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The ovarian response to exogenous gonadotrophins is highly variable, with a certain proportion of women exhibiting an unexpected poor response to controlled ovarian hyper-stimulation (COH) (Broekmans et al., 2006). Poor ovarian response (POR) is associated with treatment cancellation and reduced live-birth rates, being a significant psychological and financial burden for the couple especially in developing countries (Pu et al., 2011).
According to the two-cell two-gonadotrophin theory, androgens play an essential role in ensuring adequate follicular steroidogenesis in humans (Hillier et al., 1994).
Guo et al. (2014) implies the importance of an androgenic environment, especially testosterone, in improving pregnancy outcome. This assumption is concordant with Gleicher and Barad (2011) and Weghofer et al. (2012), which also suggest normal androgenic ovarian endocrine microenvironments would positively influence pregnancy chances with IVF.
It was concluded by the Bologna ESHRE criteria that poor ovarian responders should be considered patients having at least two of the following criteria:
A previous episode of poor ovarian response (≤3 oocytes) with a standard dose of medication.
An abnormal ovarian reserve with AFC <5–7 follicles or AMH <0.5 ng/mL.
Advanced maternal age or presenting other risk factors for poor response such as previous ovarian surgery, genetic defects, chemotherapy, radiotherapy, and autoimmune disorders (Ferraretti et al., 2011).
117 women were eligible for this study, who attended Ain shams university maternity hospital during October 2015 to March 2016.
89 women underwent the long ovarian stimulation protocol & oocyte aspiration, where 55 women (61.8%) hav been good responders, while 34 women (38.2%) have been poor responders, comparing serum testosterone level in relation to number of follicles in both ovaries(AFC),number of actual oocyte retrieved, number of embryos fertilized, positive pregnancy test among two groups.
This study aimed to assess the value of serum testosterone level as a predictor of ovarian response for induction of ovulation in women undergoing IVF cycle.
In our study, Poor responders had significantly higher FSH, FSH/LH ratio, E2 and TSH and significantly lower LH, prolactin and Testosterone than good responders had. Mean testosterone level in poor responders is 0.81±0.47, while that in good responders is 1.08±0.45, with P value (0.008).
In our study, Pregnant had significantly higher Testosterone than non-pregnant had. Mean testosterone level in non-pregnant women is 0.92±0.47 while that in pregnant women is 1.20±0.45 with P value (0.026).
ROC curve of testosterone regarding poor response and pregnancy has AUC 0.654, 0.676 respectively.
Testosterone had significant low diagnostic performance in prediction of poor response and pregnancy