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Vuong LN, Ho TM, Ha AN, Pham TD, Le TTN, Yding Andersen C, Humaidan P. The effect of intra-ovarian androgen priming on ovarian reserve parameters in Bologna poor responders. Reprod Biomed Online 2019; 40:223-228. [PMID: 31974029 DOI: 10.1016/j.rbmo.2019.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/10/2019] [Accepted: 11/20/2019] [Indexed: 11/30/2022]
Abstract
RESEARCH QUESTION What are the effects of long-term androgen priming in Bologna criteria poor ovarian reserve (POR) patients undergoing IVF? DESIGN This open-label pilot study was conducted at IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam. It included consecutive patients aged 18-41 years who fulfilled Bologna criteria for POR undergoing intra-ovarian androgen priming and ultra-long down-regulation with a gonadotrophin-releasing hormone agonist (GnRHa), followed by stimulation with gonadotrophins and GnRH antagonist co-treatment for IVF (n = 30). Priming consisted of low-dose recombinant human chorionic gonadotrophin (rHCG) 260 IU every second day plus letrozole 2.5 mg/day, both for 8 weeks; priming stopped on the first day of ovarian stimulation. The primary endpoint was serum anti-Müllerian hormone (AMH) concentration 8 weeks after priming. Secondary endpoints included antral follicle count (AFC) (2-10 mm), serum human chorionic gonadotrophin (HCG), testosterone and progesterone levels. RESULTS Circulating testosterone, progesterone, oestradiol and HCG levels remained unchanged during androgen priming; the mean AMH level decreased steadily from 0.49 ng/ml (baseline) to 0.33 ng/ml (8 weeks). AFC was 4-5 throughout the study. A mean of 1.1 ± 0.9 good transferable embryos were obtained; embryo transfer was performed in 15 patients; no ongoing pregnancies were obtained. CONCLUSIONS Long-term intra-ovarian androgen priming in the current set-up had no significant effect on hormone levels, AFC and recruitable follicles after ovarian stimulation in Bologna POR patients undergoing IVF. Further studies are needed to explore other androgen priming protocols and the clinical value of priming regimens in IVF.
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Affiliation(s)
- Lan Ngoc Vuong
- University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, District 5, Ho Chi Minh City, Vietnam; IVFMD, My Duc Hospital, 4 Duong Nui Thanh, Phuong 13, Tan Binh, Ho Chi Minh City, Vietnam; HOPE Research Center, 4 Nui Thanh Street, Ward 13, Tan Binh District, Ho Chi Minh City, Vietnam.
| | - Tuong M Ho
- IVFMD, My Duc Hospital, 4 Duong Nui Thanh, Phuong 13, Tan Binh, Ho Chi Minh City, Vietnam; HOPE Research Center, 4 Nui Thanh Street, Ward 13, Tan Binh District, Ho Chi Minh City, Vietnam
| | - Anh N Ha
- IVFMD, My Duc Hospital, 4 Duong Nui Thanh, Phuong 13, Tan Binh, Ho Chi Minh City, Vietnam; HOPE Research Center, 4 Nui Thanh Street, Ward 13, Tan Binh District, Ho Chi Minh City, Vietnam
| | - Toan D Pham
- IVFMD, My Duc Hospital, 4 Duong Nui Thanh, Phuong 13, Tan Binh, Ho Chi Minh City, Vietnam; HOPE Research Center, 4 Nui Thanh Street, Ward 13, Tan Binh District, Ho Chi Minh City, Vietnam
| | - Tam T N Le
- IVFMD, My Duc Hospital, 4 Duong Nui Thanh, Phuong 13, Tan Binh, Ho Chi Minh City, Vietnam; HOPE Research Center, 4 Nui Thanh Street, Ward 13, Tan Binh District, Ho Chi Minh City, Vietnam
| | - Claus Yding Andersen
- Laboratory of Reproductive Biology, The Copenhagen University Hospital and Faculty of Health Science, Copenhagen University, Blegdamsvej 3B, 2200 København, Copenhagen, Denmark
| | - Peter Humaidan
- The Fertility Clinic, Skive Regional Hospital, Øster Fælled Vej 5, Skive 7800, Denmark; Faculty of Health, Aarhus University, Denmark and Faculty of Health, University of Southern Denmark, Nordre Ringgade 1, Aarhus C 8000, Denmark
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