血清和卵泡液中睾酮水平与体外受精-胚胎移植结局的关系

目的：探讨体外受精-胚胎移植（IVF-ET）治疗时血清和卵泡液中睾酮浓度与IVF-ET结局的关系。方法：选择2011年5—8月在成都中医药大学第二附属医院生殖中心接受IVF-ET或胞浆内单精子注射（ICSI）-ET治疗的患者43例，检测患者基础血清及控制性超促排卵（COH）时血清和卵泡液中睾酮水平。①按获卵数分3组，低反应（L）组（1～5个）、正常反应（M）组（6～15个）、高反应（H）组（＞15个），分析各组血清和卵泡液中睾酮浓度及各组受精率和妊娠率。②按临床妊娠情况分为妊娠组与未妊娠组，比较2组间睾酮的差异。结果：①不同获卵数3组间卵泡液中睾酮水平和基础睾酮水平差异无统计学意义（P＞0.05）；人绒毛膜促性腺激素（hCG）日3组血清睾酮水平比较差异有统计学意义（P＜0.05），其中H组高于M组及L组（P分别为0.010和0.001）；COH中其余时间点睾酮水平差异无统计学意义（P＞0.05）。②3组受精率、优质胚胎率差异无统计学意义（P＞0.05）；临床妊娠率比较差异有统计学意义（P＜0.05）。③妊娠组各阶段血清睾酮水平仅在取卵日时高于未妊娠组，差异有统计学意义（P＜0.05）；2组卵泡液中睾酮差异无统计学意义（P＞0.05）。结论：IVF-ET治疗时基础血清睾酮水平不能预测卵巢反应和妊娠结局，但hCG日睾酮水平可能预测卵巢反应；取卵日血清睾酮与妊娠有关；卵泡液中睾酮对妊娠结局无显著影响。

Levels of Testosterone in Serum and Follicular Fluid Associated with Clinical Outcomes of IVF-ET

Objective: To explore the relationship between the testosterone（T） levels in serum and follicular fluid and the outcomes of stimulation in vitro fertilization-embryo transfer（IVF-ET） cycle. Methods: Data was collected from 43 patients who received IVF/ intracytoplasmic sperm injection（ICSI） treatment between May and August in 2011 at our center. T levels in serum and follicular fluid were detected by chemiluminiscence ELISA. ①43 patients were divided into 3 groups by the number of harvested oocytes: group L（1-5 oocytes）, group M （6-15 oocytes） and group H （＞15 oocytes）. T levels, the fertilization rate and the clinical pregnancy rate were compared among three groups. ②43 patients were divided into the pregnant group and the non-pregnant group. T levels were then compared. Results: ①There were not significant differences in the follicular fluid T levels and the basal serum T level among three groups（P＞0.05）. There were significant differences in the serum T levels on the day of hCG administration among three groups（P＜0.05）. T level on the day of hCG administration in the H group was significantly higher than that in the M group（P=0.010） and the L group（P=0.001）. However, there were not significant differences in the serum T levels at other time points of COH among three groups（P＞0.05）. ②There were not significant differences in the fertilization rate and the rate of high quality embryo among three groups （P＞0.05）, however there was significant difference in the clinical pregnancy rate （P＜0.05）. ③The serum T level on the day of ovum pick-up in the pregnant group was significantly higher than that in the non-pregnant group （P＜0.05）; however there was not significant difference in the T level of follicular fluid（P＞0.05）. Conclusions: During the IVF-ET treatment, the basal level of serum T can not predict ovarian response and pregnancy outcome; however the T level on the day of hCG administration could be a parameter，to predict ovarian response. The serum T level on the day of ovum pick-up is associated with pregnancy outcome; however, the T in the follicular fluid is not associated with pregnancy outcome.