ABSTRACT
Background: Delayed pregnancy in women and marked increase in the numbers of older
women who fail to respond to ovarian stimulation had been a significant issue. This study aims to assess
the value of basal serum testosterone level as a predictor of ovarian response
for induction of ovulation in women with unexplained infertility undergoing IVF
(in vitro fertilization) cycle. Patients and Methods: A prospective study was conducted in Ain Shams University Maternity hospital
Infertility Center during a period of time from October 2016 to June 2017. This
study recruited 89 women. On day
2 or 3 of a spontaneous menstrual cycle of the included women within 3 months
before fresh IVF cycle, basal hormonal (FSH, LH, estradiol, total testosterone)
concentrations, AFC (antral follicle count)
were performed. Using the Long-protocol for induction of ovulation, serial monitoring of ovarian response was
assessed by transvaginal ultrasound. When the expected ovarian response was
reached (at least three oocytes ≥ 17 mm), we gave trigger dose of HCG. Ultrasound guided oocyte aspiration was
performed 34 - 36 hours later. Two to three days after oocyte aspiration, we
transferred the embryos according to the patient’s age and the condition of
embryos available. Biochemical pregnancy was
considered if serum B-hCG test was positive at day 14 from embryo transfer, where all the data were correlated with serum
testosterone level and ovarian response as 1 ry outcome. Results: There were significant
positive correlations between testosterone and LH, Prolactin, AFC, Number of
oocytes & Number of Embryos (0.014, 0.032, 0.023, 0.004, 0.033, p < 0.001 respectively). Poor responders versus good responders as regards
testosterone level (0.81 ± 0.47 versus 1.08 ± 0.45) Fertilized & pregnant cases had
significantly higher testosterone than non-fertilized & non pregnant had (1.20 ± 0.45, 0.92 ± 0.47 p value 0.035, 0.021 respectively). Yet, testosterone had
significant low diagnostic performance in prediction of poor response and
pregnancy (AUC 0.654, 0.676 respectively), (p value 0.015, 0.022 respectively). Conclusion: Basal T levels are
helpful for predicting ovarian response, hence the dosage of gonadotropins used
in induction. But it can’t be used as
single marker for prediction of ovarian response.