ArticleJournal of endocrinological investigation2026
Impact of concordance between basal LH/FSH ratio and testosterone levels on pregnancy outcomes in patients with PCOS undergoing IVF-ET cycle: a retrospective cohort study.
Article in Journal of endocrinological investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo investigate the association of testosterone levels on ovarian stimulation response in PCOS patients-stratified by serum LH/FSH ratio-undergoing IVF-ET.
methodsA total of 1,354 PCOS patients who underwent fresh embryo transfer were ultimately included in the study. we analyzed and classified it according to the basal LH/FSH ratio values into the following groups: the LH/FSH ≥ 2 group (412 cases) and the LH/FSH < 2 group (942 cases). According to the value of basal serum T level, there were 488 cases in the high T group (> 0.75 ng/ml) and 866 cases in the non-high T group (≤ 0.75 ng/ml), and the outcomes of embryo transfer cycles were compared among the patients in each group.
resultsBased on the LH/FSH ratio and testosterone (T) levels, patients were divided into four groups: Group A (LH/FSH < 2, T ≤ 0.75 ng/ml), Group B (LH/FSH < 2, T > 0.75 ng/ml), Group C (LH/FSH ≥ 2, T ≤ 0.75 ng/ml), and Group D (LH/FSH ≥ 2, T > 0.75 ng/ml). There were no statistically significant differences in embryo quality among the four groups (P > 0.05). Regarding pregnancy outcomes, Group B had the lowest live birth rate (51.56%), which was significantly lower than those of Group A (61.87%), Group C (59.79%), and Group D (68.10%)(P ≤ 0.05). Meanwhile, Group B had the highest miscarriage rate (22.38%), significantly higher than the other three groups (10.98%, 12.43%, and 12.90%) (P ≤ 0.05). After adjusting for confounding factors, logistic regression analysis using Group A as the reference showed that Group B had a significantly increased risk of miscarriage (OR = 2.200, 95% CI = 1.325-3.653, P = 0.002) and a significantly lower live birth rate (OR = 0.719, 95% CI = 0.520-0.994, P = 0.046).
conclusionIn patients with PCOS, a high LH/FSH ratio accompanied by elevated testosterone levels was not strongly associated with the likelihood of achieving a live birth. However, in the subgroup with an LH/FSH ratio ≤ 2, elevated testosterone levels may be associated with a reduced likelihood of live birth and an increased risk of miscarriage.
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