Growth hormone co-treatment on controlled ovarian stimulation in normal ovarian response women can improve embryo quality

Abstract

To investigate the clinical efficacy of growth hormone (GH) in normal response patients with poor embryo quality in previous in vitro fertilization cycles. A total of 1562 infertile women were enrolled in this matched case–control study: 781 women were treated with GH (study group), whereas 781 matched patients were treated without GH (control group). GH was administered by a daily subcutaneous injection of 2 or 4 IU started from either D2 of the previous cycle (6 weeks GH pretreatment) or the initial day of controlled ovarian stimulation (2 weeks GH pretreatment) until hCG trigger. The study group was further divided into four subgroups: 2 IU-6 weeks GH pretreatment, 4 IU-6 weeks GH pretreatment, 2 IU-2 weeks GH pretreatment, and 2 IU-4 weeks GH pretreatment. Patients receiving GH showed significantly lower Gn dosage. The total number of oocytes retrieved, embryos formed, endometrial thickness on hCG day were significantly higher with GH. 2PN rate and high-quality embryo rate were lower in the GH group. However, GH increased clinical pregnancy rate with significant difference. 4 IU-6 weeks GH pretreatment showed lowest duration of Gn and highest clinical pregnancy rate compared with other three groups. Number of transferred embryos was confounding factor both in univariate and multivariate analysis. Our study showed that co-treatment with GH in patients with normal ovarian response could increase pregnancy rate.

Chinese abstract

研究生长激素（GH）在先前体外受精周期中胚胎质量差的正常卵巢反应患者中的临床疗效。共有1562名不孕女性参加了这项匹配的病例对照研究：781名女性接受了GH治疗（研究组）, 而781名匹配的患者接受了无GH治疗（对照组）。从前一周期的D2（6周GH预处理）或控制性卵巢刺激的初始日（2周GH预处理）开始每日皮下注射2IU或4IU GH直至hCG触发。研究组进一步分为4个亚组：2IU-6周GH预处理, 4IU-6周GH预处理, 2IU-2周GH预处理和2IU-4周GH预处理。接受GH的患者Gn剂量显著降低。获取的卵母细胞总数、胚胎形成、hCG日的子宫内膜厚度GH组显著增高。GH组的2PN率和高质量胚胎率较低。然而, GH有显著差异的增加临床妊娠率。4IU-6周GH预处理显示与其他三组相比, Gn持续时间最短, 临床妊娠率最高。移植胚胎数量在单变量和多变量分析中是混杂因素。我们的研究表明, 卵巢反应正常的患者与GH共同治疗可以提高妊娠率。

Keywords:

• Normal ovarian response
• growth hormone
• in vitro fertilization

Disclosure statement

No potential conflict of interest was reported by the authors.