title: The role of serum testosterone in early pregnancy outcome: a comparison in women with and without polycystic ovary syndrome.
abstract: OBJECTIVE
  Hyperandrogenic conditions in women are associated with increased rates of miscarriage. However, the specific role of maternal testosterone in early pregnancy and its association with pregnancy outcome is unknown. The purpose of this study was to compare serum testosterone levels during early pregnancy in women with and without polycystic ovary syndrome (PCOS) who either had successful pregnancies or miscarried.
  
  
  METHODS
  We collected serum samples from women attending a university-based fertility centre at the time of their first positive serum beta human chorionic gonadotropin pregnancy test. The samples were subsequently assayed for total testosterone level. We used logistical regression modelling to control for PCOS diagnosis, BMI, and age.
  
  
  RESULTS
  Total testosterone levels were available for 346 pregnancies, including 286 successful pregnancies and 78 first trimester miscarriages. We found no difference in total testosterone levels between women who subsequently had an ongoing pregnancy (mean concentration 3.6 ± 2.6 nmol/L) and women with a miscarriage (mean 3.6 ± 2.4 nmol/L). Using the Rotterdam criteria to identify women with PCOS, we also found no differences in serum testosterone between women who had ongoing pregnancies or miscarriages, either with PCOS (P = 0.176) or without PCOS (P = 0.561).
  
  
  CONCLUSIONS
  Our findings show that early pregnancy testosterone levels do not predict pregnancy outcome, and they call into question the role of testosterone in causing miscarriage in populations of women with PCOS. Further research is needed to elucidate the normal progression of testosterone levels during pregnancy and to investigate further the relationship between PCOS and miscarriage.
authors.affiliation: Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford CA.
authors.forename: Ruth B
authors.initials: RB
authors.lastname: Lathi
authors.affiliation: McGill Reproductive Centre, Montreal QC.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Dahan
authors.affiliation: Yale University School of Medicine, New Haven CT.
authors.forename: Margaret F
authors.initials: MF
authors.lastname: Reynolds-May
authors.affiliation: Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford CA.
authors.forename: Amin A
authors.initials: AA
authors.lastname: Milki
authors.affiliation: Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford CA.
authors.forename: Barry
authors.initials: B
authors.lastname: Behr
authors.affiliation: Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford CA.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Westphal
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000209:etiology; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D003710:Demography; D005260:Female; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology; D011264:Pregnancy Trimesters; D018570:Risk Assessment; D012307:Risk Factors; D013739:Testosterone / Q000097:blood*
chemical_list: D013739:Testosterone
keywords: androgens; infertility; polycystic ovary syndrome; pregnancy; spontaneous abortion; testosterone