A Proper Increasing in the Testosterone Level May Be Associated With Better Pregnancy Outcomes for in Vitro Fertilization (IVF)/intracytoplasmic Sperm Injection (ICSI) Patients With Tubal or Male Infertility

Abstract

Background To investigate the relationship between androgen levels and pregnancy outcomes in patients with tubal or male infertility at different times of the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Methods Patients with tubal or male infertility but normal androgen levels receiving IVF/ICSI were continuously recruited. We made longitudinal analysis of the testosterone (T) levels at three time points (T0: basal T levels, T1: T levels on the trigger day, T2: T levels on the next day of the trigger day) in three groups with different pregnancy outcomes (Group 1: no pregnancy, Group 2: clinical pregnancy but no live birth, Group 3: live birth) as repeated measurement data using linear mixed effect models. We also plotted fitting curves depicting the relationship of the T levels and the numbers of oocytes retrieved at different time points, and the inflection points of the curves were identified. Results A total of 3012 patients were recruited in the study. Improvements in androgen levels were identified at the three-time points in Group 1 and 3. The slope in Group 3 after refitting was significantly higher than Group 1 (P = 0.000). The curves that reflected the association of androgen levels and numbers of retrieved oocytes presented an upward trend before a certain inflection point, after which the curves had no obvious changes or fell with the increase of androgen levels. The inflection points for T0, T1, T2 were calculated as 0.45, 0.94, 1.09, respectively. Conclusion The faster upward trend of the T levels might be associated with better pregnancy outcomes. Within the range of lower than a certain value of the T levels, more oocytes and embryos could be obtained with the increasing of the T levels.