Growth Hormone Cotreatment for Low-Prognosis Patients According to the POSEIDON Criteria

Liu, Xueying; Xu, Jing; Bi, Lixin; Liu, Peihao

doi:10.3389/fendo.2021.790160

Cited by 9 publications

(7 citation statements)

References 26 publications

(38 reference statements)

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“…Consistent with the results reported by Liu et al. ( 27 ), we presented a tolerable live birth rate in GH+ cycle in similar to that reported in aged women in their study (POSEIDON group 2: 28.33%; group 4: 24.07%). Besides, a cumulative live birth rate per cycle of 33.33% was achieved in the GH+ cycle when comparable number of embryos transferred and much more transferrable embryos remained, which may also suggest the underlying effect of GH on ameliorating embryo quality.…”

Section: Discussionsupporting

confidence: 93%

Effect of growth hormone administration on ameliorating pregnancy outcome in women with advanced maternal age and exploration of its optimized utilization

Feng,

Wang,

Han

et al. 2023

Front. Endocrinol.

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BackgroundAge-related fertility decay is a great challenge for clinicians. Growth hormone (GH) supplementation has been studied as an adjuvant since late 1980s. However, it has not come to a consensus on the GH administration due to the ambiguous efficacy among studies with different enrolled population and dosage regime.MethodsA self-controlled retrospective study was conducted on women with advanced maternal age who underwent at least a previous cycle without GH (GH−) and a subsequent cycle with GH co-treatment (GH+). The ovarian stimulation parameters and outcomes were compared between the two cycles and logistical analysis was applied to further explore the association between GH administration protocol as well as other clinical parameters and cumulative live birth in GH+cycle.ResultsA total of 150 women aged 35-43 were included. The number of oocytes retrieved, MII oocytes, 2PNs, transferrable embryos and good-quality embryos in GH+ significantly increased (p < 0.001). The proportion of cycles with no transferrable embryos was significantly reduced in GH+ cycle compared with previous GH− cycle (3 vs. 32; p < 0.001). GH co-treatment cycles showed significantly higher clinical pregnancy rates (43.75% vs. 6.06%; 38.35% vs. 12.04%, p < 0.001), live birth rates (29.17% vs. 0; 27.07% vs. 0, p < 0.001) in both fresh and frozen-thawed embryo transfer cycle. Cumulative live birth rate of the GH+ cycle reached 33.33%. Use of GH prior to Gn stimulation and lasting until the hCG day seemed to achieve a higher successful live birth rate (OR 2.312, 95%CI 1.074-5.163, p=0.032).ConclusionGH supplementation could ameliorate pregnancy outcome in women with advanced maternal age. Dosage regimen of long-term pretreatment prior to Gn stimulation (4 IU every other day) and 4 IU per day until hCG day may of greater efficacy compared with concurrent administration with Gn. Additionally, it’s worthy of exploring whether an individualized dosage regimen based on the IGF or IGFBP level of patient would be more reasonable and effective. More well-designed prospective trials with large sample size and fundamental experiments on the mechanism are required to testify findings above.

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Section: Discussionsupporting

confidence: 93%

Effect of growth hormone administration on ameliorating pregnancy outcome in women with advanced maternal age and exploration of its optimized utilization

Feng,

Wang,

Han

et al. 2023

Front. Endocrinol.

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“…For example, several randomized controlled trials did not detect any definitive benefits of GH administration on live birth rates in poor ovarian responders (29, 30). However, other studies have reported improvements in pregnancy, implantation, and live birth rates following GH supplementation (8,(10)(11)(12)31). This discrepancy can be attributed to differences in patient groups.…”

Section: Discussionmentioning

confidence: 97%

Growth hormone supplementation ameliorates blastocyst euploidy rates and improves pregnancy outcomes in women undergoing preimplantation genetic testing for aneuploidy cycles

