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Hum. Reprod. Advance Access originally published online on February 13, 2006
Human Reproduction 2006 21(5):1204-1211; doi:10.1093/humrep/dei481
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Effects of transdermal testosterone application on the ovarian response to FSH in poor responders undergoing assisted reproduction technique—a prospective, randomized, double-blind study

N. Massin1, I. Cedrin-Durnerin1, C. Coussieu2, J. Galey-Fontaine1, J.P. Wolf3 and J.-N. Hugues1,4

1 Reproductive Medicine Unit, Jean Verdier Hospital, University Paris XIII, Bondy, 2 Department of Hormonal Biochemistry, Hotel Dieu Hospital, Paris and 3 Department of Reproductive Biology, Jean Verdier Hospital, University Paris XIII, Bondy, France

4 To whom correspondence should be addressed at: Reproductive Medicine Unit, Jean Verdier Hospital, Avenue du 14 juillet, 93143 Bondy Cedex, France. E-mail: jean-noel.hugues{at}jvr.ap-hop-paris.fr

BACKGROUND: In primates, androgens can play a synergistic role with FSH in promoting the early follicular recruitment, which is critical in assisted reproduction technique programmes. OBJECTIVE: To assess whether poor responders can benefit from androgen application. METHODS: Inclusion criteria were a previous poor ovarian response to controlled ovarian stimulation and a decreased hormonal ovarian reserve. Selected women were randomized to receive either transdermal application of testosterone (n = 24) or placebo (n = 25) gel for 15 days before FSH treatment for a second IVF cycle. Similar GnRH analogue and equivalent FSH daily doses were used in both cycles. The primary outcome was the total number of oocytes retrieved. RESULTS: Testosterone gel application resulted in a significant increase in plasma testosterone levels but did not significantly improve the antral follicle count. Furthermore, after gel application, the main parameters of the ovarian response (numbers of pre-ovulatory follicles, total and mature oocytes and embryos) did not significantly differ between testosterone and placebo-treated patients. CONCLUSION: No significant beneficial effects of androgen administration on the ovarian response to FSH could be demonstrated. However, subsequent clinical trials are needed to determine whether an optimal dose and/or a longer duration of testosterone administration may be helpful.

Key words: androgen/ART/controlled ovarian stimulation/poor responders/testosterone


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