Androgen profile in infertile women undergoing treatment with assisted reproductive technologies depending on the ovarian response


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Abstract

Objective: To evaluate the androgen profile in infertile women undergoing treatment with assisted reproductive technologies (ART) depending on the ovarian response. Materials and methods: The study included 150 women who underwent IVF/ICSI treatment at the V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, and met the inclusion criteria. The groups were stratified depending on the ovarian reserve on the basis of the POSEIDON classification and ovarian response to the stimulation in accordance with the Bologna criteria: group 1 included 50 patients with diminished ovarian reserve (AMH<1.2 ng/ml, CAF<5) and poor ovarian response to stimulation (≤3 oocytes during transvaginal puncture); group 2 consisted of 100 patients with normal ovarian reserve (AMH≥1.2 ng/ml, CAF≥5), among them there were 50 patients with normal ovarian response (>9 oocytes) and 50 patients with reduced ovarian response (<9 oocytes). The androgen profile in the follicular fluid and blood serum was studied using mass spectrometry data. Results: Depending on the decrease in the ovarian reserve and ovarian response, there was a statistically significant decrease in the concentration of total testosterone and androstenedione in the blood. The women with reduced ovarian response had a statistically significant decrease in the blood level of total testosterone and androstenedione compared to women with normal ovarian reserve and normal response. There was also a decrease in the concentration of DHEA-C in the follicular fluid associated with a decrease in ovarian reserve and ovarian response. However, there was a reverse trend for androstenedione in the follicular fluid: women with normal ovarian response and normal ovarian reserve had lower levels of androstenedione. Conclusion: This study was the first comparative assessment of the androgen profile in infertile patients using mass spectrometry which is considered to be the gold standard. This analysis indicates changes in the levels of androgens and confirms their role in the emerging androgen deficiency. Our study also confirms the hypothesis about the influence of androgens on the processes of folliculogenesis and their significant contribution to the ovarian response. It is possible to explain pathogenetically the value of studies on the effect of hormonal priming in women with infertility and diminished ovarian reserve in order to block apoptosis of follicles and increase sensitivity to FSH.

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About the authors

Alla A. Gavisova

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: gaviaha@yandex.ru
PhD, Senior Researcher at the lst Gynecological Department

Svetlana V. Kindysheva

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: s_kindysheva@oparina4.ru
PhD, Senior Researcher at the Laboratory of Proteomics and Metabolomics of Human Reproduction, Department of Systems Biology in Reproduction

Natalia L. Starodubtseva

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: aurum19@mail.ru
PhD, Head of the laboratory of Clinical Proteomics of the Department of Systems Biology in Reproductive Medicine of the Institute of Translational Medicine

Vladimir E. Frankevich

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: v_frankevich@oparina4.ru
Dr. Sci. (Physics and Mathematics), Deputy Director for Research, Head of the Department of Systems Biology in Reproduction

Nataliya V. Dolgushina

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: n_dolgushina@oparina4.ru
Dr. Med. Sci., Professor, Deputy Director - Head of the Department for Scientific Projects Administration

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