Serum dehydroepiandrosterone sulphate concentration is not a predictive factor in IVF outcomes before the first cycle of GnRH agonist administration in women with normal ovarian reserve.
OBJECTIVE
The aim of our study was to determine whether serum dehydroepiandrosterone sulphate (DHEAS) concentration and the models incorporating it could help clinicians to predict IVF outcomes in women with normal ovarian reserve undergoing their first long protocol.


METHODS
We performed a retrospective analysis of 459 women undergoing cycles of intracytoplasmic sperm injection (ICSI) for the first time in a long GnRH agonist protocol.


RESULTS
Embryo transfer was performed in 407 women (88.7%). The fertilisation rate was 78.6%. The clinical pregnancy rate was 44.8% per started cycle and 50.6% per embryo transfer. Our univariate model revealed that the best predictors of clinical pregnancy were the number of mature oocytes, the number of embryos transferred and the number of good quality embryos, account for the clinical parameters that reflect ovarian reserve the best being AMH level and AFC. DHEAS did not predict clinical pregnancy (OR 1.001, 95% CI, 0.999-1.004). After adjusting for the number of embryos transferred and class of embryos in a multivariate model, the best predictors were age (OR 0.918, 95% CI, 0.867-0.972) and AFC (OR 1.022, 95% CI, 0.992-1.053). Serum DHEAS levels were positively correlated with AFC (r = 0.098, P<0.039) and testosterone levels (r = 0.371, P<0.001), as well as the number of mature oocytes (r = 0.109, P<0.019); serum DHEAS levels were negatively correlated with age (r = -0.220, P<0.001), follicle-stimulating hormone (FSH), (r = -0.116, P<0.015) and sex hormone-binding globulin (SHBG), (r = -0.193, P<0.001).


CONCLUSIONS
DHEAS concentration (in addition to the known factors of ovarian reserve) does not predict clinical pregnancy in women with normal ovarian reserve who are undergoing ICSI.
INVICTA Fertility and Reproductive Center, Warszawa, Poland.
Michał
M
Kunicki
Department of Obstetrics and Gynaecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdańsk, Poland; Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Varmia and Masuria, Olsztyn, Poland; NVICTA Fertility and Reproductive Center, Gdańsk, Poland.
Krzysztof
K
Łukaszuk
INVICTA Fertility and Reproductive Center, Warszawa, Poland; Department of Obstetrics and Gynecology, Medical Center of Postgraduate Education, Warsaw, Poland.
Grzegorz
G
Jakiel
NVICTA Fertility and Reproductive Center, Gdańsk, Poland.
Joanna
J
Liss
D000328:Adult; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D065851:Ovarian Reserve; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome
D007987:Gonadotropin-Releasing Hormone; D019314:Dehydroepiandrosterone Sulfate