

Dynamic serum testosterone concentration may predict in vitro fertilization yield during ovarian stimulation by a gonadotrophin‐releasing hormone agonist long protocol in women with normal ovarian reserve

Show Author's information Yang Zhao1,, Xuedan Jiao2, Jiawen Xu1, Chu Chu1, Yacong Cao2, Huiyu Xu3, Wenming Xu4, Xiaomiao Zhao1 ( )
Department of Reproductive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medicine Science, Southern Medical University, Guangzhou, China
Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University, Guangzhou, China
Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China

Xuedan Jiao contributed equally to the work and should be considered as the co‐first author.

Abstract

Objective

To determine whether dynamic changes in serum total testosterone (TT) levels during controlled ovarian stimulation (COS) by a GnRH‐a (gonadotrophin‐releasing hormone agonist) long protocol may predict pregnancy in women with normal ovarian reserve in in vitro fertilization.

Methods

The TT measurements were added to routine hormone tests during COS. The TT dynamic changes, clinical pregnancy rate, and quality of oocytes and embryos of 109 patients were analyzed.

Results

Compared with the non‐pregnancy group, in the pregnancy group the TT level on Gn initial day (TTinitial‐d) increased sharply when the dominant follicle reached a diameter 10–12 mm [TTfΦ (10–12)‐d] and on human chorionic gonadotrophin (HCG) day (TTHCG‐d), also the ratios of TTfΦ (10–12)‐d to TTinitial‐d (1.23 ± 0.37 vs. 1.10 ± 0.58, p = 0.040) and TTHCG‐d to TTinitial‐d (2.32 ± 1.26 vs. 2.00 ± 1.43, p = 0.019) increased notably. Of the 2 TT ratios, the first tertile limit was regarded as the threshold of high TT ratios (1.00, 1.45). High tertiles had higher pregnancy rates than low tertiles (82.86% vs. 42.11%, p = 0.006; 71.43% vs. 44.83%, p = 0.040). The 2 TT ratios were positively associated with the number of metaphase Ⅱ oocytes and good‐quality embryos.

Conclusion

Of COS in a long GnRH‐a protocol with optimized outcome, serum TT kinetics appears to be characterized by sharp rises at the early and late stages of follicle growth. The ratios of TTΦ (10–12)‐d to TTinitial‐d and TTHCG‐d to TTinitial‐d may be predictors for pregnancy and qualitative outcomes of oocytes and embryos.

Keywords: pregnancy, controlled ovarian stimulation, in vitro fertilization, long protocol, total testosterone

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Publication history

Received: 17 May 2023
Accepted: 27 September 2023
Published: 18 December 2023
Issue date: December 2023

Copyright

© 2023 The Authors. Tsinghua University Press.

Acknowledgements

ACKNOWLEDGMENTS

The authors acknowledge the contribution of Meijun Zeng and Xiaojia Li for organizing the data for this study. Lin Li, as well as the embryologists and nursing team from the Center for Reproductive Medicine, Sun Yat‐sen Memorial Hospital, also contributed to the IVF practice for the study. This study was funded by the National Natural Science Foundation of China (82271661), the Guangdong Basic and Applied Basic Research Foundation (grant number: 2020B1515020001), and the GDPH Supporting Fund for Talent Program (KY012021439).

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