title: Low testosterone levels in women with diminished ovarian reserve impair embryo implantation rate: a retrospective case-control study.
abstract: OBJECTIVE
  To investigate the association of basal testosterone (T) levels with the outcome of in vitro fertilization (IVF) in women with diminished ovarian reserve (DOR).
  
  
  METHODS
  Complete clinical data on the first 223 IVF cycles in women with DOR were retrospectively analyzed. The associations of basal follicle stimulating hormone, luteinizing hormone, estradiol, and T levels with ovarian response and IVF outcome were studied.
  
  
  RESULTS
  Basal T levels were significantly different between pregnant and non-pregnant women. However, basal T levels showed no correlation with controlled ovarian hyperstimulation parameters after adjusting for age. The association of basal T levels with pregnancy rate was significant after adjusting for other impact factors. Using receiver operating characteristic (ROC) analysis, the basal T level of 1.115 nmol/L for predicting pregnancy outcome had a sensitivity of 82.80 % and specificity of 58.09 %. The women were divided into two groups based on this value; although the clinical characteristics and ovarian stimulation parameters were similar, the clinical pregnancy (16.18 % (11/68) vs. 40.15 % (53/132), respectively, p = 0.000) and implantation rates (10.07 % (15/149) vs. 22.41 % (65/290), respectively, p = 0.002) were significantly different in the low and high T level groups.
  
  
  CONCLUSIONS
  In women with DOR, the basal T level presented a positive association with pregnancy outcome in IVF. The poor reproductive outcome observed in women with lower basal T levels may be due to the decreased implantation rate.
authors: Reproductive Medical Center, Peking University, People's Hospital, No. 11 Xizhimen South Street, Western District, Beijing, 100044, People's Republic of China.
authors: Qun
authors: Q
authors: Lu
authors: Huan
authors: H
authors: Shen
authors: Yang
authors: Y
authors: Li
authors: Chunfang
authors: C
authors: Zhang
authors: Cong
authors: C
authors: Wang
authors: Xi
authors: X
authors: Chen
authors: Rong
authors: R
authors: Liang
authors: Lihui
authors: L
authors: Wei
mesh_terms: D016022:Case-Control Studies; D010064:Embryo Implantation; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D065851:Ovarian Reserve; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood*
chemical_list: D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone