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

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

Research output: Contribution to journalReview article

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.

Original languageEnglish
Pages (from-to)673-683
Number of pages11
JournalJournal of Assisted Reproduction and Genetics
Volume36
Issue number4
DOIs
Publication statusPublished - Apr 15 2019

Keywords

  • Clinical pregnancy rate
  • IVF outcome
  • Live birth rate
  • Poor ovarian responders
  • Supplementation
  • Testosterone

ASJC Scopus subject areas

  • Reproductive Medicine
  • Genetics
  • Obstetrics and Gynaecology
  • Developmental Biology
  • Genetics(clinical)

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    Noventa, M., Vitagliano, A., Andrisani, A., Blaganje, M., Viganò, P., Papaelo, E., Scioscia, M., Cavallin, F., Ambrosini, G., & Cozzolino, M. (2019). Testosterone therapy for women with poor ovarian response undergoing IVF: a meta-analysis of randomized controlled trials. Journal of Assisted Reproduction and Genetics, 36(4), 673-683. https://doi.org/10.1007/s10815-018-1383-2