Departments of Obstetrics and Gynecology, Hadassah Ein-Kerem Medical Centre, The Hebrew University, Jerusalem, Israel.
Reprod Biomed Online. 2009 Dec;19(6):888-98. doi: 10.1016/j.rbmo.2009.09.012.
The objective of the current report was to provide a summary of knowledge concerning the treatment of women with poor ovarian response with androgens and androgen modulating agents. This involved a review of the literature. The literature search was performed using PubMed. Information concerning the role of androgens and androgen modulating agents in treating women with poor ovarian response is limited. The search of the literature yielded five studies and one case report concerning the treatment of poor responders with androgens. The variations in patient selection, type of androgens employed and the different duration of exposure preclude drawing any definite conclusions. Aromatase inhibitors block the conversion of androgens to oestrogens, thereby promoting an androgen-rich intrafollicular environment. The evidence presented in this review suggests a potential beneficial role for the use of aromatase inhibitors in treating women who have previously experienced failure of standard IVF protocols. The optimal dose and duration of this treatment is yet to be determined. Although the results of studies concerning LH supplementation in poor responders are conflicting, the latest Cochrane review on the use of recombinant LH for ovarian stimulation supports its use in poor responders, based on pooled pregnancy estimates.
本报告的目的是总结有关雄激素和雄激素调节剂治疗卵巢反应不良女性的知识。这涉及到文献复习。文献检索使用了 PubMed。关于雄激素和雄激素调节剂在治疗卵巢反应不良女性中的作用的信息有限。文献检索共获得了五项研究和一份关于雄激素治疗卵巢反应不良患者的病例报告。由于患者选择、使用的雄激素类型和不同的暴露时间存在差异，因此无法得出明确的结论。芳香化酶抑制剂可阻止雄激素转化为雌激素，从而促进富含雄激素的卵泡内环境。本综述中提出的证据表明，使用芳香化酶抑制剂治疗之前标准 IVF 方案失败的女性可能具有潜在的益处。这种治疗的最佳剂量和持续时间仍有待确定。尽管关于 LH 补充治疗卵巢反应不良患者的研究结果存在争议，但最近关于重组 LH 用于卵巢刺激的 Cochrane 综述支持在卵巢反应不良患者中使用 LH，这是基于汇总的妊娠估计。
