Efficacy of growth hormone supplementation with ultrashort GnRH antagonist in IVF/ICSI for poor responders; randomized controlled trial

Mohammad, Ehab H.; Serour, Ahmed G. Abou El; Mohamed, E.A.; Abbasy, Amr H.; Zaatar, Mahmoud; Rageh, Kamal; Shafeek, Mohamed M.; Issak, Emad R.

doi:10.1016/j.tjog.2020.10.003

Cited by 13 publications

(10 citation statements)

References 11 publications

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“…A total of 1052 publications were retrieved from 7 databases, with 189 duplicates excluded as well as 811 papers according to the title and abstract. After further reading the full text, 16 RCTs [ 25 – 40 ] were finally included in this study (see Fig. 1 for the detailed flow chart).…”

Section: Resultsmentioning

confidence: 99%

TEAS, DHEA, CoQ10, and GH for poor ovarian response undergoing IVF-ET: a systematic review and network meta-analysis

Zhu

Yin

Yang

et al. 2023

Reprod Biol Endocrinol

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Background Assisted reproductive technology (ART) has brought good news to infertile patients, but how to improve the pregnancy outcome of poor ovarian response (POR) patients is still a serious challenge and the scientific evidence of some adjuvant therapies remains controversial. Aim Based on previous evidence, the purpose of this systematic review and network meta-analysis was to evaluate the effects of DHEA, CoQ10, GH and TEAS on pregnancy outcomes in POR patients undergoing in vitro fertilization and embryo transplantation (IVF-ET). In addition, we aimed to determine the current optimal adjuvant treatment strategies for POR. Methods PubMed, Embase, The Cochrane Library and four databases in China (CNKI, Wanfang, VIP, SinoMed) were systematically searched up to July 30, 2022, with no restrictions on language. We included randomized controlled trials (RCTs) of adjuvant treatment strategies (DHEA, CoQ10, GH and TEAS) before IVF-ET to improve pregnancy outcomes in POR patients, while the control group received a controlled ovarian stimulation (COS) regimen only. This study was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The surface under the cumulative ranking curve (SUCRA) was used to provide a pooled measure of cumulative ranking for each outcome. Results Sixteen RCTs (2323 women) with POR defined using the Bologna criteria were included in the network meta-analysis. Compared with the control group, CoQ10 (OR 2.22, 95% CI: 1.05 to 4.71) and DHEA (OR 1.92, 95% CI: 1.16 to 3.16) had obvious advantages in improving the clinical pregnancy rate. CoQ10 was the best in improving the live birth rate (OR 2.36, 95% CI: 1.07 to 5.38). DHEA increased the embryo implantation rate (OR 2.80, 95%CI: 1.41 to 5.57) and the high-quality embryo rate (OR 2.01, 95% CI: 1.07 to 3.78) and number of oocytes retrieved (WMD 1.63, 95% CI: 0.34 to 2.92) showed a greater advantage, with GH in second place. Several adjuvant treatment strategies had no significant effect on reducing the cycle canceling rate compared with the control group. TEAS was the least effective of the four adjuvant treatments in most pooled results, but the overall effect appeared to be better than that of the control group. Conclusion Compared with COS regimen, the adjuvant use of CoQ10, DHEA and GH before IVF may have a better clinical effect on the pregnancy outcome of POR patients. TEAS needs careful consideration in improving the clinical pregnancy rate. Future large-scale RCTs with direct comparisons are needed to validate or update this conclusion. Systematic review registration PROSPERO CRD42022304723

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Section: Resultsmentioning

confidence: 99%

TEAS, DHEA, CoQ10, and GH for poor ovarian response undergoing IVF-ET: a systematic review and network meta-analysis

Zhu

Yin

Yang

et al. 2023

Reprod Biol Endocrinol

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“…After the age of 35, the fertility of women declines yearly with aging, and the pregnancy rate of 45-year-old women is only 10% 13 . IVF/ICSI has become a crucial assisted reproduction method 14 . Nevertheless, the success rate is still far lower than the normal pregnancy rate in healthy people.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing clinical pregnancy outcome of in vitro fertilization/ intracytoplasmic sperm injection in older women

Gao,

Liu,

Zhong

et al. 2023

Afr H. Sci.

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Objective: To analyse the factors influencing clinical pregnancy outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in older women, and to establish a risk prediction model. Methods: A total of 425 patients receiving IVF/ICSI from March 2018 to March 2020 were divided into pregnancy group (n=194) and non-pregnancy group (n=231). The factors affecting the outcomes of IVF/ICSI were explored by univariate and multivariate logistic regression analyses. A nomogram prediction model was constructed. Results: The two groups had significantly different age, body mass index, dysmenorrhea, parity, times of full-term births, history of cesarean section, basal follicle stimulating hormone, basal antral follicle count (AFC), number of high-quality embryos, and basal estradiol, luteinizing hormone and endometrial thickness on the day of human chorionic gonadotropin (HCG) administration (P<0.05). Age ≥40 years old, dysmenorrhea, history of cesarean section, basal AFC<9, number of high-quality embryos <4, and endometrial thickness on the day of HCG administration <11 mm led to IVF/ICSI failure. The established model exhibited high calibration and discrimination degrees in predicting the outcome of IVF/ICSI. Conclusion: The risk prediction model for the pregnancy outcome of IVF/ICSI in older women helps evaluate the fertility probability and risk, providing references for formulating reasonable assisted reproduction plans. Keywords: Older pregnant woman; in vitro fertilization/intracytoplasmic sperm injection; pregnancy outcome; risk factor; nomogram prediction model.

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“…The effective gonadotropin dose and duration of stimulation were also significantly reduced in this study ( 32 ). Two randomized clinical trials demonstrated the benefits of GH in antagonist IVF/ICSI cycles ( 29 , 33 , 34 ). In those trials, GH was administered from the 6th day of the cycle at a dose of 7.5 IU/day until the day of hCG administration ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

“…Two randomized clinical trials demonstrated the benefits of GH in antagonist IVF/ICSI cycles ( 29 , 33 , 34 ). In those trials, GH was administered from the 6th day of the cycle at a dose of 7.5 IU/day until the day of hCG administration ( 34 ). The number of retrieved oocytes, metaphase II oocytes, fertilized oocytes, high-quality oocytes, and endometrial thickness all increased significantly.…”

Section: Discussionmentioning

confidence: 99%

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

Mohammadshirazi,

Alyasin,

Hosseini

et al. 2023

JRI

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Background: The efficiency of in vitro fertilization is improved by growth hormone (GH) during ovarian stimulation. Additionally, patients with diabetes experience im-paired insulin resistance and compromised glucose tolerance, which further ex-acerbate 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. Sub-cutaneous 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 admin-istration 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.

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Efficacy of growth hormone supplementation with ultrashort GnRH antagonist in IVF/ICSI for poor responders; randomized controlled trial

Cited by 13 publications

References 11 publications

TEAS, DHEA, CoQ10, and GH for poor ovarian response undergoing IVF-ET: a systematic review and network meta-analysis

TEAS, DHEA, CoQ10, and GH for poor ovarian response undergoing IVF-ET: a systematic review and network meta-analysis

Factors influencing clinical pregnancy outcome of in vitro fertilization/ intracytoplasmic sperm injection in older women

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

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