Early pregnancy testosterone after ovarian stimulation and pregnancy outcome
2012
Gustin, Stephanie L.F. | Mukherjee, Gourab | Baker, Valerie L. | Westphal, Lynn M. | Milki, Amin A. | Lathi, Ruth B.
OBJECTIVE: To examine early pregnancy (EP) testosterone (T) after ovarian stimulation and its effect on singleton pregnancy outcomes. DESIGN: Prospective cohort study. SETTING: University-based tertiary care center. PATIENT(S): Subfertile women who conceived with or without fertility treatment. INTERVENTION(S): Ovarian stimulation for assisted reproduction, collection of serum total T levels in early pregnancy, and pregnancy follow-up. MAIN OUTCOME MEASURE(S): Rate of preterm delivery, low birth weight (LBW) (<2,500 g), and hypertensive disorders of pregnancy. RESULT(S): EP serum samples were measured from 266 singleton pregnancies. The mean T level among spontaneous conceptions was 74.90 ng/dL (SD 48.35 ng/dL); 103 ng/mL was the 90th percentile. Mean EP T was increased among patients who underwent ovarian stimulation compared with nonstimulated control subjects. In patients undergoing IVF, T levels in EP were linearly correlated with the number of oocytes retrieved. When pregnancy outcomes in women with normal T were compared with women with elevated T (>90th percentile), we did not see an increased risk for preterm delivery, hypertensive disorders of pregnancy, LBW infants, or cesarean delivery (odds ratio ratios 1.43, 0.38, 1.39, and 0.85, respectively). CONCLUSION(S): Elevations in EP T are associated with ovarian stimulation but do not appear to be associated with adverse pregnancy outcome. Further investigation to determine the etiology of increased maternal and neonatal morbidity among subfertile women is warranted.
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