Testosterone does not improve ovarian response in Bologna poor responders: a randomized controlled trial (TESTOPRIM)

Subirá, Jessica; Algaba, Anna; Vázquez, Sheila; Dasí, Roser Taroncher; Robles, Guillermo Mollá; Fabuel, Susana Monzó; Baydal, Virginia; Herreros, Amparo Ruiz; Camuñas, Nuria García; Rubio, José María Rubio

doi:10.1016/j.rbmo.2021.05.021

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…Interestingly, the largest randomized clinical trial which compared 4 and 6 weeks of testosterone application could not find any difference between the 2 groups regarding the number of collected oocytes or IVF out-come ( 37 ). This conclusion was confirmed in another prospective study comparing the effects of 10 to 56 days of androgen gel application to a small number of poor responders ( 38 ). Even if a short supplementation may offer the advantages of lower cost, patient-friendly prescription and reduction in the risk of therapy interruption, these data do not support the concept that a long-term effect of androgens is required to improve folliculogenesis.…”

Section: Therapeutic Strategies In Women Classified As Poseidon Groupmentioning

confidence: 60%

Subtle perturbations of ovarian steroidogenesis in patients classified as Poseidon Group 3. Which consequences for therapeutic strategy?

Hugues

2024

Front. Endocrinol.

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The optimal strategy for stimulation of young women with a low ovarian reserve is still a challenging issue because the physio-pathogeny of this disorder is often unknown. As androgen production by the ovary plays a crucial role in folliculogenesis, it was tempting to speculate that subtle perturbations in ovarian steroidogenesis might participate to the low responsiveness to gonadotrophins. Indeed, in vitro analysis of human luteinized granulosa cells has recently provided evidence for some enzymatic deficits in steroidogenesis and altered response to gonadotrophins. Therefore, improving androgen environment of women classified in Poseidon Group 3 should be considered. In this clinical situation, the potential benefit of androgen supplementation or stimulation of theca cells by LH-activity products are respectively discussed.

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Section: Therapeutic Strategies In Women Classified As Poseidon Groupmentioning

confidence: 60%

Subtle perturbations of ovarian steroidogenesis in patients classified as Poseidon Group 3. Which consequences for therapeutic strategy?

Hugues

2024

Front. Endocrinol.

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“…Previous studies have indicated that PCOS patients with elevated DHEAS levels exhibit higher values of testosterone (T) and androstenedione (A) against those with normal DHEAS levels, potentially indicating a link between abnormal DHEAS levels to metabolic dysfunctions [ 24 ]. Additionally, among patients with diminished ovarian reserve, DHEAS concentrations showed a significant negative correlation with the number of follicles on the day of oocyte maturation triggering [ 33 – 35 ]. However, studies that explored the association between DHEAS levels and PR or LBR in PCOS patients are still limited.…”

Section: Discussionmentioning

confidence: 99%

Impact of dehydroepiandrosterone sulfate and free androgen index on pregnancy and neonatal outcomes in PCOS patients

Zhao,

Li,

Cai

et al. 2024

Reprod Biol Endocrinol

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Background Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder associated with infertility and pregnancy complications. The pathogenesis of PCOS and its impact on reproductive function may be influenced by the source of androgens, including testosterone, free androgen, dehydroepiandrosterone sulfate (DHEAS). However, the differential effects of these androgen on pregnancy and neonatal outcomes and the cut-off value of East Asian population with PCOS remain unclear. Methods A retrospective cohort study was conducted at the Reproductive Medicine Center of the First Affiliated Hospital of Sun Yat-sen University from January 2015 to November 2022, involving 636 cycles of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Subgroup analyses were performed using cut-off values of 6.4 for free androgen index (FAI), 9.5 µmol/L for DHEAS. Pregnancy and neonatal outcomes were compared between groups. Restricted cubic spline (RCS) was used to identify significant cut-off values affecting pregnancy. Results Higher FAI levels (> 6.4) were associated with decrease in clinical pregnancy rate (PR) (50.61% vs. 41.66%, p = 0.024), live birth rate (LBR) (42.42% vs. 32.35%, p = 0.011). When DHEAS levels exceeded 9.5 µmol/L, there was a significant decrease in clinical PR (51.27% vs. 42.73%, P = 0.039), LBR (42.73% vs. 32.73%, P = 0.012). Negative correlations were also observed between DHEAS levels and cumulative pregnancy rate (70.57% vs 56.62% p = 0.002) and cumulative live birth rate (CLBR) (59.35% vs 43.37%, p = 0.0007). Both FAI and DHEAS elevated is associated with the lowest clinical pregnancy rate (37.84%). Conversely, when solely FAI is elevated, the pregnancy rate increases to 52.38%, while an elevation in DHEAS alone is associated with a pregnancy rate of, both of which are lower than when neither FAI nor DHEAS are elevated (60.68%). The live birth rates exhibit a similar trend (30.00% vs 40.00% vs 41.83% vs 44.48%). RCS revealed a significant decrease in CPR and CLBR when DHEA levels exceeded 7.69 umol/L, while the cut-off value of FAI was 6.36 for CPR and CLBR. Conclusion In conclusion, PCOS patients with biochemical hyperandrogenism show unsatisfactory clinical PR and CLBR when undergoing assisted reproductive technology (ART). This may be attributed to the influence of both adrenal-derived DHEAS and ovarian-derived FAI on the unfavorable pregnancy outcomes.

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Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction

Naik,

Lepine,

Nagels

et al. 2024

Cochrane Database of Systematic Reviews

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Testosterone does not improve ovarian response in Bologna poor responders: a randomized controlled trial (TESTOPRIM)

Cited by 5 publications

References 18 publications

Subtle perturbations of ovarian steroidogenesis in patients classified as Poseidon Group 3. Which consequences for therapeutic strategy?

Subtle perturbations of ovarian steroidogenesis in patients classified as Poseidon Group 3. Which consequences for therapeutic strategy?

Impact of dehydroepiandrosterone sulfate and free androgen index on pregnancy and neonatal outcomes in PCOS patients

Androgens (dehydroepiandrosterone or testosterone) for women undergoing assisted reproduction

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