Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

The Impact of Growth Hormone Co-Treatment Duration on Outcomes in IVF/ICSI Cycles Among Poor Ovarian Responders

Authors
Zahra Mohammadshirazi 1
Ashraf Alyasin 2
Marzieh Agha Hosseini 2
Vajihe Hazari 3
1 Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
2 Department of Obstetrics and Gynecology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Obstetrics and Gynecology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran; Rooyesh Infertility Center, Birjand University of Medical Sciences, Birjand, Iran
10.18502/jri.v24i4.14155
Abstract
Background: The efficiency of in vitro fertilization is improved by growth hormone (GH) during ovarian stimulation. Additionally, patients with diabetes experience impaired insulin resistance and compromised glucose tolerance, which further exacerbate their condition. Due to these side effects, in this study, the duration of GH treatment was compared in IVF/ICSI cycles among poor ovarian responders. Methods: In this study, POSEIDON criteria were used to choose patients. Subcutaneous administration of gonadotropin-releasing hormone (GnRH) antagonist was done beginning on the sixth day of the cycle and continuing through the day of human chorionic gonadotropin (hCG) injection. In one group, GH was administered 4 units/day from the 2 nd day of the cycle until hCG injection, and in another group, the first dose was administered on the 6th day of the cycle. Following the administration of hCG, which lasted from 24 to 36 hr, oocytes were retrieved with the support of B-mode sonography. Results: In our analysis, no significant differences were observed between the two groups in terms of the number of retrieved oocytes, metaphase II oocytes, and quality of grade A and B embryos. The results show that the treatment or conditions did not have a significant impact on the outcomes among the studied groups. Conclusion: Our findings indicate that a shorter duration of GH administration can yield similar outcomes compared to a longer duration in IVF/ICSI cycles involving poor ovarian responders. This result holds the potential for a more cost-effective and patient-friendly approach in managing assisted reproductive technology procedures. It may lead to reduced side effects and improved adherence to medication regimens in patients.
Keywords
Assisted Reproductive Technology
Grade A and B embryos
growth hormone
Metaphase II oocytes
Poor ovarian responder
Retrieved oocytes
Ramanaviciene A, Popov A, Baliunaite E, Brasiunas B, Kausaite-Minkstimiene A, Tamer U, et al. Magneto-immunoassay for the detection and quantification of human growth hormone. Biosensors (Basel). 2022;12(2):65.
Sadiq NM, Tadi P. Physiology, Pituitary Hormones. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/ books/NBK557556/
Hart RJ, Rombauts L, Norman RJ. Growth hormone in IVF cycles: any hope? Curr Opin Obstet Gynecol. 2017;29(3):119-25.
Xu YM, Hao GM, Gao BL. Application of growth hormone in in vitro fertilization. Front Endocrinol (Lausanne). 2019;10:502.
Shakkarpude J, Mishra A, Lakhani P, Jain A, Kumari M, Caesar DD. Role of growth hormone in reproduction. Int J Chem Stud. 2019;7(3):4683-92.
Zafardoust S, Ansaripor S, Karimi A, Hosseinirad H, Ataei M. Effects of adjuvant growth Hormone therapy on poor ovarian responders in assisted reproductive technology. Maedica (Bucur). 2022;17 (2):336-43.
Yousef MS, Rezk WR, El-Naby A-sA-H, Mahmoud KGM, Takagi M, Miyamoto A, et al. In vitro effect of zearalenone on sperm parameters, oocyte maturation and embryonic development in buffalo. Reprod Biol. 2023;23(1):100732.
Herrick JR. Assisted reproductive technologies for endangered species conservation: developing sophisticated protocols with limited access to animals with unique reproductive mechanisms. Biol Reprod. 2019;100(5):1158-70.
Wang R, Pan W, Jin L, Li Y, Geng Y, Gao C, et al. Artificial intelligence in reproductive medicine. Reproduction. 2019;158(4):R139-54.
Yang JY, Li H, Lu N, Li L, Sun X-X. Influence of growth hormone supplementation in patients with thin endometrium undergoing frozen embryo transfer. Reprod Dev Med. 2019;3(01):49-53.
Chen Y, Tao L, Lin Y, Li X, Ma C. Outcomes of in vitro fertilization–embryo transfer in women with diminished ovarian reserve after growth hormone pretreatment. Gynecol Endocrinol. 2020;36(11):955-8.
Cai MH, Liang XY, Wu YQ, Huang R, Yang X. Six‐week pretreatment with growth hormone improves clinical outcomes of poor ovarian responders undergoing in vitro fertilization treatment: A self‐controlled clinical study. J Obstet Gynaecol Res. 2019;45(2):376-81.
Xia L, Tian L, Zhang S, Huang J, Wu Q. Hormonal replacement treatment for frozen-thawed embryo transfer with or without GnRH agonist pretreatment: a retrospective cohort study stratified by times of embryo implantation failures. Front Endo-crinol (Lausanne). 2022;13:803471.
Liu FT, Hu KL, Li R. Effects of growth hormone supplementation on poor ovarian responders in assisted reproductive technology: a systematic review and meta-analysis. Reprod Sci. 2021;28(4):936-48.
