Six‐week pretreatment with growth hormone improves clinical outcomes of poor ovarian responders undergoing <i>in vitro</i> fertilization treatment: A self‐controlled clinical study

Cai, Mengli; Liang, Xiaoyan; Wu, Yaoqiu; Huang, Rui; Yang, Xing

doi:10.1111/jog.13823

Cited by 20 publications

(23 citation statements)

References 19 publications

(19 reference statements)

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“…Another study analyzed the effects of 6-week pretreatment with GH in POR which were submitted to an in vitro fertilization treatment. This study, carried out in 380 POR, showed that the administration of the hormone significantly improved the rate of utilization of oocytes and embryo quality increasing the live birth rates, even in older patients who had previously experienced unsuccessful results from classical techniques (85). Moreover, another recent study demonstrated that co-treatment with GH in patients with normal ovarian response significantly increased pregnancy rate (86).…”

Section: Ovarian Functioningmentioning

confidence: 84%

The Role of Growth Hormone on Ovarian Functioning and Ovarian Angiogenesis

Devesa¹,

Caicedo

2019

Front. Endocrinol.

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Although not yet well-understood, today it is clear that Growth Hormone (GH) exerts a relevant role in the regulation of ovulation and fertility; in fact, fertility is lower in women with GH deficiency (GHD), and GH receptors (GHR) and GH mRNA have been found in the ovary since the onset of follicular development in humans. However, despite the strong evidence of GH in the regulation of fertility, many aspects of GH actions at this level are still not well-established, and it is likely that some controversial data depend on the species analyzed, the dose of the hormone and the duration of use of GH. Folliculogenesis, ovulation, and corpus luteum formation and maintenance are processes that are critically dependent on angiogenesis. In the ovary, new blood vessel formation facilitates oxygen, nutrients, and hormone substrate delivery, and also secures transfer of different hormones to targeted cells. Some growth factors and hormones overlap their actions in order to control the angiogenic process for fertility. However, we still know very little about the factors that play a critical role in the vascular changes that occur during folliculogenesis or luteal regression. To promote and maintain the production of VEGF-A in granulosa cells, the effects of local factors such as IGF-I and steroids are needed; that VEGF-A-inducing effect cannot be induced by luteinizing hormone (LH) or chorionic gonadotropin (CG) alone. As a result of the influences that GH exerts on the hypothalamic-pituitary-gonadal axis, facilitating the release of gonadotropins, and given the relationship between GH and local ovarian factors such as VEGF-A, FGF-2, IGF-1, or production of sex steroids, we assume that GH has to be a necessary factor in ovarian angiogenesis, as it happens in other vascular beds. In this review we will discuss the actions of GH in the ovary, most of them likely due to the local production of the hormone and its mediators.

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Section: Ovarian Functioningmentioning

confidence: 84%

The Role of Growth Hormone on Ovarian Functioning and Ovarian Angiogenesis

Devesa¹,

Caicedo

2019

Front. Endocrinol.

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“…As stated before, GH adjuvant therapy was clinically widely used in poor ovarian responders (7, 8, 10, 11, 14, 16, 19, 60–63, 67–76), poor quality of embryos (16, 17, 67, 70, 74, 77), improper endometrial reaction (5, 12, 56, 78, 79) and repeated implantation failure (1, 63, 80–82). When it is used in patients with repeat implantation failure which is defined as failure of pregnancy despite implantation of a high-quality embryo at least three times or of over 10 embryos on repeat implantation failure (1, 63, 80–82), the mechanism of this action is, as stated before, related to GH stimulating proliferation and differentiation of granulosa cells, increasing production of estradiol in both early and late follicular development for animal and human ovaries, enhancing effect of FSH on the development of ovarian follicles and improving endometrial thickness (82, 98–100).…”

Section: Subjects and Benefits Of Gh Treatmentmentioning

confidence: 99%

“…However, some randomized controlled trials discouraged the use of GH in IVF because no definitive benefits have been demonstrated in increasing the live birth rate for poor responders (18, 19), but careful evaluation of these trials showed severe drawbacks as stated before. Up to now, GH has been widely applied in the reproduction area but primarily for poor ovarian responders (7, 8, 10, 11, 14, 16, 19, 60–63, 67–76), poor quality of embryos (16, 17, 67, 70, 74, 77), improper endometrial reaction (5, 12, 56, 78, 79) and repeated failure of embryo transfer (1, 63, 80–82).…”

Section: Application Of Gh In Ivfmentioning

confidence: 99%

Application of Growth Hormone in in vitro Fertilization

Hao

Gao

2019

Front. Endocrinol.