et al. 2023

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BackgroundGrowth hormone (GH) supplementation has been shown to improve oocyte quality and live birth, but few studies have examined whether GH can reduce embryonic aneuploidy. Chromosomal abnormalities in preimplantation embryos have been regarded as the principal cause of implantation failure and miscarriage, and an increased percentage of aneuploid embryos has been observed in patient cohorts with unexplained recurrent pregnancy loss (RPL), recurrent implantation failure (RIF), and advanced maternal age.MethodsThis prospective cohort study was conducted on women whose previous PGT-A cycle ended up with no transferrable blastocysts, or the aneuploidy rate was above 50% and no live birth was acquired. The participants were divided into GH co-treatment and comparison groups according to whether GH was administered in the subsequent PGT-A cycle. In addition, within the GH co-treatment group, the previous failed cycle constituted the self-control group.Results208 women were recruited in the study (GH co-treatment group: 96 women, comparison group: 112 women). Compared to the self-control and comparison groups, the rate of euploid blastocysts was significantly higher in the GH co-treatment group (GH vs self-control: 32.00% vs 9.14%, odds ratio [OR]: 4.765, 95% confidence interval [CI]: 2.420–9.385, P < 0.01; GH vs comparison: 32.00% vs. 21.05%, OR: 1.930, 95% CI: 1.106–3.366, P = 0.021), and their frozen embryo transfers resulted in more pregnancies and live births. In the subgroup analysis, for the <35 and 35-40 years groups, the euploidy rate in the GH co-treatment group was significantly higher than those in the self-control and comparison groups, but in the >40 years group, there was no difference in euploidy rate.ConclusionOur study presents preliminary evidence that GH supplementation may ameliorate blastocyst aneuploidy and improve pregnancy outcomes in women who have previously experienced pregnancy failures along with high aneuploidy rates, particularly in those younger than 40 years. Therefore, the use of GH in such women should be considered. However, considering the limited sample size and mixed indications for PGT-A, further scientific research on the underlying mechanism as well as clinical trials with larger sample sizes are needed to confirm the effects and optimal protocols.

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“…The recent meta-analysis by Cozzolino et al 49 showed that supplementation of GH in POR patients increased the clinical pregnancy rate, but did not affect the ongoing pregnancy rate and live birth rate. Some single studies have also drawn inconsistent conclusions 35,46,50 . In our NMA, no GH supplementation protocol has been proven effective in improving the clinical pregnancy rate and live birth rate of POR patients according to the overall pooled results.…”

Section: Discussionmentioning

confidence: 99%

Comparative Efficacy of Different Growth Hormone Supplementation Protocols in Improving Clinical Outcomes in Women with Poor Ovarian Response Undergoing Assisted Reproductive Therapy: A Network Meta-analysis

Xu,

Tong,

Yang

et al. 2023

Preprint

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Growth hormone(GH) is widely used in assisted reproduction for patients with poor ovarian response(POR), but the optimal dosage and timing remains unclear. The aim of this study was to evaluate and compare the efficacy of different GH supplementation protocols through a network meta-analysis (NMA) and determine the optimal treatment protocol. This study was reported based on the Preferred Reporting Items for Systematic Reviews for Network Meta‑Analysis (PRISMA‑NMA) statement. Databases including PubMed, Web of Science, Cochrane Library and Embase were searched until June 2023. A total of 524 records were retrieved in our search, and 23 clinical studies comprising 4889 cycles were involved. Seven different GH protocols were identified. Results showed that compared to the control group, daily administration of 4–8 IU of GH during the follicular phase of the stimulation cycle had the best comprehensive therapeutic effects on improving the number of retrieved oocytes, mature oocytes, endometrial thickness, and reducing gonadotropin requirements in POR patients undergoing assisted reproductive therapy, with a relatively brief treatment duration and a moderate total GH dose. Subgroup analysis demonstrated that this protocol could significantly improve the clinical pregnancy rate of POR patients in the randomized controlled trials (RCT) subgroup and the African subgroup. Therefore, its clinical application is suggested. Besides, the potential advantages of long-term GH supplementation protocol need to be explored. Further rigorous and well-designed multi-arm RCTs are needed to confirm the conclusions drawn from this study.

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Growth Hormone Cotreatment for Low-Prognosis Patients According to the POSEIDON Criteria

Cited by 9 publications

References 26 publications

Effect of growth hormone administration on ameliorating pregnancy outcome in women with advanced maternal age and exploration of its optimized utilization

Effect of growth hormone administration on ameliorating pregnancy outcome in women with advanced maternal age and exploration of its optimized utilization

Growth hormone supplementation ameliorates blastocyst euploidy rates and improves pregnancy outcomes in women undergoing preimplantation genetic testing for aneuploidy cycles

Comparative Efficacy of Different Growth Hormone Supplementation Protocols in Improving Clinical Outcomes in Women with Poor Ovarian Response Undergoing Assisted Reproductive Therapy: A Network Meta-analysis

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