The Role of Androgen Supplementation in Women With Diminished Ovarian Reserve: Time to Randomize, Not Meta-Analyze

Front Endocrinol (Lausanne). 2021 May 17:12:653857. doi: 10.3389/fendo.2021.653857. eCollection 2021.


The management of patients with diminished ovarian reserve (DOR) remains one of the most challenging tasks in IVF clinical practice. Despite the promising results obtained from animal studies regarding the importance of androgens on folliculogenesis, the evidence obtained from clinical studies remains inconclusive. This is mainly due to the lack of an evidence-based methodology applied in the available trials and to the heterogeneity in the inclusion criteria and IVF treatment protocols. In this review, we analyze the available evidence obtained from animal studies and highlight the pitfalls from the clinical studies that prevent us from closing the chapter of this line of research.

Keywords: DHEA; androgens; diminished ovarian response (DOR); poor ovarian response (POR); testosterone.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Androgens / metabolism
  • Androgens / therapeutic use*
  • Animals
  • Dehydroepiandrosterone
  • Evidence-Based Medicine
  • Female
  • Fertilization in Vitro / methods*
  • Humans
  • Infertility, Female / drug therapy
  • Meta-Analysis as Topic
  • Ovarian Diseases / drug therapy
  • Ovarian Follicle / physiopathology
  • Ovarian Reserve*
  • Ovary / metabolism*
  • Ovary / physiology
  • Pregnancy
  • Pregnancy Rate
  • Randomized Controlled Trials as Topic
  • Research Design
  • Testosterone / metabolism


  • Androgens
  • Testosterone
  • Dehydroepiandrosterone