The effect of transdermal testosterone gel pretreatment on controlled ovarian stimulation and IVF outcome in low responders.
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).


METHODS
Prospective randomized controlled trial.


METHODS
University-affiliated infertility clinic.


METHODS
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.


METHODS
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.


METHODS
COS results and IVF outcome.


RESULTS
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.


CONCLUSIONS
TTG pretreatment might be beneficial in improving both response to COS and IVF outcome in low responders undergoing IVF/ICSI.
Kim
Chung-Hoon
CH
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
Howles
Colin M
CM
Lee
Hyang-Ah
HA
D000279:Administration, Cutaneous; D000328:Adult; D002452:Cell Count; D004334:Drug Administration Schedule; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D005782:Gels / Q000008:administration & dosage; D006801:Humans; D007247:Infertility, Female / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010053:Ovary / Q000187:drug effects / Q000473:pathology; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013739:Testosterone / Q000008:administration & dosage* / Q000494:pharmacology; D013997:Time Factors; D017211:Treatment Failure
D005782:Gels; D013739:Testosterone