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Hum. Reprod. Advance Access published online on February 13, 2006
Human Reproduction, 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
Received August 31, 2005
Revised October 25, 2005
Accepted December 6, 2005

Article

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. Massin 1, I. Cedrin-Durnerin 1, C. Coussieu 2, J. Galey-Fontaine 1, J.P. Wolf 3, and J.-N. Hugues 1 *

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

* To whom correspondence should be addressed.
J.-N. Hugues, E-mail: jean-noel.hugues{at}jvr.ap-hop-paris.fr


  Abstract

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.

Keywords: androgen/ART/controlled ovarian stimulation/poor responders/testosterone.
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