Basal serum luteinizing hormone, total testosterone, and free testosterone levels do not impact IVF outcomes in patients with polycystic ovary syndrome

Objective: To assess the influence of basal serum levels of luteinizing hormone (LH), total testosterone (TT), and free testosterone (FT) on in vitro fertilization (IVF) success rates in patients with polycystic ovary syndrome (PCOS).

Material and methods: A retrospective cohort analysis of PCOS patients who underwent freeze-all, gonadotropin releasing hormone (GnRH) antagonist IVF protocols from January 2013 to December 2019. Patients were grouped based on median basal serum levels of LH, TT, and FT to compare their IVF outcomes.

Results: A total of 76 women with PCOS diagnosed as per the 2003 Rotterdam criteria were included. When analyzed by LH levels, groups had similar baseline characteristics except for higher mean ± standard deviation TT (1.4±0.9 vs. 1.9±0.9 nmol/L, p=0.02) and FT (0.6±0.5 vs. 0.9±0.5 nmol/L, p=0.03) in the elevated LH group. However, clinical pregnancy rates (CPR) (34.2% vs. 44.7%, p=0.35) and live birth rates (LBR) (21.0% vs. 31.6%, p=0.29) were not different. The group with lower TT had more previous pregnancies (0.9±1.2 vs. 0.3±0.7, p=0.02) and shorter infertility duration (2.3±2.0 vs. 3.7±2.7 years, p=0.04), but again CPR (46.8% vs. 42.8%, p=0.90) and LBR (37.5% vs. 25.7%, p=0.33) were similar. FT analysis revealed no significant differences in CPR (48.2% vs. 36.7%, p=0.36) and LBR (23.2% vs. 37.9%, p=0.22) despite higher TT (1.1±0.4 vs. 2.2±1.1 nmol/L, p<0.001) and LH (6.1±3.8 vs. 11.2±7.2 IU/L, p<0.001) in the high FT group.

Conclusion: Basal serum levels of LH, TT, and FT did not significantly affect IVF outcomes in patients with PCOS using GnRH antagonist, freeze-all protocols.