Infertility, Female Clinical Trial
Official title:
Clinical Effect of Follicular Preparation With Testosterone in Poor Ovarian Response: a Randomized Controlled Clinical Trial (TESTOPRIM)
Trial to determine the absolute and relative efficacy of two follicular preparation regimens with transdermal testosterone during the cycle (s) prior to the initiation of COS (controlled ovarian stimulation) in patients diagnosed with POR (poor ovarian response) for the increase in the number of mature oocytes recovered.
POR is a challenge for reproductive medicine because of its impact on treatment outcomes and
the lack of sufficiently proven therapeutic tools. According to recent publications based on
retrospective studies of large registries, there is a correlation between the number of
oocytes and LBR (live birth rate), so the investigators consider that variable mature oocytes
are a reasonable compromise and a solid substitute for other outcome variables such as LBR or
CPR (clinical pregnancy rate).
Regarding the duration of treatment, the investigators decided to include two groups of
testosterone treatment (compared to the control group) with different duration. One will
explore the role of testosterone in prolonged treatments (two full menstrual cycles). The
other will test the pattern most commonly used in most studies, that is, testosterone in
luteal phase of the previous cycle (about 10 days in short protocol with GnRH antagonist). In
this way the investigators will establish an absolute comparison with the control group and
relative between both treatment groups (long testosterone vs. short testosterone) to
determine if / which of the two regimen (the two, only one or none) improves the number of
mature oocytes recovered.
The product under investigation is testosterone gel, transdermal administration, 50 mg /
single dose (Testim®, Ferring, Madrid, Spain). Regarding the dose, the investigators decided
to keep the most used in the rest of studies (12.5 mg / day).
This study population will include only patients diagnosed with POR based on ESHRE Bologna
criteria, in order to homogenize the population and allow comparisons with other studies in
the future.
Regarding the dose, the investigators decided to keep the most used in the rest of studies
(12.5 mg/day) which so far has been the only one proven effective. It is clearly possible
that lower and more physiological doses are equally effective, but this yet has to be proven
in well-designed studies. The gel is self-administered by the patients who are adequately
instructed by a research nurse.
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