The Use of Androgen Priming in Women with Reduced Ovarian Reserve Undergoing Assisted Reproductive Technology

2021 ◽  
Author(s):  
Alison Richardson ◽  
Kanna Jayaprakasan
Keyword(s):  
Ovarian Reserve ◽  
Ovarian Response ◽  
Reproductive Technology ◽  
Ivf Outcome ◽  
Poor Ovarian Response ◽  
Vitro Fertilization ◽  
Randomized Controlled ◽  
Meta Analyses

AbstractAndrogen priming with either dehydroepiandrosterone (DHEA) or testosterone has been suggested as an adjunct to improve in vitro fertilization (IVF) outcomes in women with diminished ovarian reserve (DOR). Numerous studies have investigated the effects of both DHEA and testosterone on IVF outcome. The results were inconsistent, and the quality of most studies is substandard. Meta-analyses have consistently reported that DHEA does appear to significantly improve IVF outcome in women with predicted or proven poor ovarian response (POR), but these have included some normal responders and/or nonrandomized studies. Our meta-analyses including randomized controlled trials (RCTs) incorporating only women with DOR or POR suggest that DHEA confers no benefit. While meta-analyses of RCTs on the use of testosterone in women with DOR or POR showed an improved IVF outcome, most studies included are of low quality with high risk of bias. When analysis of data from studies of only low-risk bias was performed, such a benefit with testosterone was not observed. Although recruitment may well be a challenge, a large, well-designed RCT is, however, still warranted to investigate whether or not androgen priming with either DHEA or testosterone should be recommended as an adjuvant treatment for women with DOR or POR undergoing IVF.

scholarly journals Effect of acupuncture on women with poor ovarian response: study protocol for a multicenter randomized controlled trial

2019 ◽  
Author(s):  
yigong Fang ◽  
huanfang Xu ◽  
chensi Zheng ◽  
liyun He ◽  
tongsheng Su ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Ovarian Reserve ◽  
Controlled Trial ◽  
Ovarian Response ◽  
Poor Ovarian Response ◽  
Cleavage Rate ◽  
Vitro Fertilization ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial

Abstract Background: Poor ovarian response (POR), a manifestation of low ovarian reserve and ovarian aging , leads to a significantly reduced pregnancy rate after in vitro fertilization-embryo transfer (IVF-ET) . Acupuncture is effective at improving ovarian reserve. The purpose of this study is to evaluate the effect of acupuncture on increasing the number of retrieved oocytes after controlled ovarian hyperstimulation (COH) in women with POR. Methods: This is a multicenter randomized controlled trial . A total of 140 women with POR will be randomly assigned to receive acupuncture or non-treatment for 12 weeks before COH. The primary outcome will be the number of retrieved oocytes. The secondary outcomes include antral follicle count (AFC), serum level of anti-müllerian hormone (AMH), basal serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) , the score of the self-rating anxiety scale (SAS), the fertilization rate, the cleavage rate, the available embryo rate and the high-quality embryo rate. The safety of acupuncture will also be assessed. Discussion: The results of this trial will identify the effectiveness of acupuncture in the treatment of POR. This will provide a new treatment option for POR patients and physicians.

scholarly journals Stage 2 Acupuncture for Poor Ovarian Response: A Randomized Controlled Trial

2021 ◽  
Vol 10 (10) ◽  
pp. 2182
Author(s):  
Jihyun Kim ◽  
Hoyoung Lee ◽  
Tae-Young Choi ◽  
Joong Il Kim ◽  
Byoung-Kab Kang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Ovarian Response ◽  
Controlled Ovarian Hyperstimulation ◽  
University Hospital ◽  
Ovarian Hyperstimulation ◽  
Poor Ovarian Response ◽  
Vitro Fertilization ◽  
Randomized Controlled

Acupuncture is believed to improve ovarian reserve and reproductive outcomes in women undergoing in vitro fertilization (IVF). This study was conducted to evaluate the effect of network-optimized acupuncture followed by IVF on the oocyte yield in women showing a poor ovarian response. This study was an exploratory randomized controlled trial conducted from June 2017 to January 2020 at the Pusan National University Hospital. Women diagnosed with poor ovarian response were enrolled and randomly divided into two groups: IVF alone and Ac + IVF groups (16 acupuncture sessions before IVF treatment). Eight acupoints with high degree centrality and betweenness centrality were selected using network analysis. Among the participants, compared with the IVF treatment alone, the acupuncture + IVF treatment significantly increased the number of retrieved mature oocytes in women aged more than 37 years and in those undergoing more than one controlled ovarian hyperstimulation cycle. The negative correlation between the number of retrieved mature oocytes and consecutive controlled ovarian hyperstimulation cycles was not observed in the Ac + IVF group irrespective of the maternal age. These findings suggest that physicians can consider acupuncture for the treatment of women with poor ovarian response and aged > 37 years or undergoing multiple IVF cycles.

