Correlation of Homocysteine and Testosterone Levels with BMI in PCOS AND Non-PCOS Women Undergoing ICSI Procedure

Abstract

Background: Elevated serum homocysteine (Hcy) and testosterone levels are highly linked with polycystic ovary syndrome (PCOS). However, limited information exists regarding the correlation between body mass index (BMI) and these biomarkers in PCOS women undergoing intracytoplasmic sperm injection (ICSI). Serum Hcy measured in genetic and biochemical tests, is thought to influence reproductive function similarly to high testosterone and Hcy levels interact with BMI in women with PCOS is important for evaluation fertility potential compared to non-PCOS women.

Aim: This research investigated the connection between testosterone and Hcy with BMI in infertile women undergoing ICSI and to evaluate the impact of these markers on oocyte quality.

Methods:   Forty infertile women undergoing IVF/ICSI were recruited, including 19 with PCOS and 21 with non-PCOS conditions, such as low AMH or unexplained infertility. Serum Hcy and testosterone levels were measured from cycle day 2 (CD2) to ovum pick-up (OPU) and their association with oocyte maturing were analyzed in both groups. 

Results: PCOS patients were younger and more frequently under 35 years of age compared to non-PCOS women, with similar BMI across groups. PCOS women produced a higher number of total and mature oocytes. Hcy and testosterone levels increased during stimulation in both groups, the Hcy rise was more pronounced in non-PCOS women, whereas testosterone increased more in PCOS patients. Low BMI women with PCOS had a lower CD2 levels of both markers while  the difference was less in higher BMI subgroups.

Conclusion: PCOS patients with lower BMI showed low Hcy at CD2 and testosterone levels but stronger response to hormonal stimulation. These findings reveal the physiological differences among PCOS subtypes that may call for individualized stimulation protocols according to phenotypes