Development of a novel home sperm test - temperature range
3028 relevant in a population of poor-responder women whose intercycle variability in the ovarian response to FSH is huge. (ii) Second, the duration of DHEA administration was different between individuals. Therefore, no clear relationship between DHEA intake and improvement in the number of retrieved oocytes could be eventually demonstrated. As regards the choice of androgen, it has been well established that DHEA has a weak androgenic activity as compared with testosterone, when assessed on
... ripheral tissues. To our knowledge, no informative data are yet available on the intraovarian conversion of DHEA to testosterone. It is therefore speculative to conclude that DHEA may be a potential precursor of active androgen within the ovary. Further studies are required to conclude on this issue. Although we strongly believe that intraovarian androgens play a critical role in the process of folliculogenesis in primates, our study could not demonstrate the clinical relevance of adding androgen in a selected population of poor responders with ovarian deficiency. These data do not exclude any positive effect in patients with a less-severe ovarian deficiency. However, this potential effect of androgen supplementation, clearly demonstrated in monkeys, is strictly limited to an improvement in the number of follicles in relation to a strong reduction in granulosa cell apoptosis. To our knowledge, there is no evidence so far that aneuploidy, a hallmark of oocyte quality in elderly women, might be improved by androgen supplementation. Consequently, additional well-designed, randomized, placebocontrolled clinical trials are needed to validate our hypothesis that androgen supplementation might be effective at stimulating follicular recruitment in humans. These studies should be performed in a selected population whose both oocyte quantity and quality are likely to be improved. One of the most challenging issues for clinicians is to identify predictive factors of response to androgen. Further work-up of theca cell function might be helpful to better identify the subgroup of women responsive to androgen supplementation. We do believe that this new approach is promising for some women who are often excluded from any assisted reproduction technique (ART) programmes.