Adjuvant growth hormone therapy in antagonist protocol in poor responders undergoing assisted reproductive technology

Eftekhar, Maryam; Aflatoonian, Abbas; Mohammadian, Farnaz; Eftekhar, Tahereh

doi:10.1007/s00404-012-2655-1

Cited by 104 publications

(91 citation statements)

References 29 publications

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“…Seven of the 11 studies [15,20–24] reported the cancelled cycles rate in the meta-analysis (Fig. 3C).…”

Section: Resultsmentioning

confidence: 99%

The influence of different growth hormone addition protocols to poor ovarian responders on clinical outcomes in controlled ovary stimulation cycles

Wang

et al. 2017

Medicine

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Background:Growth hormone (GH) is used as an adjuvant therapy in in vitro fertilization and embryo transfer (IVF-ET) for poor ovarian responders, but findings for its effects on outcomes of IVF have been conflicting. The aim of the study was to compare IVF-ET outcomes among women with poor ovarian responders, and find which subgroup can benefit from the GH addition.Methods:We searched the databases, using the terms “growth hormone,” “GH,” “IVF,” “in vitro fertilization.” Randomized controlled trials (RCT) were included if they assessed pregnancy rate, live birth rate, collected oocytes, fertilization rate, and implantation rate. Extracted the data from the corresponding articles, Mantel–Haenszel random-effects model, or fixed-effects model was used. Eleven studies were included.Results:Clinical pregnancy rate (RR 1.65, 95% CI 1.23–2.22), live birth rate (RR1.73, 1.25–2.40), collected oocytes number (SMD 1.09, 95% CI 0.54–1.64), MII oocytes number (SMD 1.48, 0.84–2.13), and E2 on human chorionic gonadotropin (HCG) day (SMD 1.03, 0.18–1.89) were significantly increased in the GH group. The cancelled cycles rate (RR 0.65, 0.45–0.94) and the dose of gonadotropin (Gn) (SMD –0.83, –1.47, –0.19) were significantly lower in patients who received GH. Subgroup analysis indicated that the GH addition with Gn significantly increased the clinical pregnancy rate (RR 1.76, 1.25–2.48) and the live birth rate (RR 1.91, 1.29–2.83).Conclusion:The GH addition can significantly improve the clinical pregnancy rate and live birth rate. Furthermore, the GH addition time and collocation of medications may affect the pregnancy outcome.

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“…Seven of the 11 studies [15,20–24] reported the cancelled cycles rate in the meta-analysis (Fig. 3C).…”

Section: Resultsmentioning

confidence: 99%

The influence of different growth hormone addition protocols to poor ovarian responders on clinical outcomes in controlled ovary stimulation cycles

Wang

et al. 2017

Medicine

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“…However, due to the small number of the patients and the heterogeneity of the frequency and dosage of GH administered amongst the studies, the fact that the addition of GH during ovarian stimulation enhances the probability of pregnancy needs to be urgently evaluated in further properly designed trials to prove or disprove this finding. In fact, until now, there are not very recent and robust data suggesting routinary addition of GH in ovarian stimulation protocols for poor responders patients [89, 90]. …”

Section: Alternative Approachesmentioning

confidence: 99%

Management of Poor Responders in IVF: Is There Anything New?

Ubaldi

Vaiarelli²,

D’Anna³

et al. 2014

BioMed Research International

123

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Despite the fact that in the last two decades an enormous number of papers on the topic of poor ovarian response have been published in the literature, so far it has been impossible to identify any efficient treatment to improve the ovarian response and the clinical outcome of this group of patients. The incidence of poor ovarian responders among infertile women has been estimated at 9–24% but according to recent reviews, it seems to have slightly increased. The limitation in quantifying the incidence of these patients among the infertile population is due to the difficulty of a clear definition in literature. A recent paper by the Bologna ESHRE working group on poor ovarian response has been the first real attempt to find a common definition. Current literature proposes new risk factors which could be the cause of a reduction in ovarian reserve, which also includes genetic factors. This represents the first necessary step towards finding applicable solutions for these patients. To date, there is a substantial lack of literature that identifies an ideal protocol for these patients. The use of the “Bologna criteria” and the introduction of long acting gonadotropin in clinical practice have given rise to new promising stimulation protocols for this group of patients.

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“…Following the early cancellation of the treatment cycle, administration of pretreatment adjuvants like dehydroepiandrosterone sulphate (DHEA), growth hormone, and/or testosterone, can reduce the number of cycles of the potentially poor responders without several failed IVF-ET treatment cycles [Eftekhar et al 2013;Fouany and Sharara 2013;Fusi et al 2013;Narkwichean et al 2013;Singh et al 2013;Yilmaz et al 2013]. In a randomized study Eftekhar et al [2013] evaluated the IVF-ET cycle outcome after the addition of growth hormone in an antagonist protocol among poor responders.…”

Section: Discussionmentioning

confidence: 99%

“…In a randomized study Eftekhar et al [2013] evaluated the IVF-ET cycle outcome after the addition of growth hormone in an antagonist protocol among poor responders. They concluded that although the number of oocytes retrieved and the number of embryos obtained were significantly higher in patients who received growth hormone therapy during COH treatment, there were no significant differences between groups regarding implantation, and chemical and clinical pregnancy rates.…”

Section: Discussionmentioning

confidence: 99%

Can serum estradiol levels on the fourth day of IVF/ICSI cycle predict outcome in poor responder women?

Kahyaoğlu

Yumusak

Özgü-Erdinç

et al. 2015

Systems Biology in Reproductive Medicine

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We aimed to investigate the value of fourth day serum estradiol levels in predicting cycle outcome in poor responders. The medical records of 426 patients with low oocyte yield following controlled ovarian hyperstimulation (COH) treatment for a procedure in our institution's center for ART between 2008 and 2013 were evaluated. Eighty-eight patients exhibiting poor ovarian response (POR) were included in the study. The clinical outcomes of IVF/ICSI were compared based on the basal hormone profile, clinical, and laboratory parameters. Cycle day 4 E2 levels below 110 pg/ml had an odds ratio of 6.05 (95% CI 2.33-15.7; p50.001) for embryo transfer. The early follicular response to ovarian stimulation can be anticipated with the cycle day 4 estradiol levels during COH. When a low day 4 serum estradiol level is encountered, abandoning the current COH and proceeding with agents that increase ovarian response to ovarian stimulation before the next treatment cycle can be a realistic approach.

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Adjuvant growth hormone therapy in antagonist protocol in poor responders undergoing assisted reproductive technology

Abstract: Our study showed that co-treatment with growth hormone in antagonist protocol in patients with a history of poor response in previous IVF-ET cycles did not increase pregnancy rates.

Cited by 104 publications

References 29 publications

The influence of different growth hormone addition protocols to poor ovarian responders on clinical outcomes in controlled ovary stimulation cycles

The influence of different growth hormone addition protocols to poor ovarian responders on clinical outcomes in controlled ovary stimulation cycles

Management of Poor Responders in IVF: Is There Anything New?

Can serum estradiol levels on the fourth day of IVF/ICSI cycle predict outcome in poor responder women?

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