Predictive value of ovarian hormone-producing function assessment in poor responders undergoing assisted reproductive technologies

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Hypothesis/aims of study. The management of poor responders to ovarian stimulation for in vitro fertilization (IVF) has always been a challenge. It is difficult for both doctors and patients to make decision to proceed to oocyte donation or abandon fertility treatment. More predictors of successful IVF treatment in poor responders are needed. The aim of this study was to assess hormonal ovarian function in poor responders undergoing ovarian stimulation and to identify predictors of the chance of clinical pregnancy after IVF cycle.

Study design, materials and methods. The study included 45 infertile patients undergoing ovarian stimulation with poor ovarian response according to the Bologna criteria. All patients underwent standard IVF or IVF/ICSI protocol using gonadotropin releasing hormone antagonists. Letrozole (5 mg/day) was administered during the first 5 days of stimulation in standard antagonist FSH/hMG protocol to 13 of the patients included in the study, with standard antagonist FSH/hMG protocol being only administered to other 32 patients. Serum and follicular fluid were collected at the time of follicle aspiration, and the concentrations of total testosterone, estradiol and androstenedione were determined.

Results. Follicular fluid concentrations of testosterone and androstenedione were higher and serum estradiol level was lower in the letrozole group. The serum concentrations of testosterone and androstenedione were comparable in both groups, while the serum estradiol/testosterone ratio was lower in the letrozole group. The threshold level of estradiol/testosterone ratio × 1000 on the day of oocyte retrieval above which pregnancy and implantation rates were increased was 1532.68 (odds ratio — 7.0 (95% CI 1.39–35.35), р = 0.02).

Conclusion. Evaluating of the serum estradiol / testosterone ratio has been shown to determine aromatase activity of ovarian preovulatory follicles and to predict IVF outcome in poor responders undergoing assisted reproductive technology.

作者简介

Alexandra Merkulova

Saint Petersburg State University

编辑信件的主要联系方式.
Email: merkulova.alexandra@gmail.com
ORCID iD: 0000-0001-5555-2425
SPIN 代码: 5109-0816

MD, Postgraduate student. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty

俄罗斯联邦, Saint Petersburg

Lyailya Dzhemlikhanova

Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: dzhemlikhanova_l@mail.ru
ORCID iD: 0000-0001-6842-4430
SPIN 代码: 1691-6559

MD, PhD, Associate Professor. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty; the Department of Assisted Reproductive Technologies

俄罗斯联邦, Saint Petersburg

Dariko Niauri

Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: d.niauri@mail.ru
ORCID iD: 0000-0003-1556-248X
SPIN 代码: 4384-9785

MD, PhD, DSci (Medicine), Professor, the Head of the Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty; Leading Researcher. The Gynecological Department with the Operation Unit

俄罗斯联邦, Saint Petersburg

Alexander Gzgzyan

Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: agzgzyan@mail.ru
ORCID iD: 0000-0003-3917-9493
SPIN 代码: 6412-4801

MD, PhD, DSci (Medicine), Professor. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty; the Head of the Department of Assisted Reproductive Technologies

俄罗斯联邦, Saint Petersburg

Igor Kogan

Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: ikogan@mail.ru
ORCID iD: 0000-0002-7351-6900
SPIN 代码: 6572-6450

MD, PhD, DSci (Medicine), Professor, Corresponding Member of RAS. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty; Director

俄罗斯联邦, Saint Petersburg

Inna Krikheli

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: ikrikhely@gmail.com
ORCID iD: 0000-0002-5439-1727
SPIN 代码: 7356-6189

MD, PhD, Senior Researcher

俄罗斯联邦, Saint Petersburg

Natalya Tapilskaya

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; Saint Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation

Email: tapnatalia@yandex.ru
ORCID iD: 0000-0001-5309-0087
SPIN 代码: 3605-0413

MD, PhD, DSci (Medicine), Professor, Leading Researcher; Professor. The Department of Obstetrics and Gynecology with the Course of Pediatric and Adolescent Gynecology

俄罗斯联邦, Saint Petersburg

Natalia Tkachenko

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: liberin@mail.ru
ORCID iD: 0000-0001-6189-3488
SPIN 代码: 9633-6701

PhD, the Head of the Laboratory of Endocrinology

俄罗斯联邦, Saint Petersburg

Irina Mekina

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: iagmail@ott.ru
ORCID iD: 0000-0002-0813-5845
SPIN 代码: 4682-8590

PhD, Senior Researcher. The Department of Assisted Reproductive Technologies

俄罗斯联邦, Saint Petersburg

Elena Lesik

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: iagmail@ott.ru

PhD, Senior Researcher. The Department of Assisted Reproductive Technologies

俄罗斯联邦, Saint Petersburg

Evgenia Komarova

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: iagmail@ott.ru
ORCID iD: 0000-0002-9988-9879
SPIN 代码: 1056-7821

PhD, Researcher. The Department of Assisted Reproductive Technologies

俄罗斯联邦, Saint Petersburg

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版权所有 © Merkulova A.I., Dzhemlikhanova L.K., Niauri D.A., Gzgzyan A.M., Kogan I.Y., Krikheli I.O., Tapilskaya N.I., Tkachenko N.N., Mekina I.D., Lesik E.A., Komarova E.M., 2020

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