Outcomes of poor responders following growth hormone co-treatment with IVF/ICSI mild stimulation protocol: a retrospective cohort study

Chu, Kun; Pang, Wenjuan; Sun, Ning; Zhang, Qing; Li, Wen

doi:10.1007/s00404-018-4725-5

Cited by 20 publications

(22 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While this is not a direct measurement of embryo quality, it does imply that those with GH may have more opportunities for ET (and ensuing pregnancies) in later cycles. Nonetheless, several other reports have demonstrated that GH enhanced embryo quality as assessed by morphological grading [5,16], although in our study this enhancement was not detectable. It is possible that such embryos (and the oocytes from which they were derived) have higher competency for generating pregnancies, which is not measured by current morphological grading systems.…”

Section: Discussioncontrasting

confidence: 95%

“…In accordance with this previous work on fresh transfers [12,13], the current findings indicated that the use of GH as an adjuvant cotreatment during IVF stimulation had a positive outcome on fresh ET and in addition, in subsequent FET cycles. As GH was not administered during the FET cycles, this suggested that the potential beneficial effects of GH may extend to embryo quality as presented previously [5,9,16], rather than involving an effect on endometrium receptivity [15,17]. However, in our previous studies on embryos generated under GH action, we failed to demonstrate that the adjuvant altered embryo quality to a measurable extent, as the proportion of highquality embryos on morphological assessment was the same with or without GH [12,13].…”

Section: Discussionmentioning

confidence: 60%

“…Some studies have already investigated the role of GH co-treatment directly with hormone replacement therapy (HRT) in frozen ET (FET) cycles, and indicated that GH may affect endometrium thickness, CP and LB rates [14][15][16][17]. Due to their study design, those investigations suggested that GH may have additonal positive effects on outcomes that are related to the endometrium, rather than embryo quality, as the embyros were generated previously without GH exposure.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Live birth outcomes of vitrified embryos generated under growth hormone stimulation are improved for women categorized as poor-prognosis

Keane

Hinchliffe

et al. 2019

Clin Exp Reprod Med

View full text Add to dashboard Cite

Objective: To determine the clinical pregnancy (CP) and live birth (LB) rates arising from frozen embryo transfers (FETs) that had been generated under the influence of in vitro fertilization (IVF) adjuvants given to women categorized as poor-prognosis. Methods: A registered, single-center, retrospective study. A total of 1,119 patients with first FETs cycle include 310 patients with poor prognosis (109 treated with growth hormone [GH], (+)GH group vs. 201 treated with dehydroepiandrosterone, (-)GH group) and 809 patients with good prognosis (as control, (-)Adj (Good) group). Results: The poor-prognosis women were significantly older, with a lower ovarian reserve than the (-)Adj (Good) group, and demonstrated lower chances of CP (p< 0.005) and LB (p< 0.005). After adjusting for confounders, the chances of both CP and LB in the (+)GH group were not significantly different from those in the (-)Adj (Good) group, indicating that the poor-prognosis patients given GH had similar outcomes to those with a good prognosis. Furthermore, the likelihood of LB was significantly higher for poor-prognosis women given GH than for those who did not receive GH (p< 0.028). This was further confirmed in age-matched analyses. Conclusion: The embryos cryopreserved from fresh IVF cycles in which adjuvant GH had been administered to women classified as poor-prognosis showed a significant 2.7-fold higher LB rate in subsequent FET cycles than a matched poor-prognosis group. The women with a poor prognosis who were treated with GH had LB outcomes equivalent to those with a good prognosis. We therefore postulate that GH improves some aspect of oocyte quality that confers improved competency for implantation.

show abstract

Section: Discussioncontrasting

confidence: 95%

Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Live birth outcomes of vitrified embryos generated under growth hormone stimulation are improved for women categorized as poor-prognosis

Keane

Hinchliffe

et al. 2019

Clin Exp Reprod Med

View full text Add to dashboard Cite

show abstract

“…GH has been applied in the treatment of infertility, especially for poor responders. Some studies showed that GH administration during ovarian stimulation can improve IVF/ICSI outcomes, such as oocyte quality, pregnancy rate, and live birth [12][13][14]. In 2010, a Cochrane review suggested that due to few number of RCTs and small sample size, the role of GH in IVF/ICSI needs further research [15].…”

Section: Introductionmentioning

confidence: 99%

The effect of growth hormone supplementation in poor ovarian responders undergoing IVF or ICSI: a meta-analysis of randomized controlled trials

