Low Basal Testosterone Levels Linked to Recurrent Pregnancy Loss, confirms study
Researchers have discovered in a new study that women with recurrent pregnancy loss (RPL) have significantly lower levels of total testosterone (TT) than those with no pregnancy complications. The research points out that chronic low basal TT levels can be a factor in poor pregnancy outcomes, and this indicates a possible role for androgens in maintaining pregnancy. This study was published in the European Journal of Obstetrics Gynecology and Reproductive Biology by Yang Zhao and colleagues.
Androgens such as testosterone are important in female reproduction, affecting ovarian function, folliculogenesis, and maintenance of pregnancy. While their role in male fertility is well established, their significance in female fertility is coming to light. The current study was proposed with the aim to explore the association between decreased TT levels and RPL risk, especially in women who are candidates for in vitro fertilization (IVF).
561 women younger than 40 years of age with infertility, normal ovary reserve, and normal ovulation were involved in this study. Subjects were equally divided into two groups: 364 women in the RPL group (having a history of repeated pregnancy loss) and 197 women in the control group (no history of miscarriage). Day 2 serum TT and other sex hormones were assessed. Researchers also evaluated endocrine and coagulation parameters.
Key Findings
• The median TT level was profoundly lower in the RPL group than in the control group (1.21 vs. 1.37 nmol/L, p=0.001).
• Women in the RPL group were older (34 vs. 33 years, p=0.010) than controls.
• Fasting plasma insulin levels were elevated in the RPL group (10.67 vs. 8.84 mU/L, p< 0.001), suggesting potential metabolic distinctions.
• There was a negative correlation between basal levels of TT and frequency of pregnancy loss.
• Women with TT levels less than 1.33 nmol/L were at significantly higher risk of RPL (OR: 1.58, 95% CI: 1.04 – 2.41, p< 0.001).
TT level monitoring in recurrent miscarriage women would allow for identification of at-risk women, potentially leading to hormone-based treatments. The increase in fasting insulin levels in RPL patients also points to a relationship between metabolic health and pregnancy success, which requires further exploration.
The study authors concluded that there was significantly more chance of pregnancy loss among women with TT of less than 1.33 nmol/L. This highlights androgenergic role during maintenance of pregnancy but more investigation should be undertaken regarding their therapeutic as well as prognostic implication in the realm of reproductive medicine.
Reference:
Zhao, Y., He, F., Pan, P., Xu, W., Xu, H., Yang, D., & Zhao, X. (2025). Association between low basal serum total testosterone levels and the risk of recurrent pregnancy loss in women with infertility. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 307, 191–196. https://doi.org/10.1016/j.ejogrb.2025.02.018
