Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility
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RESEARCH
Open Access
Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility Tiina Murto1*, Kerstin Bjuresten2, Britt-Marie Landgren2 and Anneli Stavreus-Evers1
Abstract Background: Infertile women might get pregnant sometime after fertility treatment, but today, there is no prediction model on who will eventually have children. The objective of the present study was to characterize hormone levels in an arbitrary menstrual cycle in women with unexplained infertility and male infertility, and to determine the predictive value for long-term possibility of live birth. Methods: In this cross-sectional study, with 71 infertile women with diagnosis unexplained infertility and male infertility, blood samples were obtained during the proliferative and secretory phases of an arbitrary menstrual cycle. Serum concentrations of FSH, LH, AMH, inhibin B, estradiol, progesterone, PRL and TSH were determined. The predictive value of ovulation and hormonal analysis was determined by identifying the proportion of women with at least one live birth. Mann Whitney U test, chi2 test and Spearman’s correlation were used for statistical analysis. A value of p < 0.05 was considered statistically significant. Results: There were no differences in hormone values and live birth rates between women with unexplained infertility and male infertility. The best sole predictors of live birth were age of the women, followed by ovulatory cycle, defined as serum progesterone concentration of greater than or equal to 32 nmol/L, and a serum TSH concentration of less than or equal to 2.5 mIU/L. Combining the age with the ovulatory cycle and serum TSH less than or equal to 2.5 mIU/L or serum AMH greater than or equal to 10 pmol/L the predictive value was close to 90%. Conclusions: Age in combination with the presence of an ovulatory cycle and serum TSH or serum AMH is predictive for long-term live birth. The advantage of serum AMH compared with serum TSH is the very little variation throughout the menstrual cycle, which makes it a useful tool in infertility diagnosis. Keywords: AMH, FSH, Inhibin B, LH, Oestrogen, Progesterone, Prolactin, TSH
Background The menstrual cycle reflects a complex combination of synchronized endocrine events in which the hypothalamus, the anterior pituitary and the ovaries are involved [1]. These events are necessary for successful oocyte development, ovulation, fertilization and implantation. Gonadotrophin-Releasing Hormone (GnRH), FollicleStimulating Hormone (FSH) and Luteinizing Hormone (LH) control ovarian function through a sensitive feedback * Correspondence: [email protected] 1 Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden Full list of author information is available at the end of the article
system. A high level of serum FSH in the early follicular phase, a consequence of reduced ovarian function, is predictive of impaired pregnancy outcome after infertility treatment [2] and it has been shown that a combination of low F
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