Reproductive BioMedicine Online 40: 223-228 (2019) – 2019-11-28
Lan N Vuong1,2,3, Manh T Ho2,3, Anh N Ha2,3, Toan D Pham2,3, Tam TN Le2,3, Claus Yding Andersen4, Peter Humaidan5,6
Published: November 28, 2019
Author information
- 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 Chí Minh City, Vietnam
- HOPE Research Center, 4 Nui Thanh Street, Ward 13, Tan Binh District, Ho Chi Minh City, Vietnam
- Laboratory of Reproductive Biology, The Copenhagen University Hospital and Faculty of Health Science, Copenhagen University, Blegdamsvej 3B, 2200 København, Copenhagen, Denmark
- The Fertility Clinic, Skive Regional Hospital, Øster Fælled Vej 5, 7800 Skive, Denmark
- Faculty of Health, Aarhus University, Denmark and Faculty of Health, University of Southern Denmark, Nordre Ringgade 1, 8000, Aarhus C, Denmark
Abstract
Research question
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 IVFMC, 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 gonadotropin-releasing hormone agonist (GnRHa), followed by stimulation with gonadotropins and GnRH antagonist co-treatment for IVF (n=30). Priming consisted of low-dose recombinant human chorionic gonadotropin (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) concentrations 8 weeks after priming. Secondary endpoints included AFC (2-10 mm), serum hCG, testosterone, and progesterone levels.
Results
Circulating testosterone, progesterone, estradiol 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.
KEYWORDS:
Ovarian reserve, Poor response, in vitro fertilization, intra-ovarian androgen priming, Bologna criteria