Growth Hormone (GH) Improvement of Ovarian Responses and Pregnancy Outcome in Poor Ovarian Responders: A Randomized Study

Document Type: Research Articles

Authors

1 Department of Gynecology and Obstetrics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

2 Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Recent evidence has emphasized growth hormone benefits in increasing the ovarian response and improving the
pregnancy rate in poor responders (POR), caused by aging, ovarian surgery, chemotherapy and other reasons, undergoing
IVF/ICSI. The most important factor in the treatment of POR patients is the quality and quantity of oocytes following
ovarian stimulation; thus, efforts should be made to provide opportunities for young patients to improve their fertility
and ovarian responses. The use of GH in these patients may offer a promising aid to successful fertility.In the present
single-blinded clinical trial, POR patients were randomly assigned to receive one of three regimens: (A) Gonadotropin,
a GnRH antagonist and GH from the eighth day of the cycle for about 5 days (n = 34); (B) Gonadotropin, a GnRH
antagonist and GH from the third day of the previous cycle for about 20 days (n = 32); and (C) Gonadotropin, a GnRH
antagonist, and a placebo from the eight day of the cycle for about 5 days (n = 26). Oocyte quality and pregnancy rates
were compared across the three groups. A significantly lower number of collected oocytes, MII oocytes, fertilized
oocytes, transferred embryos, and clinical pregnancy rate in the placebo group was noted as compared to the two
experimental groups receiving GH. Live clinical pregnancies in B group were significantly greater than in the other
groups. Our results together indicate that GH may play an important role in recruitment of dominant follicles and
enhance follicular survival and the cell proliferation leading to high- quality embryos. Accordingly,

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