Effects of exogenous testosterone supplementation in gonadotrophin stimulated cycles

Abstract

Despite increased testosterone levels, a short course of androgens had no significant effect on the number of follicles over 10 mm during stimulation with FSH in women of late reproductive age.

Androgens and poor responders: are we ready to take the plunge into clinical therapy?

“…Yet the positive effects of increasing androgen availability in the ovary, in particular, in women displaying a reduced number of growing follicles and/or follicle responsiveness to FSH still have to be clearly demonstrated in properly designed investigations. It is possible that the lukewarm results of studies aiming to examine the effects of exogenous (34)(35)(36)(37)(38)(39)(40) or endogenous (38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48) androgens are, at least in part, due to methodological limitations, such as dose and duration of treatment. The ''androgen hypothesis'' remains interesting and plausible and should be examined in further prospective and randomized clinical trials.…”

“…Massin et al (39), in a placebo-controlled study, failed to show any improvement in ovarian response to COH in 24 poor responders having received T gel (15 mg/d) during the 15 days before the start of FSH treatment. The lack of effectiveness of T pretreatment observed by Massin et al (39) was later confirmed by another study that used 2.5-mg T patches during 12 days before FSH administration (40). The inconclusive results regarding the effectiveness of T pretreatment to improving ovarian response to COH may at least in part be due to problems linked to the intraovarian bioavailability of such a steroid administered systemically at nonvirilizing doses.…”

“…In an effort to achieve a sufficient increase in androgen availability at the ovarian level, some clinical approaches have been proposed. The most straightforward of them undoubtedly is the systemic administration of either DHEA (34)(35)(36) or T (37)(38)(39)(40). Yet, this approach depends on the amount of androgens that effectively become available to ovarian follicles.…”

Role of decreased androgens in the ovarian response to stimulation in older women

“…In a very small group of normal women averaging 42 years of age with a mean AFC of over 12, luteal administration of a T patch for 12 days failed to affect the response to a small dose of FSH (75 IU) (42). Cai et al (15) have shown that only poor responders to a stronger gonadotropin stimulus have reduced GC FSH receptor activity, and (as noted earlier) poor responders have a marked decrease of follicular fluid IGF-I (37).…”

Successful controlled ovarian stimulation despite elevated hCG levels after first-trimester abortion in the context of fertility preservation

“…hCG could have resulted in an androgen linked priming effect on the follicular recruitment. Pretreatment with testosterone may improve the oocyte retrieval rate [8], but results in randomized controlled studies are not conclusive yet [9].…”