Abstract
In order to identify and describe the effectiveness of transdermal testosterone pretreatment on poor ovarian responders, MEDLINE, EMBASE, the Cochrane library and the Chinese biomedical database were searched for randomized controlled trials (RCTs). Three RCTs, which compared the outcomes of female pretreatment with transdermal testosterone prior to in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) with those of control groups, were included in the present review. The three RCTs enrolled a total of 221 randomized subjects. The meta-analysis revealed that females who received transdermal testosterone treatment prior to their IVF/ICSI cycle had a two-fold increase in live birth rate [risk ratio (RR)=2.01, 95% confidence interval (CI) 1.03–3.91], clinical pregnancy rate (RR=2.09, 95% CI 1.14–3.81) and a significantly more oocyte retrieved [mean difference (MD)=1.36, 95% CI 0.82–1.90]. The current findings provide evidence that pretreatment with transdermal testosterone may improve the clinical outcomes for poor ovarian responders undergoing IVF/ICSI. However, the results should be interpreted with caution due to the small sample size of the studies used and the heterogeneities. Further good quality RCTs would be needed to reach further conclusions.
Highlights
Poor ovarian response to controlled ovarian hyperstimulation (COH) remains a major problem in assisted reproduction
Pretreatment of poor ovarian responders with androgen or androgen-modulating agents has been a popular topic for debate for many years, with one other systematic review already published in this area
The results of the meta-analysis did not reveal any significant differences in the number of oocytes retrieved and the ongoing pregnancy/live birth rate with androgen supplementation or modulation compared with the control group
Summary
Poor ovarian response to controlled ovarian hyperstimulation (COH) remains a major problem in assisted reproduction. Numerous techniques and therapies have been developed in an effort to improve success in the poor responders, but few have met with success [3,4] Androgens and their ovarian receptors have been shown to play an important role in ovarian physiology and follicular growth by numerous studies [5,6,7]. The main androgen treatments involve direct androgen supplementation [including dehydroepiandrosterone (DHEA) and testosterone] and the indirect increase of intra‐ovarian androgen levels The latter has been achieved through aromatase inhibitors (anastrozole and letrozole), which are able to elevate intra-ovarian androgen levels by blocking the conversion of androgen substrate to estrogen [8]. The aim of the present study was to review the current studies available on the use of transdermal testosterone in poor ovarian responders undergoing IVF/ICSI
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
