Meta-analysis: testosterone improves IVF success in women with POR

  • Noventa M & al.
  • J Assist Reprod Genet
  • 5 Jan 2019

  • curated by Craig Hicks
  • Clinical Essentials
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Takeaway

  • Pretreatment with testosterone may improve the success of in vitro fertilization (IVF) in patients with poor ovarian response (POR).

Why this matters

  • POR is a major challenge for fertility care providers, especially in older patients, who are at considerably greater risk for IVF failure.

Study design

  • Researchers analyzed 7 randomized controlled trials evaluating the effects of testosterone supplementation on IVF outcomes in patients with POR (N=573).
  • Primary outcome: live birth rate (LBR).
  • Secondary outcomes: clinical pregnancy rate (CPR), miscarriage rate, total and meiosis II (MII) oocytes, total embryos.
  • Funding: None.

Key results

  • Women receiving testosterone showed higher (95% CIs):
    • LBR: risk ratio (RR), 2.29 (1.31-4.01; P=.004).
    • CPR: RR, 2.32 (1.47-3.64; P=.0003).
    • Total oocytes: mean difference (MD), 1.28 (0.83-1.73; P<.00001>
    • MII oocytes: MD, 0.96 (0.28-1.65; P=.006).
    • Total embryos: MD, 1.17 (0.67-1.67; P<.00001>
  • They showed no difference in miscarriage rate (P value not significant).

Limitations

  • Researchers calculated outcomes by pooling the results of a small number of studies, patients, and events.
  • Findings should be confirmed by a large trial with rigorous methodology and inclusion criteria.