Women Testosterone Levels And Ovarian Reserve Evaluation Index And The Correlation Of IVF Outcome Studies

Objective: By a retrospective study, we evaluate the relationship of serum basal testosterone (T) level of patients who have accepted controlled ovarian hyperstimulation with ovarian reserve evaluation index and in vitro fertilization (IVF) outcome. At the same time ,we are also hoping through the study of the basis of serum testosterone level and trying to find optimum serum basal testosterone level to supplement androgen so we can provide a basis for effective clinical use in androgen replacement therapy. Method: Retrospective analysis of the data from Kunming medical university second affiliated hospital of reproductive medicine,a total of 229 stimulation IVF-ET or ICSI-ET cycles in January 2014 to January 2014.Patients’s infertility reasons including tubes factors.the men factors,and Meetting the inclusion criteria of infertility patients .Recording all of the patients’s age, body mass index (BMI), the menstruation check base values of serum sex hormone (FSH, LH, E2, P, PRL, T), and FSH/LH ratio were calculated before falling tone in patients with blood check miao le tube hormone (AMH) value, parallel counting vaginal ultrasound in patients with sinus follicle number (AFC). Conventional scheme after entering cycle long, thickness of the lining of h CG day,(Em) and designed,the Gn days, The dosage of Gn,the number of eggs, MⅡ egg number, the total number of embryos, embryo quality and the 30 days after embryo transfer pregnancy vaginal ultrasound. First of all, based on patients’ serum testosterone level values are divided into two groups:;group A:testosterone≤20 ng/dl; Group B:testosterone> 20 ng/dl; Each group isfurther divided into pregnancy and the non-pregnancy groups,discussing the femaleserum testosterone levels and ovarian reserve evaluation index and the correlation ofIVF outcome, and analyzing the relationship of ovarian response ability andpregcnany outcome of each group and based serum testosterone level. Second, tothe patients age is divided into three groups:Ⅰ groups:age≤30; Ⅱ groups:30<age≤35;Ⅲgroups:35<age<40.Analyzing the patient age and serum testosterone levelsbetween the relationship.Results:1. T≤20 ng/dl group with T> 20 ng/dl fixed number of year of the two groups ofpatient’s age, infertility, transplantation days intrauterine membrane thickness (Em),days designed.the Gn and designed.the Gn dosage had no statistical significance (P>0.05). Between the two groups of follicle stimulating hormone (bFSH), foundation ofluteinizing hormone (bLH), FSH/LH, basic estradiol (bE2) had no statisticalsignificance (P> 0.05); Based AMH comparison between the two groups, P= 0.01,the difference was statistically significant.2. T≤20 ng/dl group with T> 20 ng/dl for egg rate between the two groups, thehigh quality embryo rate, normal fertilization rate and embryo implantation rate, rateof multiple pregnancy, abortion and ectopic pregnancy rate had no statisticaldifference (P> 0.05); M Ⅱ egg rate between the two groups, P= 0.021, thedifference was statistically significant; Clinical pregnancy rate between the twogroups, P= 0.04, the difference was statistically significant.3. The area under the ROC curve is 0.6 (0.5 to 0.7 for moderate), T value for theforecast of pregnancy outcome is moderate, and T is the best boundary value of20.475 ng/dl. As a boundary value, M Ⅱ egg rate comparisons between two groups, P=0.012, the difference was statistically significant; Clinical pregnancy rate, P= 0.014,the difference was statistically significant. The correlation coefficient analysis, T 20ng/dl or less group with T> 20 ng/dl compared two groups of AMH, P= 0.01, thedifference was statistically significant. Pregnancy compared with non pregnancygroup T, P= 0.04, the difference was statistically significant.4.In age≤30 years group and 35< age≤40 years group,the T and AMHcomparison between the two groups (P= 0.018,0.009), the difference had statisticalsignificance; The 30<age≤35 years group and the 35<age≤40 years group, the Tand AMH comparison between the two groups (P= 0.003,0.033), the difference wasstatistically significant. age≤30 years group and 30<age≤35 years group,the T andAMH comparison between the two groups (P= 0.446,0.589), there was nostatistically significant difference.5.Ovarian reserve function, the assessment of the evaluation index and Tcorrelation analysis showed that:basic AMH was positively correlated with T (r=1.032, P=1.032), with statistical significance， Positive correlation between T and E2(r=0.055, P=0.027), with statistical significance. According to the correlationcoefficient r arranged from high to low, and the correlation of T as follows:the basicAMH> E2. And age, foundation of FSH, LH, FSH/LH were negative correlation andserum testosterone, no statistical significance (P> 0.05).Conclusion:1, Basic AMH, E2 and T were positively correlated;T≤20 ng/dl indicates possibleovarian reserve function decline.2,A certain range, increased T, M Ⅱ egg rate and clinical pregnancy rate hasincreased accordingly, can obtain a good result.3, Basic T to predict IVF outcome, T threshold value of 20.475 ng/dl, its sensitivityand specificity is not high, the current clinical application of meaningless.4, AMH and T gradually decreases with the increase of age, especially women afterage 35.