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Testosterone Supplementation in Women with Diminished Ovarian Reserve

Purpose: To evaluate the efficacy of transdermal testosterone as an adjuvant to the standard IVF protocol to improve outcomes in women with diminished ovarian reserve (DOR). 

Background: Women with DOR have extremely low pregnancy rates after IVF cycles, and there are currently few treatment options available. Testosterone supplementation may improve ovarian response to stimulation via enhanced folliculogenesis. 

Methods: This retrospective cohort study analyzed 83 IVF cycles based on inclusion criteria of age < 42 and diagnosis of DOR (basal FSH > 10, AMH < 1, antral follicle count < 6, or history of poor response [< 4 follicles]). Cycles in the control group were carried out using the standard IVF protocol while cycles in the treatment group involved the addition of transdermal testosterone prior to ovarian stimulation. Four primary outcomes were evaluated: total number of oocytes retrieved, number of mature oocytes retrieved, number of embryos generated, and pregnancy potential of the embryos.  

Results: Pretreatment with transdermal testosterone had no impact on the total number of eggs retrieved after ovarian stimulation. Testosterone had a negative impact of the number of mature oocytes retrieved, but had no impact on the number of embryos generated from those oocytes. Pregnancy rates between the treatment and control groups were no different per embryo transfer, but were lower per cycle initiation with testosterone therapy.

Discussions: Within this study population, retrospective analysis of testosterone therapy revealed no improvement in IVF outcomes. A randomized controlled trial is recommended to further investigate this association. 

Topics: Reproductive Endocrinology & Infertility, Team-Based Learning, Problem-Based Learning, CME, GME, Medical Knowledge, Patient Care, Faculty, Resident, Student, 2019, CREOG & APGO Annual Meeting,

General Information


Intended
Audience
Student,Resident,Faculty,
Competencies
Addressed
Patient Care,Medical Knowledge,
Educational
Continuum
GME,CME,
Educational
Focus
Problem-Based Learning,Team-Based Learning,
Clinical Focus
Reproductive Endocrinology & Infertility,

Author Information

Erin Ahart, BA, University of Kansas School of Medicine; Matthew Goering, PhD, HCLD; Courtney Marsh, MD, MPH

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