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Growth Hormone Impact on Ovarian Response

1. Ten studies examined the use of growth hormone (GH) as an adjuvant to gonadotropin therapy in women undergoing controlled ovarian stimulation for in vitro fertilization (IVF). The studies used varying GH regimens and definitions of poor ovarian response. 2. Most studies found GH significantly increased clinical pregnancy and live birth rates in women classified as poor ovarian responders compared to controls. However, GH did not restore poor responders to normal response levels. 3. Two meta-analyses found GH increased pregnancy rates in poor responders but not in women not considered poor responders. GH supplements alone did not increase response or oocyte yield but combining GH with a proven poor-response protocol improved outcomes.

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Devina Harsono
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8 views3 pages

Growth Hormone Impact on Ovarian Response

1. Ten studies examined the use of growth hormone (GH) as an adjuvant to gonadotropin therapy in women undergoing controlled ovarian stimulation for in vitro fertilization (IVF). The studies used varying GH regimens and definitions of poor ovarian response. 2. Most studies found GH significantly increased clinical pregnancy and live birth rates in women classified as poor ovarian responders compared to controls. However, GH did not restore poor responders to normal response levels. 3. Two meta-analyses found GH increased pregnancy rates in poor responders but not in women not considered poor responders. GH supplements alone did not increase response or oocyte yield but combining GH with a proven poor-response protocol improved outcomes.

Uploaded by

Devina Harsono
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

No Study Study design and

sample size
Definition of POR used Ovulation
stimulation regimen
GH regimen Result
1 Kolibianakis
EM (2009)
Meta-analyses from
6 trials
No significant statistical
heterogeneity in the
definition of oor o!arian
resonse
"ll of them #sing
$n%&' ()&' and h*$
in !arying dose
"ll of them #sing
!aryinging dose and
regimen on $& theray
+robability of clinical
regnancy ,as significantly
increased (-%. 2/02' 912 *3.
1/2456/607
$& addition led to an
absol#te
increase of clinical
regnancy rate by 162
2 &a8o#t "
(2009)
-bser!ational st#dy
s#lement in 241
,omen
+re!io#sly failed 6
assisted rerod#cti!e
techni9#es ("%:)
cycles for no kno,n
reason
less than 102 of
dysmorhic oocytes in
their re!io#s assisted
cycles
$n%& agonist 0/1
mg' decreased to
0/01 mg
r()& or &M$ at a
starting dose of
221 3; er day for
1 days/
0 3; (1/66 mg) of
recombinant h#man $&
(r&$&) on day 1 of
stim#lation/
:he n#mbers of oocytes
retrie!ed and inseminated
,ere higher in the $& gro#7
clinical regnancy rate ,as
significantly higher in the
$& gro# (21/<2 !ers#s
10/<2' P = 0/01)/
6 >#ffy ?MN
(2010)
Meta-analysis on 10
trials (2 not
considered oor
rognosis7 0
considered oor
rognosis) ,ith a
total of 440
s#bfertile co#les
No significant statistical
heterogeneity in the
definition of oor o!arian
resonse
"ll of them #sing
$n%&' ()&' and h*$
in !arying dose
"ll of them #sing
!arying dose and
regimen on $& theray
3n ,omen ,ho are not
considered oor resonders
there is no e!idence to
s#ort the #se of gro,th
hormone/ 3n ,omen ,ho are
considered oor resonders
significantly imro!e li!e
birth and regnancy rates
,ith -% @ 6/207 912/
4 Ao!ich B
(2010)
Ekserimental
crosso!er st#dy to
119 ,omen
+ast fail#re to
concei!e (mean 6/01
cycles) d#e to lo,
resonse to high-dose
stim#lation (=6
$& ,as gi!en 10 3; in
t,o sched#les.
3n the first fo#r years
$& ,as' therefore'
gi!en in the re!io#s
*o-treatment ,ith $& ,as
sho,n to significantly
increase the clinical
regnancy and li!e birth in
both yo#nger ,omen (=61
metahase 33 oocytes)
+oor-9#ality embryos
cycle on days <' 14 and
21 ,ith a final inCection
on day 2 of the
reatment cycle/
:he maCority of cases in
2001 and 2006 adoted
a re!ised blend ,hereby
atients recei!ed siD
inCections ,ith the first
beginning on day 21 of
the receding cycle and
the s#bse9#ent
inCections being on days
2' 6' 0' 10 and' if still
rogressing' a final
inCection on day 12/
years) and older ,omen yet
it does not restore these
atients to a EnormalF
resonder
1 Kyro# >
(2009)
)ystematic re!ie,
and meta-analysis
from 1 randomi8ed
controlled trials
No significant statistical
heterogeneity in the
definition of oor o!arian
resonse
"ll of them #sing
$n%&' ()&' and h*$
in !arying dose
"ll of them #sing
!arying dose and
regimen on $& theray
$& significantly increased
the robability of li!e birth
in oor resonders (-% 1/22'
*3 912 1/09524/99)/
6 K#c#k :
(2000)
%andomi8ed
rosecti!e st#dy
that in!ol!ed 61
atients
"nyone ,ho resonded
oorly to high dose
gonadotroin treatment in
their first cycles
$n%& 0/1 mgGday
started at day 21'
decreased into 0/01
on the menstr#ation
day #ntil h*$ ,as
gi!en/
410 3; of ()&
d#ring 1 days of
stim#lation #ntil
h*$ ,as gi!en/
10/000 3; h*$
,hen one follicle
had reached diameter
12 3; of $& from day
21 of receding cycle
More regnancies and more
clinical regnancies ,ith
fetal heart acti!ity ,ere
achie!ed in $& (12 of 61)'
comared to the control
gro# (6 of 60)/
H 10 mm/
< :esarik et al
(2001)
+rosecti!e
randomi8ed st#dy
that in!ol!ed 100
atient
"d!anced female age
(I40 years old)
$n%&-a 0/1 mgGday
started at mid l#teal
hase' decreased into
0/01 on the
menstr#ation day
#ntil h*$ ,as gi!en
410 3; of ()& and
110 3; of hM$ #ntil
h*$ ,as gi!en
210mg recombinant
h*$
0 3;Gday of $&
recombinant
*linical regnancy and
imlantation rates ,ere
higher at 262 and 6/22'
resecti!ely' in $&-treated
,omen
0 Jiegler >/>
(2011)
Meta-analyses st#dy
that e!al#ated in
total 14 st#dies
No significant statistical
heterogeneity in the
definition of oor o!arian
resonse
"ll of them #sing
$n%&' ()&' and h*$
in !arying dose
"ll of them #sing
!arying dose and
regimen on $& theray
$& s#lements did not
increase controlled o!arian
stim#lation resonse or
n#mber of oocytes'
combining a $& s#lement
,ith a ro!en oor-resonse
rotocol is imro!ed
regnancy and li!e-birth
rates

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