Role of decreased androgens in the ovarian response to stimulation in older women

Capsule:
As decreased ovarian testosterone production with age may compromise ovarian stimulation, we review maneuvers aimed at increasing ovarian testosterone and the likely potentiating effects of insulin-like growth factor I.

Authors:
David R. Meldrum, M.D., R. Jeffrey Chang, M.D., Linda C. Giudice, M.D., Ph.D., Juan Balasch, M.D., Robert L. Barbieri, M.D.

Volume 99, Issue 1, Pages 5-11, January 2013

Abstract:

Ovarian testosterone increases antral follicles and their response to stimulation, it declines with age, and its effects are mediated or potentiated by insulin-like growth hormone-I (IGF-I). Increased circulating insulin and IGF-1, exogenous testosterone, and increased local ovarian testosterone concentrations due to aromatase inhibition or exogenous LH/hCG are all associated with an increased ovarian response to gonadotropins. These factors should be further investigated alone or in combination for enhancing oocyte yield with fertility treatments, particularly in older reproductive age women.

  • Lots of centers are using T enhancements. Really needs some more science. We have some anecdotes.

    • Joe — what are you using in your center? DHEAS , T gel , etc etc. Practice is widely variant here with mostly anecdotal experience. The T lasts longer and raised some concerns about early fetal exposure.

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