Department of Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain.
Conceptum - Unidad de Fertilidad del Country, Bogotá, Colombia.
Curr Opin Obstet Gynecol. 2019 Jun;31(3):188-194. doi: 10.1097/GCO.0000000000000532.
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.
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.
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.
本文综述了雄激素在辅助生殖技术（ART）中的应用，提供了最新的证据，从动物研究到其在卵巢反应不良（POR）患者中的临床应用，以及未来将要发表的研究。
动物研究表明，睾酮补充剂可能是增加 POR 募集卵泡池的一种选择。然而，其潜在的作用机制、剂量和治疗持续时间仍在研究中。早期的人类研究报告了支持雄激素[脱氢表雄酮（DHEA）或睾酮]在 POR 中应用的有前景的结果。然而，最近的证据似乎与最初的结果不符，而睾酮的给药类型、剂量和持续时间似乎对治疗效果至关重要。
睾酮似乎在调节卵巢功能中起着重要作用。然而，令人担忧的是，尽管现有证据薄弱，但雄激素仍被滥用于非适应证。尽管睾酮补充可能对 POR 有益，但已发表的研究使用了不一致的剂量和治疗持续时间。一项正在进行的试验（T-TRANSPORT 试验）首次旨在提供确凿的证据，证明经皮给予睾酮是否可以改善接受 IVF/ICSI 的患者的生殖结局。
