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- Title
Transdermal testosterone may improve ovarian response to gonadotrophins in low-responder IVF patients: a randomized, clinical trial.
- Authors
Francisco Fábregues; Joana Peñarrubia; Montserrat Creus; Dolors Manau; Gemma Casals; Francisco Carmona; Juan Balasch
- Abstract
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, 15.7â61.6; P P = 0.09), the difference reaching statistical significance (81.2 versus 41.1%; P 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.
- Subjects
TESTOSTERONE; TRANSDERMAL medication; GONADOTROPIN; HUMAN in vitro fertilization; OVARIES; FOLLICLE-stimulating hormone; HEALTH outcome assessment; CLINICAL trials
- Publication
Human Reproduction, 2009, Vol 24, Issue 2, p349
- ISSN
0268-1161
- Publication type
Article