Yang P, Wu R, Zhang H. The effect of growth hormone supplementation in poor ovarian responders undergoing IVF or ICSI: a meta-analysis of randomized controlled trials. Reprod Biol Endocrinol. 2020;18(1):76.
Liu FT, Wu Z, Yan J, Norman RJ, Li R. The potential role of growth hormone on the endometrium in assisted reproductive technology. Front Endocrinol (Lausanne). 2020;11:49.
Cai MH, Gao LZ, Liang XY, Fang C, Wu YQ, Yang X. The effect of growth hormone on the clinical outcomes of poor ovarian reserve patients undergoing in vitro fertilization/intracytoplasmic sperm injection treatment: A retrospective study based on POSEIDON criteria. Front Endocrinol (Lausanne). 2019;10:775.
Taulbee JD, Symons MJ. Sample size and duration for cohort studies of survival time with covariables. Biometrics. 1983;39(2):351-60.
Tesarik J, Mendoza C, Greco E. Paternal effects acting during the first cell cycle of human preimplantation development after ICSI. Hum Reprod. 2002;17(1):184-9.
Gong Y, Zhang K, Xiong D, Wei J, Tan H, Qin S. Growth hormone alleviates oxidative stress and improves the IVF outcomes of poor ovarian responders: a randomized controlled trial. Reprod Biol Endocrinol. 2020;18(1):91
Safdarian L, Aghahosseini M, Alyasin A, Samaei-Nouroozi A, Rashidi S, Shabani-Nashtaei M, et al. Growth hormone (GH) improvement of ovarian responses and pregnancy outcome in poor ovarian responders: a randomized study. Asian Pac J Cancer Prev. 2019;20(7):2033-7.
Zhang Y, Zhang C, Shu J, Guo J, Chang HM, Leung PC, et al. Adjuvant treatment strategies in ovarian stimulation for poor responders undergoing IVF: a systematic review and network meta-analysis. Hum Reprod Update. 2020;26(2):247-63.
Cozzolino M, Cecchino GN, Troiano G, Romanelli C. Growth hormone cotreatment for poor responders undergoing in vitro fertilization cycles: a systematic review and meta-analysis. Fertil Steril. 2020;114(1):97-109.
Jeve YB, Bhandari HM. Effective treatment protocol for poor ovarian response: a systematic review and meta-analysis. J Hum Reprod Sci. 2016;9(2):70-81.
Polyzos NP, Devroey P. A systematic review of randomized trials for the treatment of poor ovarian responders: is there any light at the end of the tunnel? Fertil Steril. 2011;96(5):1058-61.e7.
Li XL, Wang L, Lv F, Huang XM, Wang LP, Pan Y, et al. The influence of different growth hormone addition protocols to poor ovarian responders on clinical outcomes in controlled ovary stimulation cycles: a systematic review and meta-analysis. Medicine (Baltimore). 2017;96(12):e6443.
Yovich JL, Ye Y, Regan SL, Keane KN. The evolving concept of poor-prognosis for women undertaking IVF and the notion of growth hormone as an adjuvant; a single-center viewpoint. Front Endocrinol (Lausanne). 2019;10:808.
Keane KN, Hinchliffe PM, Rowlands PK, Borude G, Srinivasan S, Dhaliwal SS, et al. DHEA supplementation confers no additional benefit to that of growth hormone on pregnancy and live birth rates in IVF patients categorized as poor prognosis. Front Endocrinol (Lausanne). 2018;9:14.
Dakhly DM, Bassiouny YA, Bayoumi YA, Hassan MA, Gouda HM, Hassan AA. The addition of growth hormone adjuvant therapy to the long down regulation protocol in poor responders undergoing in vitro fertilization: randomized control trial. Eur J Obstet Gynecol Reprod Biol. 2018;228:161-5.
Norman RJ, Alvino H, Hull LM, Mol BW, Hart RJ, Kelly TL, et al. Human growth hormone for poor responders: a randomized placebo-controlled trial provides no evidence for improved live birth rate. Reprod Biomed Online. 2019;38(6):908-15.
Kyrou D, Kolibianakis EM, Venetis CA, Papanikolaou EG, Bontis J, Tarlatzis BC. How to improve the probability of pregnancy in poor responders undergoing in vitro fertilization: a systematic review and meta-analysis. Fertil Steril. 2009;91(3):749-66.
Kutluk Oktay, Samir Babayev. Approach to ovarian stimulation and in vitro fertilization in patients with transplanted ovarian tissue. In: Kutluk Oktay, editor. Principles and practice of ovarian tissue cryopreservation and transplantation; 2022. p. 185-92.
Li J, Chen Q, Wang J, Huang G, Ye H. Does growth hormone supplementation improve oocyte competence and IVF outcomes in patients with poor embryonic development? A randomized controlled trial. BMC Pregnancy Childbirth. 2020;20 (1):310.
Mohammad EH, Abou El Serour AG, Mohamed EAH, Abbasy AH, Zaatar M, Rageh KA, et al. Efficacy of growth hormone supplementation with gonadotropins in IVF/ICSI for poor responders: randomised controlled trial. Taiwan J Obstet Gynecol. 2021;60(1):51-5.
Journal of Reproduction & Infertility
Volume 24, Issue 4
Autumn 2023
Pages 279-286