Growth hormone for in vitro fertilization

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization (IVF)
• Ovulation Induction

Background:

• Optimizing ovulation induction protocols for IVF is crucial for improving follicular recruitment and pregnancy rates while reducing gonadotropin requirements.
• While most studies on growth hormone (GH) in ovulation induction focus on normally ovulating women, its effect on poor responders is gaining attention.

Purpose of the Study:

• To evaluate the efficacy of growth hormone (GH) as an adjuvant therapy in ovulation induction for in vitro fertilization (IVF).
• To compare outcomes in two distinct patient groups: those with no prior history of poor response and those with a history of poor response.

Main Methods:

• A systematic review of randomized controlled trials (RCTs) was conducted, drawing on established search strategies.
• Included RCTs provided outcome data on pregnancy rates, oocyte/embryo numbers, and peak estradiol levels for intervention and control groups.
• Data extraction and validity assessment were performed independently by two reviewers, utilizing standardized methods.

Main Results:

• In women without a history of poor stimulation, growth hormone (GH) adjuvant therapy showed no significant improvement in pregnancy rates (OR 0.97; 95% CI 0.34-2.76).
• For women with a history of poor response, a trend towards improved pregnancy rates was observed with GH treatment (OR 2.55; 95% CI 0.64-10.12), though not statistically significant.
• No significant differences were found in gonadotropin dosage or oocyte yield between GH-treated and placebo groups in either patient category.

Conclusions:

• Current evidence from small trials suggests that growth hormone (GH) augmentation does not enhance pregnancy rates in women with no prior history of poor response during IVF.
• A potential benefit of GH treatment in poor responders warrants further investigation due to observed trends towards improved outcomes.