Hum. Reprod. Advance Access published online on December 3, 2008
Human Reproduction, doi:10.1093/humrep/den428
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Transdermal testosterone may improve ovarian response to gonadotrophins in low-responder IVF patients: a randomized, clinical trial
Institut Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine-University of Barcelona, C/Casanova 143, 08036- Barcelona, Spain
1 Correspondence address. Tel: +34-93-2275534; Fax: +34-93-2279325; E-mail: jbalasch{at}ub.edu
BACKGROUND: Studies in macaques have indicated that androgens have some synergistic effects with FSH on folliculogenesis. This study investigated the usefulness of pretreatment with transdermal testosterone in low-responder IVF patients.
METHODS: Randomized clinical trial including 62 infertile women who had a background of the first IVF treatment cycle cancelled because of poor follicular response. Patients were randomized in two treatment groups in their second IVF attempt. In patients in Group 1 (n = 31), transdermal application of testosterone preceding standard gonadotrophin ovarian stimulation under pituitary suppression was used. In Group 2 (n = 31 patients), ovarian stimulation was carried out with high-dose gonadotrophin in association with a minidose GnRH agonist protocol. The primary end-point was the incidence of low-responder patients. The main secondary outcome was the incidence of patients reaching ovum retrieval.
RESULTS: The percentage of cycles with low response was significantly lower in Group 1 than in Group 2 (32.2 versus 71% 95% confidence interval for the difference, 15.7–61.6; P < 0.05). The number of patients with ovum retrieval tended to be higher in Group 1 than in Group 2 (80.6 versus 58.1% P = 0.09), the difference reaching statistical significance (81.2 versus 41.1%; P < 0.05) when only patients having normal basal FSH levels (16 and 17 patients in Groups 1 and 2, respectively) were considered.
CONCLUSIONS: Pretreatment with transdermal testosterone may improve the ovarian sensitivity to FSH and follicular response to gonadotrophin treatment in previous low-responder IVF patients. This approach leads to an increased follicular response compared with a high-dose gonadotrophin and minidose GnRH agonist protocol.
Key words: androgens/IVF/low responders/ovarian stimulation
Submitted on August 10, 2008; resubmitted on November 1, 2008; accepted on November 5, 2008.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  E.H. Dickerson, L.W. Cho, S.D. Maguiness, S.L. Killick, J. Robinson, and S.L. Atkin Insulin resistance and free androgen index correlate with the outcome of controlled ovarian hyperstimulation in non-PCOS women undergoing IVF Hum. Reprod., November 17, 2009; (2009) dep393v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Balasch, F. Fabregues, F. Carmona, R. Casamitjana, and M. Tena-Sempere Ovarian Luteinizing Hormone Priming Preceding Follicle-Stimulating Hormone Stimulation: Clinical and Endocrine Effects in Women with Long-Term Hypogonadotropic Hypogonadism J. Clin. Endocrinol. Metab., July 1, 2009; 94(7): 2367 - 2373. [Abstract] [Full Text] [PDF]
|
|