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Journal of Assisted Reproduction and Genetics
Published in: Journal of Assisted Reproduction and Genetics 4/2019

01-04-2019 | Testosterone | Assisted Reproduction Technologies

Testosterone therapy for women with poor ovarian response undergoing IVF: a meta-analysis of randomized controlled trials

Authors: Marco Noventa, Amerigo Vitagliano, Alessandra Andrisani, Mija Blaganje, Paola Viganò, Enrico Papaelo, Marco Scioscia, Francesco Cavallin, Guido Ambrosini, Mauro Cozzolino

Published in: Journal of Assisted Reproduction and Genetics | Issue 4/2019

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Abstract

Purpose

The aim of the present systematic review and meta-analysis was to summarize evidence on the effectiveness of testosterone supplementation for poor ovarian responders (POR) on IVF outcomes. The primary outcome was live birth rate (LBR); secondary outcomes were clinical pregnancy rate (CPR), miscarriage rate (MR), total and MII oocytes, and total embryos.

Methods

This meta-analysis of randomized controlled trials (RCTs) evaluates the effects of testosterone administration before/during COS compared with a control group in patients defined as POR. The primary outcome was live birth rate (LBR); secondary outcomes were clinical pregnancy rate (CPR), miscarriage rate (MR), total and MII oocytes, and total embryos. Pooled results were expressed as risk ratio (RR) or mean differences (MD) with 95% confidence interval (95% CI). Sources of heterogeneity were investigated through sensitivity and subgroup analysis. All analyses were performed by using the random-effects model.

Results

Women receiving testosterone showed higher LBR (RR 2.29, 95% CI 1.31–4.01, p = 0.004), CPR (RR 2.32, 95% CI 1.47–3.64, p = 0.0003), total oocytes (MD = 1.28 [95% CI 0.83, 1.73], p < 0.00001), MII oocytes (MD = 0.96 [95% CI 0.28, 1.65], p = 0.006), and total embryos (MD = 1.17 [95% CI 0.67, 1.67], p < 0.00001) in comparison to controls, with no difference in MR (p = ns). Sensitivity and subgroup analysis did not provide statistical changes to the pooled results.

Conclusions

Testosterone therapy seems promising to improve the success at IVF in POR patients. Further RCTs with rigorous methodology and inclusion criteria are still mandatory.
Appendix
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Metadata
Title
Testosterone therapy for women with poor ovarian response undergoing IVF: a meta-analysis of randomized controlled trials
Authors
Marco Noventa
Amerigo Vitagliano
Alessandra Andrisani
Mija Blaganje
Paola Viganò
Enrico Papaelo
Marco Scioscia
Francesco Cavallin
Guido Ambrosini
Mauro Cozzolino
Publication date
01-04-2019
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 4/2019
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-018-1383-2

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