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Growth hormone (GH) is a peptide hormone secreted mainly by the anterior part of the pituitary gland and plays a critical role in cell growth, development, and metabolism throughout the body. GH can not only directly influence human oocytes and cumulus cells but also indirectly improve oocyte quality through activating synthesis of insulin-like growth factor-I or promoting follicle-stimulating hormone-induced ovarian steroidogenesis. Since GH can regulate female and male infertility, it has been applied in the management of infertility for many years, especially in patients with poor ovarian response or poor prognosis. During ovarian stimulation, GH administration might improve the success rate of in vitro fertilization (IVF) probably through the beneficial effects of GH on oocyte quality as indicated by a higher number of mature oocytes and embryos arriving at the transfer stage and a higher fertility rate in GH-treated patients. However, there is still great controversy in the application of GH in IVF. While some researchers showed that pregnancy, implantation and live birth rates could be increased by ovarian pretreatment with GH, others did not support GH as an effective adjuvant for infertility treatment because the live birth rate was not increased. This study reviewed and summarized recent advancements and benefits in clinical application of GH, trying to reach a just unbiased conclusion regarding the effect of GH therapy in IVF.

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“…A number of studies have suggested that GH adjuvant therapy increases the number of retrieved oocytes, mature oocytes, and good quality embryos in POR cohorts (18)(19)(20)(21)(22)(23). Moreover, a systematic review, including randomized controlled trials and single center retrospective studies, suggested that the addition of GH in ovarian stimulation increased the probability of clinical pregnancies and live births in PORs (24)(25)(26). However, a recent updated meta-analysis, including the largest multicentered randomized controlled trial (RCT) conducted by the LIGHT investigators failed to find a significant difference in the live birth rate (LBR) after GH adjuvant therapy in PORs (27).…”

Section: Introductionmentioning

confidence: 99%

Growth Hormone Supplementation May Not Improve Live Birth Rate in Poor Responders

et al. 2020

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Backgrounds: Growth hormone (GH) was used for many years to increase ovarian response in poor ovarian responders (PORs). Although meta-analysis suggested that GH therapy improve early clinical outcomes, the benefit of GH usage on chance of live birth was still widely debated. This study was to determine whether or not GH supplementation influences the live birth rate (LBR). Methods: A total of 3,080 expected PORs receiving and not receiving (control) GH adjuvant therapy at Peking University Third Hospital from January 2017 to March 2018 were retrospectively analyzed. The basal characteristics of patients were compared using analysis of variance (continuous variables) and categorical variables were evaluated with a chi-square test. Logistic regression analyses were used to evaluate potential associations of LBR with GH treatment while adjusting other confounding factors. Results: No statistically significant differences existed in miscarriage rate (5.3 vs. 12.5%; p = 0.076) and LBR (37.7 vs. 34.5%; p = 0.426) in young expected PORs (< 35 years of age). Moreover, no significant differences existed in the miscarriage rate (25.6 vs. 23.3%; p = 0.681), and LBR (17.8 vs. 17.9%; p = 0.977) in the old expected PORs (≥35 years of age). Logistic regression suggested that GH adjuvant therapy did not improve the LBR in young (OR, 1.27; 95% CI, 0.88-1.85; p = 0.203) and elderly expected PORs (OR, 1.20; 95% CI, 0.82-1.76; p = 0.342), while GH was not associated with risk of miscarriage in young (OR, 0.37; 95% CI, 0.11-1.24; p = 0.108) and elderly expected PORs (OR, 0.91; 95% CI, 0.43-1.93; p = 0.813). In subgroup analysis, GH treatment significantly increased the day 3 embryos available rate in the subgroup of young PORs with the long down-regulation (63.11 vs. 49.35%; p = 0.004), while significantly reduced the risk of miscarriage in the subgroup of young PORs with GnRH antagonist protocol (0.00 vs. 12. %; p = 0.023). There was no significant difference for LBR in PORs with GnRH antagonist (<35 years [35.19 vs. 28.45%; p = 0.183]; ≥35 years [12.96 vs. 14.03%; p = 0.707]), GnRH-a long (<35 years [33.33 vs. 36.99%; p = 0.597]; ≥35 years [17.44 vs. 20.28%; p = 0.574]) and long down-regulation (<35 years [58.82 vs. 41.90%; p = 0.193]; ≥35 years [43.33 vs. 25.30%; p = 0.065]). Conclusions: Growth hormone treatment may not improve live birth rate in expected poor responders.

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Six‐week pretreatment with growth hormone improves clinical outcomes of poor ovarian responders undergoing in vitro fertilization treatment: A self‐controlled clinical study

Cited by 20 publications

References 19 publications

The Role of Growth Hormone on Ovarian Functioning and Ovarian Angiogenesis

The Role of Growth Hormone on Ovarian Functioning and Ovarian Angiogenesis

Application of Growth Hormone in in vitro Fertilization

Growth Hormone Supplementation May Not Improve Live Birth Rate in Poor Responders

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