High androgen level during controlled ovarian stimulation cycle impairs endometrial receptivity in PCOS patients.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Polycystic Ovary Syndrome*/metabolism ; Endometrium*/metabolism ; Ovulation Induction*/methods ; Leukemia Inhibitory Factor*/metabolism ; Embryo Transfer* ; Testosterone*/blood; Humans ; Female ; Pregnancy ; Adult ; Retrospective Studies ; Pregnancy Rate ; Embryo Implantation ; Infertility, Female/metabolism ; Infertility, Female/blood ; Infertility, Female/therapy ; Insulin-Like Growth Factor Binding Protein 1/metabolism ; Insulin-Like Growth Factor Binding Protein 1/blood ; Androgens/metabolism ; Androgens/blood ; Pregnancy Outcome ; Fertilization in Vitro/methods

PCOS is one of the most common endocrine disorders among women of reproductive age. While the mechanism involved is not yet fully characterized. Our study aims to examine the pregnancy outcomes of embryo transfers in women with PCOS after pretreatment, and to explore the possible effect of high androgen levels on endometrial receptivity. Retrospective cohort study was conducted to analyze pregnancy outcomes among 2714 infertile women with tubal factor and 452 PCOS women. Endometrium samples were collected from 6 controls and 6 PCOS patients to detect the expression of endometrial receptivity marks. The implantation rate, clinical and ongoing pregnancy rates and live birth rate in women with PCOS followed fresh embryo transfers were obviously decreased even after the pretreatment. Similar pregnancy outcomes were found in frozen-thawed embryo transfer cycles between women with or without PCOS. Strikingly, serum total testosterone (TT) levels on trigger day were significantly higher in PCOS women. Women with high TT levels presented significantly lower clinical and ongoing pregnancy rates, and the expression of insulin-like growth factor binding protein 1 (IGFBP-1), and leukemia inhibitory factor (LIF) in the endometria decreased significantly as well. High doses of testosterone significantly down-regulated the expression of IGFBP-1 and LIF in Ishikawa cells. Although endocrine abnormalities had been improved before the controlled ovarian stimulation (COS) cycle started, higher serum TT levels were detected on the trigger day of the COS cycle in PCOS patients, which may contribute to the decreased fresh embryo implantation by impairing endometrial receptivity.
(© 2024. The Author(s).)

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IPMCH2022CR1-03 Shanghai Frontiers Science Research Base of Reproduction and Development and the Clinical Research Plan of IPMCH; 2018YFC1005001 National Key Research and Development Program of China; 82071730 National Natural Science Foundation of China; SHDC12019X17 Research Grant from Shanghai Hospital Development Center

Keywords: Androgen; Embryo transfer; Endometrial receptivity; PCOS

0 (Leukemia Inhibitory Factor)
3XMK78S47O (Testosterone)
0 (Insulin-Like Growth Factor Binding Protein 1)
0 (Androgens)
0 (LIF protein, human)
0 (IGFBP1 protein, human)

Date Created: 20241004 Date Completed: 20241004 Latest Revision: 20241007

20241007

PMC11452613

10.1038/s41598-024-74295-7

39367050