Background: Sex hormone-binding globulin (SHBG) is related to several human systems such as reproductive system and endocrine system. SHBG binds to testosterone and estradiol, therefore we explored ethe role of SHBG on reproductive process. Methods: We carried out secondary analysis of Polycystic Ovary Syndrome and Acupuncture Clinical Trail (PCOSAct) at 21 sites in China, comprising a total of 1000 women with PCOS. A total of 954 women with baseline homocysteine (HCY) were included in the study. Results: Multivariate analysis of predictors of ovulation showed that age, body mass index (BMI), estradiol (E2), total testosterone (T) and SHBG are predictors of ovulation (P=0.0211, 0.0011, 0.0211, 0.0029, 0.0434) whereas luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio is negatively correlated with ovulation (P=0.0539). A multivariate logistic regression model (MLRM) of all baseline serum parameters showed the strongest predictive ability for ovulation, followed by MLRM without SHBG. In addition to treatment, baseline SHBG was the strongest single predictor for ovulation. Patients in higher SHBG quartile showed significantly higher ovulation rate (HR=1.138; 95%CI [1.054,1.229], P=0.0009). Notably, significance was observed after adjustment for testosterone (HR=1.139, 95%CI [1.055,1.229], P=0.0009). However, quartiles of T, free testosterone (FT) and E2 all showed no correlation with ovulation. Kaplan-Meier curves showed that high SHBG is positively correlated with high ovulation, conception and pregnancy rates. Conclusions: Higher baseline SHBG is associated with higher ovulation rate and is an independent predictive marker.Trial registration: ClinicalTrials.gov (No. NCT01573858). Registered 10 April 2012, https://clinicaltrials.gov/ct2/show/NCT01573858?cond=NCT01573858&draw=2&rank=1.
Objective. Our aim was to investigate the effect of age on the outcome of IVF-ET and ICSI in infertile PCOS patients under the guidance of Tiangui theory in traditional Chinese medicine. Method. This was a retrospective analysis of 532 infertile women with PCOS and 1,392 women with infertility due to tubal factors as the controls. All of the participants were divided into different age groups-aged 20–28 years, 29–35 years, and ≥36 years-according to the stages of female reproductive development in Tiangui theory as described in the Canon of Internal Medicine-Treatise of Ancient Natural Truth. We explored the effect of age on controlled ovarian hyperstimulation (including the initial dosage and duration of Gn and the estradiol level on the day of human chorionic gonadotropin administration); the numbers of retrieved oocytes, 2PN zygotes, and embryos; and the rates of fertilization, clinical pregnancy, abortion, live birth, and OHSS incidence. Results. Compared to controls, the maximum follicular diameter and the numbers of follicles with d ≥ 20 mm, retrieved oocytes, and 2PN zygotes were greater in the PCOS group with age >28 years (
p
<
0.05
). The abortion rate of PCOS patients with age ≤28 years was higher than that of the controls. All PCOS groups and the control group showed reduced numbers of retrieved oocytes and live births with age. The difference in age was not significant in the PCOS groups but was significant in the control group (
p
<
0.05
), and the trend in the PCOS groups was more gradual. Conclusion. The fertility of all subjects decreased with age, but PCOS patients decreased more slowly than in controls at the same age, which verified the applicability of the guiding principles of Tiangui theory in the clinic.
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