Growth hormone for in vitro fertilisation (IVF)

Area of Science:

• Reproductive Medicine
• Endocrinology
• In Vitro Fertilisation (IVF)

Background:

• In vitro fertilisation (IVF) outcomes are crucial for infertile women, particularly 'poor responders'.
• Adjuvant growth hormone (GH) therapy is being explored to enhance ovarian stimulation in IVF cycles.
• This review compares IVF outcomes with and without adjuvant GH, focusing on routine use and poor responders.

Purpose of the Study:

• To assess the effectiveness and safety of growth hormone (GH) as an adjunct to standard IVF treatment.
• To compare outcomes in women receiving adjuvant GH versus standard IVF.
• To specifically evaluate GH's impact on poor responders undergoing IVF.

Main Methods:

• Systematic review and meta-analysis of randomised controlled trials (RCTs).
• Searched multiple databases up to November 2020 for relevant trials.
• Included 16 RCTs involving 1352 women; data extracted on live birth rate, pregnancy rate, oocytes retrieved, embryo transfer, gonadotropin units, and adverse events.

Main Results:

• For routine IVF use, evidence on GH's effect on live birth rate and oocyte retrieval is very uncertain (low to very low certainty).
• In poor responders, adjuvant GH slightly increases pregnancy rates (low certainty) and oocyte retrieval (low certainty), but live birth rate effects are uncertain (very low certainty).
• GH use in poor responders reduced gonadotropin units (low certainty) but data on embryo transfer and adverse events were uncertain or unreported.

Conclusions:

• Adjuvant GH in IVF has uncertain effects on live birth rates and oocyte retrieval in normal responders.
• GH may slightly improve oocyte retrieval and pregnancy rates in poor responders, but live birth rate impact is uncertain.
• Further research is needed due to limitations in existing studies (small sample size, bias, heterogeneity, variable GH protocols).