Effect Of Androgen Supplementation For Women With Diminished Ovarian Reserve: A Meta-analysis

Objective: To evaluate the effectiveness and safety of androgensupplements(testosterone or dehydroepiandrostereone) for women withdiminished ovarian function. Methods：The databases such as CNKI(1994to2012),VIP(1989to2012),WanFang Data(1982to2012), PubMed（1966-2012）,Cochrane Library and FMJS(2000to2012) were searched and related journalsto identify randomized controlled trials(RCTs) on the effectiveness ofthe androgen supplements (testosterone or dehydroepiandrostereone) forwomen with diminished ovarian reserve or poor ovarian response.Thequality of the retrieved trials was critically appraised andmeta-analyses were conducted using RevMan5.1software. Results：Fourpublished RCTs involving258participants were included.All of them werepublished in English and methoclogical quality ara graded B.The resultsof meta-analyses showed there were no significant differences betweenandrogen supplement group and control group in the number of oocytesretrieved[WMD=0.51，95%CI（-0.66，1.68），P=0.39] and endometrial thicknesson hCG day[WMD=-0.13，95%CI（-0.46，0.20），P=0.44].The total dose ofgonadotrophins used was significantly lowe in those with androgensupplementation compared with those without androgensupplememtation[WMD=-462.66，95%CI （-612.90，-312.42），P<0.00001].Clinical pregnancy rate[RR=2.06，95%CI（1.17，3.61），P=0.01]and ongoing pregnancy rate[RR=2.08，95%CI（1.10，3.93），P=0.02] showeda significantly higher in the study group compared with the controlgroup.Conclusions：There were no significant differences between androgen supplement group and control group in the number of oocytes retrieved andendometrial thickness on hCG day. The total dose of gonadotrophins usedwas significantly lowe in those with androgen supplementation. Clinicalpregnancy rate and ongoing pregnancy rate showed a significantly higherin the study group compared with the control group. The existing evidenceprovides a treatment hope to the women with diminished ovarian functionor poor ovarian response.The above conclusion still needs morewell-designed,multi-center,and large-scal RCTs to confirm and update.