[The use of growth hormone (hGH) in ovulation induction in women]

Number of in vitro experiments have shown increasing evidence for local ovarian actions of GH by demonstrating: the presence of receptors for GH in human granulosa cells; the ability of GH to enhance estradiol (E2) production by human granulosa cells withdrawn in late follicular phase; the increasing effect of GH on progesterone (P) biosynthesis by human luteal cells. Moreover, GH being the main regulator of IGF-I plasma levels, its indirect effect by means of hepatic and/or ovarian IGF-I production remains possible. Few patients have been included in randomized studies using hGH with gonadotropins for induction of ovulation and their selection criteria were heterogeneous so that no definitive conclusion can be drawn about the beneficial effect of GH in facilitating ovulation. The reduction both in duration of stimulation and in the requirement for menopausal gonadotropins found in some studies have been challenged by others. The recombinant human growth hormone (hGH) is able to modify the game of intraovarian regulators and may affects ovocyte and embryo. Such a potential impact cannot be occulted, justifying to develop larger in vivo animal experimentation before new further clinical studies.