Does the addition of growth hormone to the in vitro fertilization/intracytoplasmic sperm injection antagonist protocol improve outcomes in poor responders? A randomized, controlled trial

Bassiouny, Yasmin A.; Dakhly, Dina M.R.; Bayoumi, Yasser; Hashish, Nawara M.

doi:10.1016/j.fertnstert.2015.11.026

Cited by 80 publications

(111 citation statements)

References 18 publications

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“…Our own recent retrospective analysis also showed little benefit in women over 41 years of age [12], which has implications for GH use in poor-prognosis patients with at least one Bologna criterion, advanced age [30]. However, in prospective studies with 80-145 participants, other researchers have shown that GH had no influence on CP or LB rates in ART [3,4,6]. Moreover, systematic reviews of the literature are also divided on the therapeutic effects of GH, possibly because of the heterogeneity among clinical studies.…”

Section: Discussionmentioning

confidence: 72%

“…The biological and biochemical mechanisms by which growth hormone (GH) can lead to better clinical outcomes in assisted reproductive technology (ART) remain unclear, but are believed to be related to oocyte development and/or subsequent embryo quality, along with potential effects in the endometrium. Several clinical studies over the past decade have focused on the use of GH for women classified as poor-prognosis in ART programs [1][2][3][4][5][6][7][8][9] as a desperate means to establish a pregnancy in severely infertile patients. However, the data around any beneficial effect is perplexing, with many studies claiming positive effects and an almost equivalent number of other investigations reporting no significant effect.…”

Section: Introductionmentioning

confidence: 99%

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Live birth outcomes of vitrified embryos generated under growth hormone stimulation are improved for women categorized as poor-prognosis

Keane

Hinchliffe

et al. 2019

Clin Exp Reprod Med

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Objective: To determine the clinical pregnancy (CP) and live birth (LB) rates arising from frozen embryo transfers (FETs) that had been generated under the influence of in vitro fertilization (IVF) adjuvants given to women categorized as poor-prognosis. Methods: A registered, single-center, retrospective study. A total of 1,119 patients with first FETs cycle include 310 patients with poor prognosis (109 treated with growth hormone [GH], (+)GH group vs. 201 treated with dehydroepiandrosterone, (-)GH group) and 809 patients with good prognosis (as control, (-)Adj (Good) group). Results: The poor-prognosis women were significantly older, with a lower ovarian reserve than the (-)Adj (Good) group, and demonstrated lower chances of CP (p< 0.005) and LB (p< 0.005). After adjusting for confounders, the chances of both CP and LB in the (+)GH group were not significantly different from those in the (-)Adj (Good) group, indicating that the poor-prognosis patients given GH had similar outcomes to those with a good prognosis. Furthermore, the likelihood of LB was significantly higher for poor-prognosis women given GH than for those who did not receive GH (p< 0.028). This was further confirmed in age-matched analyses. Conclusion: The embryos cryopreserved from fresh IVF cycles in which adjuvant GH had been administered to women classified as poor-prognosis showed a significant 2.7-fold higher LB rate in subsequent FET cycles than a matched poor-prognosis group. The women with a poor prognosis who were treated with GH had LB outcomes equivalent to those with a good prognosis. We therefore postulate that GH improves some aspect of oocyte quality that confers improved competency for implantation.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Live birth outcomes of vitrified embryos generated under growth hormone stimulation are improved for women categorized as poor-prognosis

Keane

Hinchliffe

et al. 2019

Clin Exp Reprod Med

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“…3A). Six [15,16,18,20–22] studies showed an increase of pregnancy rate among women who received GH, whereas the difference did not reach to statistical significance. A pooled result using fixed-effects model showed that clinical pregnancy rate (RR 1.65, 95% CI 1.23–2.22; p < 0.001) was significantly increased in the GH group.…”

Section: Resultsmentioning

confidence: 99%

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

Section: Resultsmentioning

confidence: 99%

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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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Growth hormone for in vitro fertilisation (IVF)

Sood

Mohiyiddeen

Ahmad

et al. 2021

Cochrane Database of Systematic Reviews

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Does the addition of growth hormone to the in vitro fertilization/intracytoplasmic sperm injection antagonist protocol improve outcomes in poor responders? A randomized, controlled trial

Cited by 80 publications

References 18 publications

Live birth outcomes of vitrified embryos generated under growth hormone stimulation are improved for women categorized as poor-prognosis

Live birth outcomes of vitrified embryos generated under growth hormone stimulation are improved for women categorized as poor-prognosis

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

Growth hormone for in vitro fertilisation (IVF)

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