Received June 28, 2018
Accepted December 28, 2018

Objective: Transdermal testosterone has been used with different doses and in different stimulation protocols in poor responders. The aim of the present study is to compare luteal estradiol/GnRH antagonists protocol versus long GnRH agonists in poor responder patients according to the Bologna criteria, in which transdermal testosterone has been used prior to the stimulation with gonadotropins. Methods: In this retrospective analysis, a total of 141 poor responder patients according to the Bologna criteria were recruited. All patients were treated with transdermal testosterone preceding ovarian stimulation with gonadotropins during 5 days. In 53 patients conventional antagonist protocol was performed (Group 1). In 88 patients (Gr pituitary suppression was achieved by leuprolide acetate according conventional long protocol (Group 2). Ovarian stimulation parameters and IVF outcomes were analyzed. Results: Comparing groups 1 and 2, there were no significant differences between cancellation rates and number of oocytes retrieved. However the total gonadotropin dose used and the mean length of stimulation were significantly lower in group 1 compared to group 2. There were not significant differences in pregnancy outcomes; however there was slight increase in the implantation rate in group 1 respect to group 2 although statistical significance was not achieved. Conclusion: TT in poor responder patients can be effective both with the conventional agonists long protocol and with conventional antagonists protocol. However, short regimes with antagonists previous estradiol in the luteal phase facilitate ovarian stimulation by shortening the days of treatment and the consumption of gonadotropins