Yang

Zhang

2020

Reprod Biol Endocrinol

View full text Add to dashboard Cite

The aim of this meta-analysis was to evaluate the effect of growth hormone (GH) supplementation in poor responders undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Methods: PubMed, MEDLINE and Cochrane Library databases were searched for the identification of relevant randomized controlled trials. Outcome measures were live birth rate, clinical pregnancy rate, miscarriage rate, cycle cancelation rate, number of retrieved oocytes and total dose of gonadotropin. Results: Fifteen randomized controlled trails (RCTs) involving 1448 patients were eligible for the analysis. GH supplementation improved live birth rate (RR, 1.74; 95% CI, 1.19-2.54), clinical pregnancy rate (RR, 1.65; 95% CI, 1.31-2.08) and retrieved oocytes number (SMD, 0.72; 95% CI, 0.28-1.16), while reducing cancelled cycles rate (RR, 0.62; 95% CI, 0.44-0.85) and dose of Gonadotropin (SMD,-1.05 95% CI, − 1.62-0.49) for poor ovarian response patients. Besides, there was no significant difference in the miscarriage rate between GH group and control group. Conclusions: Based on the limited available evidence, growth hormone supplementation seems to improve IVF/ICSI outcomes for poor ovarian responders. Further randomized controlled trials with large sample sizes are required to clarify the effect of GH adjuvant therapy in the treatment of women with poor ovarian response.

show abstract

“…Among these, the double ovarian stimulation, that is the ovarian stimulation in follicular and luteal phases within a single ovarian cycle, seems capable of increasing the number of retrieved oocytes and available embryos for the single patient (64). The first data have been published on possible advantages of a GH co-treatment with the mild stimulation protocol or the GnRH antagonist protocol in poor responders (65–67). Some RCTs and meta-analysis have also been published regarding LH supplementation within the rFSH stimulation in IVF cycles: there is no agreement on the benefit of this therapy in the general population, while particularly in POR patients it showed an improvement of the clinical pregnancy rate and live birth rate (51, 52, 68, 69).…”

Section: Ovarian Response Prediction and Managementmentioning

confidence: 99%

Ovarian Reserve Markers to Identify Poor Responders in the Context of Poseidon Classification

2019

View full text Add to dashboard Cite

It is well-known that poor ovarian reserve is a cause of infertility, poor response to gonadotrophin stimulation and poor success rate after in vitro fertilization (IVF) cycles. Some years ago a consensus was elaborated on precise criteria which can lead to a correct identification of poor responders (the Bologna criteria). More recently, the POSEIDON group has proposed a new stratified classification of patients with low prognosis, also with the aim of providing clinical indications for the management of these patients. A literature search was carried out for studies that investigated the ability of ovarian reserve markers, in particular AMH and AFC, to predict poor ovarian response in IVF cycles; secondly, studies regarding the Bologna criteria and their prognostic value were analyzed and available literature on POSEIDON classification was reported. The most recent markers of ovarian reserve (serum AMH and ultrasound AFC) have shown to provide a direct and accurate measurement of ovarian follicle pool. These markers have generally shown comparable predictive power for ovarian response and a number of retrieved oocytes in IVF cycles. “Abnormal ovarian reserve test” is a very important parameter both in the Bologna criteria and in the POSEIDON classification. Several studies have already been published about the reproductive outcome of patients defined as poor responders according to the ESHRE Bologna criteria: all of them agree on the poor IVF outcome and low pregnancy rate of these patients. Instead, being the POSEIDON classification of very recent publication, the efficacy of the POSEIDON approach in improving management and outcomes of POR patients has yet to be tested and validated with future prospective clinical trials. Prediction of poor response may help clinicians choose the stimulation protocol with the aim of gaining patient compliance and cost reduction, and many efforts have been made by researchers in this sense, including the formulation of the Bologna criteria and of the POSEIDON classification, in which the ovarian reserve markers (AMH and AFC) play a fundamental role.

show abstract

Outcomes of poor responders following growth hormone co-treatment with IVF/ICSI mild stimulation protocol: a retrospective cohort study

Abstract: The results suggested that the adjuvant GH treatment in mild stimulation protocol for poor responders could significantly improve good-quality embryo rate, and might therefore improve the clinical outcomes.

Cited by 20 publications

References 29 publications

Live birth outcomes of vitrified embryos generated under growth hormone stimulation are improved for women categorized as poor-prognosis

Live birth outcomes of vitrified embryos generated under growth hormone stimulation are improved for women categorized as poor-prognosis

The effect of growth hormone supplementation in poor ovarian responders undergoing IVF or ICSI: a meta-analysis of randomized controlled trials

Ovarian Reserve Markers to Identify Poor Responders in the Context of Poseidon Classification

Contact Info

Product

Resources

About