title: Pretreatment with transdermal testosterone may improve ovarian response to gonadotrophins in poor-responder IVF patients with normal basal concentrations of FSH.
abstract: BACKGROUND
  Treatment of poor-responder patients to controlled ovarian stimulation for assisted reproduction, who have normal basal FSH concentrations, is one of the most difficult challenges in reproductive medicine. This study investigated the usefulness of testosterone pretreatment in such patients.
  
  
  METHODS
  Prospective, therapeutic, self-controlled clinical trial including 25 consecutive infertile patients who had a background of the first and second IVF treatment cycle cancellations due to poor follicular response, in spite of vigorous gonadotrophin ovarian stimulation and having normal basal FSH levels. In the third IVF attempt, all patients received transdermal testosterone treatment (20 microg/kg per day) during the 5 days preceding gonadotrophin treatment.
  
  
  RESULTS
  Twenty patients (80%) showed an increase of over fivefold in the number of recruited follicles, produced 5.8+/-0.4 (mean+/-SEM) oocytes, received two or three embryos and achieved a clinical pregnancy rate of 30% per oocyte retrieval. There were 20% cancelled cycles.
  
  
  CONCLUSIONS
  Pretreatment with transdermal testosterone may be a useful approach for women known to be low responders on the basis of a poor response to controlled ovarian stimulation but having normal basal FSH concentrations.
authors.affiliation: Institut Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Spain. jbalasch@ub.edu
authors.forename: Juan
authors.initials: J
authors.lastname: Balasch
authors.forename: Francisco
authors.initials: F
authors.lastname: Fábregues
authors.forename: Joana
authors.initials: J
authors.lastname: Peñarrubia
authors.forename: Francisco
authors.initials: F
authors.lastname: Carmona
authors.forename: Roser
authors.initials: R
authors.lastname: Casamitjana
authors.forename: Montserrat
authors.initials: M
authors.lastname: Creus
authors.forename: Dolors
authors.initials: D
authors.lastname: Manau
authors.forename: Gemma
authors.initials: G
authors.lastname: Casals
authors.forename: Juan A
authors.initials: JA
authors.lastname: Vanrell
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000735:Androstenedione / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D043373:Follicle Stimulating Hormone, Human / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007986:Luteinizing Hormone / Q000097:blood; D009865:Oocytes; D006080:Ovarian Follicle / Q000187:drug effects / Q000254:growth & development; D010053:Ovary / Q000187:drug effects / Q000502:physiology*; D011247:Pregnancy; D018873:Pregnancy Rate; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000008:administration & dosage* / Q000097:blood; D020858:Tissue and Organ Harvesting / Q000379:methods
chemical_list: D043373:Follicle Stimulating Hormone, Human; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D000735:Androstenedione; D004958:Estradiol; D007334:Insulin-Like Growth Factor I; D007986:Luteinizing Hormone