Androgens and poor responders: are we ready to take the plunge into clinical therapy?

Objective: To review and summarize data from the scientific literature on the use of androgens to improve ovarian function. Design: Review of pertinent literature. Setting: University hospital. Patient(s): Women exposed to androgens. Intervention(s): None. Main Outcome Measure(s): Critical review of the literature. Result(s): The artificial increase of intra-ovarian androgen concentrations constitutes an attractive concept for improving the deficient ovarian function of poor responders. Data from studies conducted in animals treated with high-dose androgens, together with observations made in hyperandrogenic women or female-to-male transsexuals receiving virilizing androgen doses, indicate that androgens may increase follicle responsiveness to FSH and/or the number of growing follicles in the ovary. Yet, definite clinical demonstration of such a concept still is not available. Conclusion(s): Current clinical approaches aiming at increasing androgen availability in the ovary showed conflicting results. Therefore, additional studies using proper strategies to achieving higher intra-ovarian androgen concentrations for longer intervals are required to define the clinical efficiency of androgens in poor responders. (Fertil Steril (R) 2011;96:1062-5. (C) 2011 by American Society for Reproductive Medicine.)