Evaluation of a new transdermal testosterone dosage used for 60 days prior to controlled ovarian stimulation in poor responders: preliminary results

Objectives: Studies suggest a beneficial effect of transdermal testosterone (TT) used prior to controlled ovarian stimulation (COS) on reproductive outcomes in poor responders. Our aim was to evaluate the adverse effects and serum concentrations of testosterone, sex hormone-binding globulin (SHBG), and estradiol, following a new TT dosage associated with combined oral contraceptive (COC) before COS in poor responders. Methods: Pilot case-control study in which each patient was her own case-control. Women with poor ovarian response fulfilling Bologna Criteria were recruited and submitted to COS (Control Cycle - CC) to perform ICSI. Those who did not become pregnant were subjected to another COS with previous use of TT (25 mg/48 hours, for 60 days), associated with COC (Testosterone Cycle-TC). Blood samples were taken at the beginning of the first COS (D1); day of first oocyte retrieval (D2), first day of transdermal testosterone use (D3); 60 days after Testo-COC usage (D4); and day of second oocyte retrieval (D5). Adverse effects and serum concentrations of total and free testosterone, estradiol, and SHBG were analyzed. Results: Six women concluded both cycles. Testosterone was higher at D4 than D1 (p=0.009, p=0.041) and D3 (p=0.010, p=0.031). SHBG was higher at D4 than D1 (p=0.028). Estradiol was higher at D2 than D1 (p<0.001) and at D5 than D3 (p=0.001) and D4 (p=0.002). Mild adverse effects were observed. Conclusion: The TT dosage used before COS caused only mild adverse effects and resulted in significantly higher concentrations of total and free testosterone than in basal conditions.