Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, South Korea.
Fertil Steril. 2011 Feb;95(2):679-83. doi: 10.1016/j.fertnstert.2010.07.1077.
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).
Prospective randomized controlled trial.
University-affiliated infertility clinic.
PATIENT(S): 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.
INTERVENTION(S): 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.
MAIN OUTCOME MEASURE(S): COS results and IVF outcome.
RESULT(S): 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.
CONCLUSION(S): TTG pretreatment might be beneficial in improving both response to COS and IVF outcome in low responders undergoing IVF/ICSI.
探讨经皮睾酮凝胶（TTG）治疗对 GnRH 拮抗剂多剂量方案（MDP）控制性卵巢刺激（COS）前低反应者行体外受精/卵胞浆内单精子注射（ICSI）的疗效。
前瞻性随机对照试验。
大学附属不孕不育诊所。
共 110 例低反应者，定义为在前一次失败的 IVF/ICSI 周期中使用高剂量促性腺激素（>2500IU）仍未能产生≥16mm 平均直径的≤3 个卵泡，从而仅获得≤3 个卵母细胞的患者。
患者随机分为 TTG 预处理组或对照组。对于 TTG 预处理组，在 COS 前的周期中，每天应用 12.5mg TTG，共 21 天。
COS 结果和 IVF 结局。
两组患者的特征无差异。TTG 预处理组的总 rhFSH 剂量和天数明显少于对照组。TTG 预处理组的获卵数、成熟卵母细胞数、受精卵数和优质胚胎数明显更高。胚胎着床率和每周期启动的临床妊娠率也明显更高。没有患者报告归因于 TTG 使用的不良反应。
TTG 预处理可能有益于改善低反应者行 IVF/ICSI 的 COS 反应和 IVF 结局。
