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Association of body mass index, age, and cigarette smoking with serum testosterone levels in cycling women undergoing in vitro fertilization.

Barbieri RL, Sluss PM, Powers RD, McShane PM, Vitonis A, Ginsburg E, Cramer DC

Ob-Gyn Epidemiology Center, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA 02115, USA. rbarbieri@partners.org

OBJECTIVE: [1] To examine the effects of body mass index (BMI), age, cigarette smoking, cause of infertility, and use of oral contraceptives on baseline serum testosterone (T), and [2] to examine associations between baseline serum T and IVF outcomes such as pre-hCG serum E(2), number of oocytes retrieved, oocyte fertilization rate, and pregnancy outcome in regularly cycling women. DESIGN: Prospective, cohort study. SETTING: Three IVF programs in eastern Massachusetts. PATIENT(S): Four hundred twenty-five regularly cycling women planning to undergo IVF. Women with polycystic ovary syndrome, ovulatory infertility, or irregular cycles were excluded from this study. INTERVENTION(S): Collection of epidemiological data and baseline serum in women undergoing IVF. MAIN OUTCOME MEASURE(S): Baseline serum total T, sex hormone binding globulin (SHBG), and calculation of free androgen index. RESULT(S): Body mass index >26 kg/m(2) was associated with a significant increase in serum T (P<.01) and free androgen index (P<.0001). Serum T decreased significantly throughout the fourth decade of life (P<.03). A history of cigarette smoking >10 pack years was associated with increased serum T (P<.01). A diagnosis of endometriosis was associated with decreased serum T. Serum T correlated positively with pre-hCG serum E(2) and number of oocytes retrieved. However, serum T did not significantly influence fertilization or pregnancy rates. CONCLUSION(S): In cycling infertile women, increasing BMI and cigarette smoking are associated with increased serum T. Advancing age and endometriosis are associated with decreased serum T.

Published 11 February 2005 in Fertil Steril, 83(2): 302-8.
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