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Short-term androgen priming by use of aromatase inhibitor and hCG before controlled ovarian stimulation for IVF. A randomized controlled trial.
Hum Reprod. 2008 Aug; 23(8):1820-9.HR

Abstract

BACKGROUND

Temporary exposure of follicles to increased levels of androgens may augment follicular responsiveness. The present study tested whether short-term androgen priming by aromatase inhibitor and human chorionic gonadotrophin (hCG) before controlled ovarian stimulation (COS) increases the number of top-quality embryos after IVF/ICSI.

METHODS

Patients were randomized to androgen priming (n = 53): anastrozole 1 mg cycle day (c.d.) 2, 3 and 4, hCG 1250 IU and cetrorelix 3 mg on c.d. 2, rFSH 150 IU from c.d. 5 following a flexible antagonist protocol; or control (n = 50): flexible antagonist protocol.

RESULTS

The mean (confidence interval) number of top-quality embryos was 1.08 (0.83,1.40) and 1.43 (1.12,1.81) in the priming and control group, respectively, being 32% (-7%, 89%) higher in the control compared to priming group (P = 0.120). Stimulation duration was longer in the priming group (P < 0.001). On the day of hCG administration, the proportion of c.d. 2 antral follicles reaching >or=14 mm was higher in the priming group (P = 0.014), as were serum estradiol (E(2)) (P < 0.001) and E(2) per follicle >or=14 mm (P = 0.005). Pre-ovulatory follicular fluid levels of E(2) (P = 0.007) and testosterone (P = 0.014) were higher in the priming group. The number of oocytes retrieved was similar. The fertilization rate was lower in the priming group (P = 0.007). Ongoing pregnancy rates in priming and control group were 30 and 36% (P = 0.531).

CONCLUSIONS

Administration of aromatase inhibitor and hCG before COS for IVF/ICSI failed to improve the number of top-quality embryos.

Authors+Show Affiliations

The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark. kristine.loessl@rh.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18487212

Citation

Lossl, K, et al. "Short-term Androgen Priming By Use of Aromatase Inhibitor and hCG Before Controlled Ovarian Stimulation for IVF. a Randomized Controlled Trial." Human Reproduction (Oxford, England), vol. 23, no. 8, 2008, pp. 1820-9.
Lossl K, Andersen CY, Loft A, et al. Short-term androgen priming by use of aromatase inhibitor and hCG before controlled ovarian stimulation for IVF. A randomized controlled trial. Hum Reprod. 2008;23(8):1820-9.
Lossl, K., Andersen, C. Y., Loft, A., Freiesleben, N. L., Bangsbøll, S., & Andersen, A. N. (2008). Short-term androgen priming by use of aromatase inhibitor and hCG before controlled ovarian stimulation for IVF. A randomized controlled trial. Human Reproduction (Oxford, England), 23(8), 1820-9. https://doi.org/10.1093/humrep/den131
Lossl K, et al. Short-term Androgen Priming By Use of Aromatase Inhibitor and hCG Before Controlled Ovarian Stimulation for IVF. a Randomized Controlled Trial. Hum Reprod. 2008;23(8):1820-9. PubMed PMID: 18487212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short-term androgen priming by use of aromatase inhibitor and hCG before controlled ovarian stimulation for IVF. A randomized controlled trial. AU - Lossl,K, AU - Andersen,C Yding, AU - Loft,A, AU - Freiesleben,N L C, AU - Bangsbøll,S, AU - Andersen,A Nyboe, Y1 - 2008/05/15/ PY - 2008/5/20/pubmed PY - 2008/9/30/medline PY - 2008/5/20/entrez SP - 1820 EP - 9 JF - Human reproduction (Oxford, England) JO - Hum. Reprod. VL - 23 IS - 8 N2 - BACKGROUND: Temporary exposure of follicles to increased levels of androgens may augment follicular responsiveness. The present study tested whether short-term androgen priming by aromatase inhibitor and human chorionic gonadotrophin (hCG) before controlled ovarian stimulation (COS) increases the number of top-quality embryos after IVF/ICSI. METHODS: Patients were randomized to androgen priming (n = 53): anastrozole 1 mg cycle day (c.d.) 2, 3 and 4, hCG 1250 IU and cetrorelix 3 mg on c.d. 2, rFSH 150 IU from c.d. 5 following a flexible antagonist protocol; or control (n = 50): flexible antagonist protocol. RESULTS: The mean (confidence interval) number of top-quality embryos was 1.08 (0.83,1.40) and 1.43 (1.12,1.81) in the priming and control group, respectively, being 32% (-7%, 89%) higher in the control compared to priming group (P = 0.120). Stimulation duration was longer in the priming group (P < 0.001). On the day of hCG administration, the proportion of c.d. 2 antral follicles reaching >or=14 mm was higher in the priming group (P = 0.014), as were serum estradiol (E(2)) (P < 0.001) and E(2) per follicle >or=14 mm (P = 0.005). Pre-ovulatory follicular fluid levels of E(2) (P = 0.007) and testosterone (P = 0.014) were higher in the priming group. The number of oocytes retrieved was similar. The fertilization rate was lower in the priming group (P = 0.007). Ongoing pregnancy rates in priming and control group were 30 and 36% (P = 0.531). CONCLUSIONS: Administration of aromatase inhibitor and hCG before COS for IVF/ICSI failed to improve the number of top-quality embryos. SN - 1460-2350 UR - https://www.unboundmedicine.com/medline/citation/18487212/Short_term_androgen_priming_by_use_of_aromatase_inhibitor_and_hCG_before_controlled_ovarian_stimulation_for_IVF__A_randomized_controlled_trial_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/den131 DB - PRIME DP - Unbound Medicine ER -