Predictors of poor ovarian response in in vitro fertilization: a prospective study comparing basal markers of ovarian reserve

2002 ◽  
Vol 77 (2) ◽  
pp. 328-336 ◽  
Author(s):  
László F.J.M.M Bancsi ◽  
Frank J.M Broekmans ◽  
Marinus J.C Eijkemans ◽  
Frank H de Jong ◽  
J.Dik F Habbema ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Prospective Study ◽  
Ovarian Reserve ◽  
Ovarian Response ◽  
Poor Ovarian Response ◽  
Vitro Fertilization ◽  
A Prospective Study

scholarly journals Type and dose of gonadotropins in poor ovarian responders: does it matter?

2021 ◽  
Vol 15 ◽  
pp. 263349412110242
Author(s):  
Liese Boudry ◽  
Annalisa Racca ◽  
Herman Tournaye ◽  
Christophe Blockeel
Keyword(s):  
In Vitro Fertilization ◽  
Ovarian Stimulation ◽  
Ovarian Response ◽  
Oocyte Donation ◽  
Reproductive Technology ◽  
Poor Ovarian Response ◽  
Vitro Fertilization ◽  
Poor Ovarian Responders ◽  
Infertile Patients

Infertile patients with a diminished ovarian reserve, also referred to as poor ovarian responders, constitute a substantial and increasing population of patients undergoing in vitro fertilization. The management of patients with poor ovarian response is still a controversial issue. Almost a century has passed since the introduction of the first gonadotropin. A broad collection of urinary and recombinant gonadotropins, including biosimilars, is commercially available now. Despite great advances in assisted reproductive technology, there remains uncertainty about the optimal treatment regimen for ovarian stimulation in poor ovarian responders. Although oocyte donation is the most successful and ultimate remedy for poor ovarian responders, most patients persist on using their own oocytes in several attempts, to achieve the desired pregnancy. The aim of this review is twofold: first, to provide an overview of the commercially available gonadotropins and summarize the available evidence supporting the use of one or another for ovarian stimulation in poor ovarian responders, and second, to address the controversies on the dosage of gonadotropins for this specific in vitro fertilization population.

scholarly journals Dehydroepiandrosterone supplementation in women undergoing assisted reproductive technology with poor ovarian response. A prospective case-control study

2017 ◽  
Vol 46 (1) ◽  
pp. 143-149 ◽  
Author(s):  
Haifa A. Al-Turki
Keyword(s):  
Pregnancy Rate ◽  
Live Birth ◽  
Case Control Study ◽  
Ovarian Response ◽  
Case Control ◽  
Poor Ovarian Response ◽  
Control Study ◽  
Prospective Case Control Study

Objective The effects of dehydroepiandrosterone (DHEA) supplementation in Saudi Arabian women with poor ovarian response (POR) is presently unknown. The present study aimed to assess the benefits of DHEA supplementation in women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Methods This was a prospective case-control study involving 62 women who were diagnosed with POR and underwent IVF/ICSI between January 2012 and June 2016. The positive influence of DHEA in 34 women, compared with 28 women without supplementation, was defined as improvements in the number of oocytes retrieved, the fertilization rate, the number of grade I embryos generated and the pregnancy rate. Results Both groups were evenly matched for age, body mass index and laboratory test parameters. There were statistically significant differences between the groups with and without DHEA supplementation for oocyte yield (6.35 ± 2.41 versus 3.98 ± 3.2), Grade I embryos generated (55% versus 30%), positive pregnancy rate (21/34 versus 10/28), and live birth rate (18/34 versus 4/28). Conclusion DHEA supplementation in women with POR had a positive effect on hormonal profiles, the quality of the endometrium, the number of oocytes retrieved, the quality of embryos, and the pregnancy and live birth rates.

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