Many women have the frustrating experience of pursuing costly IVF only to have their cycles cancelled and their hopes dashed when poor ovarian response to stimulation eventuates in them being diagnosed as a ‘poor responder.’
Even when massive doses of gonadotropin stimulants are used, some women's ovaries seem recalcitrant to stimulation and do not produce follicles as expected. Many strategies have been pursued to find novel ways of boosting the ovarian response of poor responders, testosterone is one such strategy that may give such women new hope.
Historically, a number of studies have been performed on the benefits of giving poor responders testosterone prior to IVF as a means of improving IVF response. The results have been very positive thus far.
In a 2011 South Korean study, poor responder women were given a transdermal testosterone gel before ovarian stimulation began. In this study poor responders were defined as women who had failed during previous IVFs to produce more that 3 follicles over 16 mm diameter, despite high gonadotropin stimulation.
The 110 women were randomized to receive either transdermal testosterone pretreatment with 12.5 mg daily for 21 days in the cycle preceding the IVF or a placebo. The results of the study showed that the women who received testosterone pretreatment needed less gonadotropin stimulation and had a significantly higher number of oocytes retrieved. They also had more mature oocytes that fertilized and more high quality embryos.
The testosterone pretreated women also had a higher pregnancy rate and there were no adverse effects from the male hormone treatment. The researchers concluded that;
"TTG pretreatment might be beneficial in improving both response to COS and IVF outcome in low responders undergoing IVF/ICSI."
This study echoes the findings of previous studies that have likewise found that pretreatment with testosterone can offer poor responder women a novel, inexpensive and low-risk way to up the odds of IVF succeeding.
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Fertil Steril. 2011 Feb;95(2):679-83.
The effect of transdermal testosterone gel pretreatment on controlled ovarian stimulation and IVF outcome in low responders. Kim CH, Howles CM, Lee HA.