Association of Basal Serum Androgen Concentration with Follicles Number on the Day of Triggering Final Oocyte Maturation in Low Responders According to the Bologna Criteria: A Prospective Cohort Study

Studies in animals have shown that androgens promote early follicular development and granulosa cell proliferation by augmenting follicle-stimulating hormone (FSH) receptor expression in granulosa cells. Inconsistency exists regarding the association between basal serum androgen levels and follicular development in low responders undergoing in vitro fertilization (IVF), although the number of studies is limited. The aim of the current study was to assess the association between basal serum androgen concentrations and the number of follicles ≥ 11 mm on the day of triggering final oocyte maturation in low responders undergoing IVF. This prospective study was performed from June 2020 to September 2024 in 96 low responders, categorized according to the Bologna criteria. Total testosterone, dehydroepiandrosterone sulfate (DHEAS), 17-OH progesterone (17-OH-P), Δ₄-androstenedione (Δ4-A), and sex hormone-binding globulin (SHBG) were measured on the day of initiation of ovarian stimulation. No association was found between basal serum testosterone (coef.: -0.002, <i>p</i> = 0.98), DHEAS (coef.: -0.096, <i>p</i> = 0.35), 17-OH-P (coef.: +0.086, <i>p</i> = 0.40), Δ₄-A (coef.: -0.028, <i>p</i> = 0.79), and SHBG (coef.: +0.160, <i>p</i> = 0.12) concentrations and the number of follicles ≥ 11 mm on the day of triggering final oocyte maturation. The results of the current study challenge the usefulness of basal serum androgen measurements prior to ovarian stimulation in low responders as predictors of ovarian response.