Testosterone for poor ovarian responders: Lessons from ovarian physiology

Nikolaos P Polyzos, Susan R Davis, Panagiotis Drakopoulos, Peter Humaidan, Christian De Geyter, Antonio Gosalvez Vega, Francisca Martinez, Evangelos Evangelou, Arne van der Vijver, Johan Smitz, Herman Tournaye, Pedro Barri, T-TRANSPORT Investigators Group

Research output: Contribution to journalLetterOtherpeer-review

Abstract

Testosterone, an androgen that directly binds to the androgen receptor, has been shown in previous small randomized controlled trials to increase the reproductive outcomes of poor ovarian responders. In most of these studies, transdermal testosterone in relatively high doses was administered before ovarian stimulation with a duration varying from 5 to 21 days. Nevertheless, the key question to be asked is whether, based on ovarian physiology and testosterone pharmacokinetics, a short course of testosterone administration of more than 10 mg could be expected to have any beneficial effect on reproductive outcome. The rationale for asking this question lies in the existing scientific evidence derived from basic research and animal studies regarding the action of androgens during folliculogenesis, showing that their main effect in follicular development is defined during the earlier developmental stages. In addition, extreme testosterone excess is not only likely to induce adverse events but has also the potential to be ineffective and even detrimental. Thus, evidence from clinical studies is not enough to either “reopen” or “close” the “androgen chapter” in poor responders, mainly because the short administration and the high dose of testosterone is not in line with the ovarian actions of androgens and the presence of androgen receptors during follicular development.

Original languageEnglish
Pages (from-to)980-982
Number of pages3
JournalReproductive Sciences
Volume25
Issue number7
DOIs
Publication statusPublished - 1 Jan 2018

Keywords

  • Infertility
  • Poor ovarian response
  • Poor responders
  • Testosterone

Cite this

Polyzos, N. P., Davis, S. R., Drakopoulos, P., Humaidan, P., De Geyter, C., Vega, A. G., ... T-TRANSPORT Investigators Group (2018). Testosterone for poor ovarian responders: Lessons from ovarian physiology. Reproductive Sciences, 25(7), 980-982. https://doi.org/10.1177/1933719116660849
Polyzos, Nikolaos P ; Davis, Susan R ; Drakopoulos, Panagiotis ; Humaidan, Peter ; De Geyter, Christian ; Vega, Antonio Gosalvez ; Martinez, Francisca ; Evangelou, Evangelos ; van der Vijver, Arne ; Smitz, Johan ; Tournaye, Herman ; Barri, Pedro ; T-TRANSPORT Investigators Group. / Testosterone for poor ovarian responders : Lessons from ovarian physiology. In: Reproductive Sciences. 2018 ; Vol. 25, No. 7. pp. 980-982.
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Polyzos, NP, Davis, SR, Drakopoulos, P, Humaidan, P, De Geyter, C, Vega, AG, Martinez, F, Evangelou, E, van der Vijver, A, Smitz, J, Tournaye, H, Barri, P & T-TRANSPORT Investigators Group 2018, 'Testosterone for poor ovarian responders: Lessons from ovarian physiology' Reproductive Sciences, vol. 25, no. 7, pp. 980-982. https://doi.org/10.1177/1933719116660849

Testosterone for poor ovarian responders : Lessons from ovarian physiology. / Polyzos, Nikolaos P; Davis, Susan R; Drakopoulos, Panagiotis; Humaidan, Peter; De Geyter, Christian; Vega, Antonio Gosalvez; Martinez, Francisca; Evangelou, Evangelos; van der Vijver, Arne; Smitz, Johan; Tournaye, Herman; Barri, Pedro; T-TRANSPORT Investigators Group.

In: Reproductive Sciences, Vol. 25, No. 7, 01.01.2018, p. 980-982.

Research output: Contribution to journalLetterOtherpeer-review

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T2 - Lessons from ovarian physiology

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AU - Davis, Susan R

AU - Drakopoulos, Panagiotis

AU - Humaidan, Peter

AU - De Geyter, Christian

AU - Vega, Antonio Gosalvez

AU - Martinez, Francisca

AU - Evangelou, Evangelos

AU - van der Vijver, Arne

AU - Smitz, Johan

AU - Tournaye, Herman

AU - Barri, Pedro

AU - T-TRANSPORT Investigators Group

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N2 - Testosterone, an androgen that directly binds to the androgen receptor, has been shown in previous small randomized controlled trials to increase the reproductive outcomes of poor ovarian responders. In most of these studies, transdermal testosterone in relatively high doses was administered before ovarian stimulation with a duration varying from 5 to 21 days. Nevertheless, the key question to be asked is whether, based on ovarian physiology and testosterone pharmacokinetics, a short course of testosterone administration of more than 10 mg could be expected to have any beneficial effect on reproductive outcome. The rationale for asking this question lies in the existing scientific evidence derived from basic research and animal studies regarding the action of androgens during folliculogenesis, showing that their main effect in follicular development is defined during the earlier developmental stages. In addition, extreme testosterone excess is not only likely to induce adverse events but has also the potential to be ineffective and even detrimental. Thus, evidence from clinical studies is not enough to either “reopen” or “close” the “androgen chapter” in poor responders, mainly because the short administration and the high dose of testosterone is not in line with the ovarian actions of androgens and the presence of androgen receptors during follicular development.

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Polyzos NP, Davis SR, Drakopoulos P, Humaidan P, De Geyter C, Vega AG et al. Testosterone for poor ovarian responders: Lessons from ovarian physiology. Reproductive Sciences. 2018 Jan 1;25(7):980-982. https://doi.org/10.1177/1933719116660849