Chung-Hoon Kim1, Colin M Howles, Hyang-Ah Lee. 1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, South Korea. chnkim@amc.seoul.kr
Abstract
OBJECTIVE: To investigate the effectiveness of treatment with transdermal testosterone gel (TTG) before controlled ovarian stimulation (COS) using GnRH antagonist multiple-dose protocol (MDP) in low responders undergoing IVF/intracytoplasmic sperm injection (ICSI). DESIGN: Prospective randomized controlled trial. SETTING: University-affiliated infertility clinic. PATIENT(S): A total of 110 low responders, who were defined as patients who failed to produce ≤ 3 follicles with a mean diameter of ≥ 16 mm with the result that ≤ 3 oocytes were retrieved despite the use of a high gonadotropin dose (>2,500 IU) in a previous failed IVF/ICSI cycle. INTERVENTION(S): Patients were randomized into TTG pretreatment group or control group. For TTG pretreatment group, 12.5 mg TTG were applied daily for 21 days in the cycle preceding COS for IVF. MAIN OUTCOME MEASURE(S): COS results and IVF outcome. RESULT(S): There were no differences in patients' characteristics between the two groups. Total dose and days of rhFSH used were significantly fewer in the TTG pretreatment group than in the control group. The numbers of oocytes retrieved, mature oocytes, fertilized oocytes, and good-quality embryos were significantly higher in the TTG pretreatment group. Embryo implantation rate and clinical pregnancy rate per cycle initiated also were significantly higher in the women pretreated with TTG. No patient reported adverse effects attributed to TTG use. CONCLUSION(S): TTG pretreatment might be beneficial in improving both response to COS and IVF outcome in low responders undergoing IVF/ICSI.
RCT Entities:
OBJECTIVE: To investigate the effectiveness of treatment with transdermal testosterone gel (TTG) before controlled ovarian stimulation (COS) using GnRH antagonist multiple-dose protocol (MDP) in low responders undergoing IVF/intracytoplasmic sperm injection (ICSI). DESIGN: Prospective randomized controlled trial. SETTING: University-affiliated infertility clinic. PATIENT(S): A total of 110 low responders, who were defined as patients who failed to produce ≤ 3 follicles with a mean diameter of ≥ 16 mm with the result that ≤ 3 oocytes were retrieved despite the use of a high gonadotropin dose (>2,500 IU) in a previous failed IVF/ICSI cycle. INTERVENTION(S): Patients were randomized into TTG pretreatment group or control group. For TTG pretreatment group, 12.5 mg TTG were applied daily for 21 days in the cycle preceding COS for IVF. MAIN OUTCOME MEASURE(S): COS results and IVF outcome. RESULT(S): There were no differences in patients' characteristics between the two groups. Total dose and days of rhFSH used were significantly fewer in the TTG pretreatment group than in the control group. The numbers of oocytes retrieved, mature oocytes, fertilized oocytes, and good-quality embryos were significantly higher in the TTG pretreatment group. Embryo implantation rate and clinical pregnancy rate per cycle initiated also were significantly higher in the women pretreated with TTG. No patient reported adverse effects attributed to TTG use. CONCLUSION(S): TTG pretreatment might be beneficial in improving both response to COS and IVF outcome in low responders undergoing IVF/ICSI.
Authors: Ludmila Bercaire; Sara Mb Nogueira; Priscila Cm Lima; Vanessa R Alves; Nilka Donadio; Artur Dzik; Mario Cavagna Journal: JBRA Assist Reprod Date: 2018-03-01
Authors: Erica T Wang; Michael P Diamond; Ruben Alvero; Peter Casson; Gregory M Christman; Christos Coutifaris; Karl R Hansen; Fangbai Sun; Richard S Legro; Randal D Robinson; Rebecca S Usadi; Margareta D Pisarska; Nanette F Santoro; Heping Zhang Journal: Fertil Steril Date: 2020-03 Impact factor: 7.329