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Androgens and poor responders: are we ready to take the plunge into clinical therapy?
Renato Fanchin1, Nelly Frydman, Marc Even
1Center of Reproductive Medicine and Biology, Hôpital Antoine Béclère, University Paris-Sud, and INSERM, U782, Clamart. renato.fanchin@abc.aphp.fr
Objective:
To review and summarize data from the scientific literature on the use of androgens to improve ovarian function.
Design:
Review of pertinent literature.
Setting:
University hospital.
Patient(S):
Women exposed to androgens.
Intervention(S):
None.
Main Outcome Measure(S):
Critical review of the literature.
Result(S):
The artificial increase of intra-ovarian androgen concentrations constitutes an attractive concept for improving the deficient ovarian function of poor responders. Data from studies conducted in animals treated with high-dose androgens, together with observations made in hyperandrogenic women or female-to-male transsexuals receiving virilizing androgen doses, indicate that androgens may increase follicle responsiveness to FSH and/or the number of growing follicles in the ovary. Yet, definite clinical demonstration of such a concept still is not available.
Conclusion(S):
Current clinical approaches aiming at increasing androgen availability in the ovary showed conflicting results. Therefore, additional studies using proper strategies to achieving higher intra-ovarian androgen concentrations for longer intervals are required to define the clinical efficiency of androgens in poor responders.
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