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Androgen supplementation in assisted reproduction

where are we in 2019?

Montoya-Botero, Pedroa,b; Rodriguez-Purata, Jorgea; Polyzos, Nikolaos P.a,c,d

Current Opinion in Obstetrics and Gynecology: June 2019 - Volume 31 - Issue 3 - p 188–194
doi: 10.1097/GCO.0000000000000532
FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. García Velasco

Purpose of review The purpose of this review is to provide an overview of androgen supplementation in ART with the most updated evidence, from animal studies to its clinical applications in poor ovarian responders (POR) and the future studies to be published.

Recent findings Animal studies, has shown that testosterone supplementation, can be an option to increase the recruitable follicular pool in POR. However, the potential mechanism of action, dose, and duration of treatment is still under investigation. Early studies in humans reported promising results in favor of androgens [dehydroepiandrosterone (DHEA) or testosterone] in POR. Nevertheless, recent evidence does not appear to follow the initial results, whereas the type, dose, and duration of testosterone administration appear to be crucial for treatment effect.

Summary Testosterone seems to play an essential role in regulating ovarian function. However, it is worrisome that androgens are used off-label, despite that the available evidence is weak. Although testosterone supplementation may be beneficial in POR, published studies have used inconsistent doses and duration of administration. An ongoing trial (T-TRANSPORT trial) for the first time aims to provide conclusive evidence on whether transdermal testosterone administration can improve the reproductive outcomes in patients undergoing IVF/ICSI.

aDepartment of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain

bConceptum – Unidad de Fertilidad del Country, Bogotá, Colombia

cDepartment of Surgical and Clinical Science, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium

dDepartment of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark

Correspondence to Nikolaos P. Polyzos, MD, PhD, Department of Reproductive Medicine, Dexeus University Hospital, Gran Via de Carles III, 71–75, Barcelona 08022, Spain. E-mail:;

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