Biological and Clinical Rationale for Androgen Priming in Ovarian Stimulation
Androgen receptors are expressed by all stages of growing follicles, and follicular fluid androgen levels are positively correlated to granulosa cell androgen receptor and follicle-stimulating hormone (FSH) receptor expression. Thus, androgens may promote follicular growth, accumulation and/or respo...
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doaj-91598b2564614dada2a894f7c77632772020-11-25T03:21:27ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922020-09-011110.3389/fendo.2020.00627566555Biological and Clinical Rationale for Androgen Priming in Ovarian StimulationKristine Løssl0Nina la Cour Freiesleben1Marie Louise Wissing2Kathrine Birch Petersen3Marianne Dreyer Holt4Linn Salto Mamsen5Richard A. Anderson6Claus Yding Andersen7Claus Yding Andersen8The Fertility Clinic, Copenhagen University Hospital, Rigshospitalet, Copenhagen, DenmarkThe Fertility Clinic, Copenhagen University Hospital Hvidovre, Hvidovre, DenmarkAlleris-Hamlet Fertility, Søborg, DenmarkVivaNeo Denmark, Copenhagen, DenmarkZealand Fertility Clinic, Zealand University Hospital, Køge, DenmarkLaboratory of Reproductive Biology, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, Copenhagen, DenmarkMRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United KingdomLaboratory of Reproductive Biology, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, Copenhagen, DenmarkFaculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkAndrogen receptors are expressed by all stages of growing follicles, and follicular fluid androgen levels are positively correlated to granulosa cell androgen receptor and follicle-stimulating hormone (FSH) receptor expression. Thus, androgens may promote follicular growth, accumulation and/or responsiveness to gonadotropins. This is explored therapeutically in the concept of androgen priming, to improve the ovarian response to stimulation in assisted reproduction. Androgen effects may be achieved in two different ways, either directly by providing exogenous androgen or by providing luteinizing hormone (LH) activity [i.e., LH or human chorionic gonadotropin (hCG)] to stimulate local ovarian production of androgen. The androgen concentrations in follicular fluid by far exceed the levels in female circulation and it has recently been shown that there was no correlation between serum testosterone levels and follicular fluid androgen levels. There is some evidence that administration of exogenous dehydroepiandrosterone or testosterone increases live birth rates, but an optimal protocol has not been established and such adjuvant treatment should be considered experimental. Furthermore, studies exploring long-term administration of LH activity, achieving LH levels comparable to those seen in women with polycystic ovary syndrome, are awaited. The aim of the present review is to discuss critically the most suitable approach for androgen priming from a biological and clinical standpoint, and to evaluate current approaches and results obtained in clinical trials.https://www.frontiersin.org/article/10.3389/fendo.2020.00627/fullandrogen primingtestosteronefollicular responsivenessfollicular recruitmentlocal androgen productionLH activity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kristine Løssl Nina la Cour Freiesleben Marie Louise Wissing Kathrine Birch Petersen Marianne Dreyer Holt Linn Salto Mamsen Richard A. Anderson Claus Yding Andersen Claus Yding Andersen |
spellingShingle |
Kristine Løssl Nina la Cour Freiesleben Marie Louise Wissing Kathrine Birch Petersen Marianne Dreyer Holt Linn Salto Mamsen Richard A. Anderson Claus Yding Andersen Claus Yding Andersen Biological and Clinical Rationale for Androgen Priming in Ovarian Stimulation Frontiers in Endocrinology androgen priming testosterone follicular responsiveness follicular recruitment local androgen production LH activity |
author_facet |
Kristine Løssl Nina la Cour Freiesleben Marie Louise Wissing Kathrine Birch Petersen Marianne Dreyer Holt Linn Salto Mamsen Richard A. Anderson Claus Yding Andersen Claus Yding Andersen |
author_sort |
Kristine Løssl |
title |
Biological and Clinical Rationale for Androgen Priming in Ovarian Stimulation |
title_short |
Biological and Clinical Rationale for Androgen Priming in Ovarian Stimulation |
title_full |
Biological and Clinical Rationale for Androgen Priming in Ovarian Stimulation |
title_fullStr |
Biological and Clinical Rationale for Androgen Priming in Ovarian Stimulation |
title_full_unstemmed |
Biological and Clinical Rationale for Androgen Priming in Ovarian Stimulation |
title_sort |
biological and clinical rationale for androgen priming in ovarian stimulation |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Endocrinology |
issn |
1664-2392 |
publishDate |
2020-09-01 |
description |
Androgen receptors are expressed by all stages of growing follicles, and follicular fluid androgen levels are positively correlated to granulosa cell androgen receptor and follicle-stimulating hormone (FSH) receptor expression. Thus, androgens may promote follicular growth, accumulation and/or responsiveness to gonadotropins. This is explored therapeutically in the concept of androgen priming, to improve the ovarian response to stimulation in assisted reproduction. Androgen effects may be achieved in two different ways, either directly by providing exogenous androgen or by providing luteinizing hormone (LH) activity [i.e., LH or human chorionic gonadotropin (hCG)] to stimulate local ovarian production of androgen. The androgen concentrations in follicular fluid by far exceed the levels in female circulation and it has recently been shown that there was no correlation between serum testosterone levels and follicular fluid androgen levels. There is some evidence that administration of exogenous dehydroepiandrosterone or testosterone increases live birth rates, but an optimal protocol has not been established and such adjuvant treatment should be considered experimental. Furthermore, studies exploring long-term administration of LH activity, achieving LH levels comparable to those seen in women with polycystic ovary syndrome, are awaited. The aim of the present review is to discuss critically the most suitable approach for androgen priming from a biological and clinical standpoint, and to evaluate current approaches and results obtained in clinical trials. |
topic |
androgen priming testosterone follicular responsiveness follicular recruitment local androgen production LH activity |
url |
https://www.frontiersin.org/article/10.3389/fendo.2020.00627/full |
work_keys_str_mv |
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