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Abstract
Background: Treatment solutions for patients who respond poorly to ovarian stimulation are still less effective and have not reached a consensus. Using testosterone gel has been proven by several studies to increase the number of oocytes retrieved, increase the clinical pregnancy rate and increase the live birth rate in women who respond poorly to ovarian stimulation. Objectives: To compare the results of in vitro fertilization between the group using testosterone gel and the group not using testosterone gel on patients who had poor ovarian response. Methods: A randomized control trial study. Women who met at least two of the criteria:
(1) advanced maternal age (40 years) or any other POR risk factor; (2) A previous incident of POR (cycles canceled or 3 oocytes with a conventional ovarian stimulation protocol); (3) A low ovarian reserve test (AFC ≤ 5-7 or AMH ≤ 0.5-1.1 ng/mL) were enrolled randomly in two groups of this study. The study group (n=62) was prescribed to apply 12.5mg Androgel 1% transdermal daily for 4 weeks prior to ovarian stimulation. The control group (n=60) did not use any treatment. Both groups were undergoing controlled ovarian stimulation with GnRH antagonist protocol, using rFSH. Embryo transfer was conducted on the third day after the oocyte retrieval. The number of oocytes retrieved, mature oocytes, embryos retrieved, and clinical pregnancy rate (CPR) were compared between the two groups. Results: The total number of oocytes retrieved (5.10±2.27 vs. 5.74±2.88; p=0.18) and the number of mature oocytes (4.23±1.89 vs. 4.65±2, 57; p=0.96) tended to be higher in the intervention group, but the difference was not statistically significant. The endometrium in the treatment group was statistically significantly thicker than the control group (10.39±1.69 vs. 11.45±2.03; p=0.00). The implantation rate in the treatment group was statistically significantly higher than the control group (15.38% vs. 4.03%; p=0.00). The rates of pregnancy, clinical pregnancy, and ongoing pregnancy in the treatment group were higher than the control group. The differences were statistically significant as follows (33.33% vs. 13.56%, p=0 .01); (31.67% vs 10.17%, p=0.00); (28.33% vs. 8.47%, p=0.01). Conclusions: Using testosterone gel before ovarian stimulation tends to improve the number of oocytes retrieved and increase the IVF results of patients with poor ovarian response.
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Copyright (c) 2023 Journal of Science and Technology in Medicine and Pharmacy
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