Growth hormone alleviates oxidative stress and improves oocyte quality in Chinese women with polycystic ovary syndrome: a randomized controlled trial

Abstract

Oxidative stress (OS) is associated with poor oocyte quality and in vitro fertilization and embryo transfer (IVF-ET) outcomes for patients with polycystic ovary syndrome (PCOS). Growth hormone (GH) can function to reduce OS in some types of cells. Therefore, this prospective randomized study investigated whether GH can significantly improve OS and oocyte quality in women with PCOS. This study enrolled 109 and 50 patients with and without PCOS (controls), respectively. The patients with PCOS were randomly assigned to receive treatment with GH (PCOS-T) or not (PCOS-C). The primary outcome included markers of OS in serum and FF, and secondary outcomes were mitochondrial function in granulosa cells (GCs) and IVF-ET outcomes. The PCOS groups showed higher basal serum total oxidant status (TOS) and OS index (OSI) levels. The follicle fluid (FF) TOS and OSI and GC apoptosis rate were significantly higher, whereas the GC mitochondrial membrane potential (MMP) was significantly lower in the PCOS-C group than in the PCOS-T and non-PCOS control groups (P < 0.05). Significantly more oocytes were fertilised and cleavage stage embryos were produced in the PCOS-T group than in the PCOS-C group (P < 0.05). GH also improved the rates of implantation and clinical pregnancy, but not significantly (P > 0.05). This study showed that GH alleviated the TOS and OSI level in FF and improved GC mitochondrial dysfunction and oocyte quality in patients with PCOS. Clinical Trial Registration Number: This project was prospectively registered on the Chinese Clinical Trial Registry on October 20, 2018. (ChiCTR1800019437) (https://www.chictr.org.cn/edit.aspx?pid=28663&htm=4).

Mitochondrial Dysfunction and Chronic Inflammation in Polycystic Ovary Syndrome

“…Growth hormone (GH) has a long history of administration in cases of infertility and patients with disordered ovulation [ 149 ]. GH treatment reduces TOS (total oxidant status) and OSI (oxidative stress index) in PCOS patients’ oocytes, improves MMP and decreases apoptosis by >50% [ 150 ]. The exact molecular mechanism of such GH activity implies the activation of the PI3K (phosphatidylinositol 3-kinase) signalling pathway.…”

Follicular GH and IGF1 Levels Are Associated With Oocyte Cohort Quality: A Pilot Study

“…In humans, GH is involved in (i) initiating and sustaining the development of primordial follicles into preovulatory human follicles, (ii) cytoplasmic and nuclear maturation in the oocyte, and (iii) cumulus cell expansion ( 47 , 48 ). In addition to these direct effects on oocyte development, adjuvant treatment with GH in IVF is associated with lower FF levels of oxidative stress markers ( 49 ). Furthermore, systemic and/or local IGF1 stimulates the proliferation, differentiation and activity of granulosa cells ( 48 ).…”

Study on the Reparative Effect of PEGylated Growth Hormone on Ovarian Parameters and Mitochondrial Function of Oocytes From Rats With Premature Ovarian Insufficiency

“…Currently, we explored the effect of rhGH on POI. Growing studies have revealed the potential role of rhGH treatment or pretreatment during IVF/ICSI cycles in patients with aging, poor ovarian response or even polycystic ovary syndrome ( Bayoumi et al, 2015 ; Lan et al, 2019 ; Gong et al, 2020 ). We did not observe significant changes in these phenotypes after treatment, but rhGH indeed increased the number of retrieved secondary oocytes at the high dosage and increased ovarian weight at the medium and high dosages.…”