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Cotreatment with growth hormone, after pituitary suppression, for ovarian stimulation in in vitro fertilization: a
E J Owen1, Z Shoham, B A Mason
1Cobbold Laboratories, University College and Middlesex School of Medicine, Middlesex Hospital, London, United Kingdom.
Objective:
To explore the effect of cotreatment with growth hormone (GH) for ovarian stimulation after pituitary suppression.
Design:
A randomized, double-blind, placebo-controlled study.
Setting:
Specialist Reproductive Endocrine and In Vitro Fertilization (IVF) Unit.
Patients, Participants:
Twenty-five IVF patients who had responded suboptimally in a previous treatment cycle. A subgroup of 18 patients were found to have ultrasound (US) findings of polycystic ovaries (PCO).
Main Outcome Measure:
The amount of gonadotropin used, development of follicles greater than or equal to 14 mm, number of oocytes collected, fertilized, cleaved and replaced, serum and follicular fluid (FF) insulin-like growth factor I (IGF-I) concentrations.
Results:
Cotreatment with GH was associated with a significant reduction in gonadotropins requirement (P less than 0.05). In patients with US-diagnosed PCO more follicles developed (P less than 0.05), more oocytes were collected (P less than 0.03), fertilized (P less than 0.004), and cleaved (P less than 0.02). A significantly higher FF IGF-I concentrations were found in patients receiving cotreatment with GH compared with those who received placebo (P less than 0.04).
Conclusion:
We believe that there may be a place for GH treatment in selected IVF cycles after pituitary suppression but what the role of IGF-I should further be investigated.