The role of androgens in follicle maturation and ovulation induction: friend or foe of infertility treatment?

Reproductive Biology and Endocrinology

Review

Andrea Weghofer¹  Norbert Gleicher²  David H Barad³ 

[1] Center for Human Reproduction, New York, New York, USA;Department of Obstetrics and Gynecology, Medical University Vienna, Vienna, Austria;Center for Human Reproduction, New York, New York, USA;Foundation for Reproductive Medicine, New York, New York, USA;Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA;Center for Human Reproduction, New York, New York, USA;Foundation for Reproductive Medicine, New York, New York, USA;Departments of Epidemiology and Social Medicine and Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York, USA;

关键词: Androgen;    Androgen Receptor;    Granulosa Cell;    Follicle Stimulate Hormone;    Antral Follicle;   

DOI  :  10.1186/1477-7827-9-116

 received in 2011-06-16, accepted in 2011-08-17,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundEffects of androgens on follicle maturation have been controversial for some time. Here, we review the potential of their applications in improving human ovulation induction, based on human and animal data, reported in the literature.MethodsWe reviewed the published literature for the years 2005-2011, using relevant key words, in PubMed, Medline and Cochrane reviews, and then performed secondary reviews of referenced articles, which previously had not been known or preceded the searched time period. A total of 217 publications were reviewed.ResultsContrary to widely held opinion, recent data, mostly developed in the mouse, convincingly demonstrate essential contribution of androgens to normal follicle maturation and, therefore, female fertility. Androgens appear most engaged at preantral and antral stages, primarily affect granulosa cells, and exert effects via androgen receptors (AR) through transcriptional regulation but also in non-genomic ways, with ligand-activated AR modulating follicle stimulating hormone (FSH) activity in granulosa cells. While some androgens, like testosterone (T) and dehydroepiandrosterone (DHEA), appear effective in improving functional ovarian reserve (FOR) in women with diminished ovarian reserve (DOR), others may even exert opposite effects. Such differences in androgens may, at least partially, reflect different levels of agonism to AR.DiscussionSelective androgens appear capable of improving early stages of folliculogenesis. They, therefore, may represent forerunners of a completely new class of ovulation-inducing medications, which, in contrast to gonadotropins, affect follicle maturation at much earlier stages.

【 授权许可】

CC BY   
© Gleicher et al; licensee BioMed Central Ltd. 2011