The Effect of Growth Hormone on In Vitro Fertilization Outcomes During Ovarian Stimulation: A Matched Cohort Study

Abstract

Background. While growth hormone (GH) is commonly used as an adjuvant treatment to controlled ovarian stimulation (COS) for in vitro fertilization (IVF) cycles, the data regarding its efficacy is inconsistent. Design. A retrospective matched cohort study of poor responder patients who underwent COS without the use of GH (COS-GH) subsequently followed by COS cycles that included adjuvant GH (COS+GH) treatment. Materials and Methods. A list of all patients having filled a prescription for GH from January 2018 – March 2020 was obtained. GH was administered daily at 3mg (9IU) starting on the first day of stimulation and ending on the day of trigger. Only women who had documentation of a previous cycle without the use of GH were included in the study. Results. 182 cycles (91 patients) were included in the study, and COS-GH cycles were compared to COS+GH cycles. The total dose of gonadotropins used (5757 vs 4252 mIU, p=0.002), duration of stimulation (10.4 vs 10.1 days, p=-.045), maximum Estradiol (E2) (2411 vs 1932 pg/ml, p=0.010), endometrial thickness (11.2 vs 10.6 mm, p=0.010), number of oocytes retrieved (14.2 vs 11.8, p=0.001), number of mature oocytes (11.1 vs 9.7, p=0.028), number of blastocysts (3.98 vs 2.56, p=<0.001) and number of usable blastocysts (2.5 vs 1.6, p=<0.001) were all significantly greater in the GH group. Conclusions. Adding GH to the COS protocol in poor responder patients may lead to improvements in the number of oocytes retrieved, number of mature oocytes, endometrial thickness, number of blastocysts, the number of usable blastocysts.

The Effects of Growth Hormone Administration on ICSI Outcomes in Poor Ovarian Reserve. A Randomized Control Study

“…Both GH and IGF-1 important in the formation of steroid hormones in the ovary. (Kurtz et al, 2021; F.-T. They also play a major role in the intracellular signaling pathway, therefore inhibiting atresia, and promoting the growth of the leading follicle.…”

“…In induction of ovulation the follicles reach 18-21 mm, and the treatment dose and duration are tailored according to each case and monitored by the ultrasound scans. (Kurtz et al, 2021;Tülek & Kahraman, 2021) Human chorionic Gonadotropin (HCG) is a similar structure to the natural luteinizing hormone (LH). (Wu et al, 1994) Injection with it leads to the same effect of LH surge and causes the release of ova from the ovaries 34-36 hours after injection.…”