Growth hormone during in vitro fertilization in older women modulates the density of receptors in granulosa cells, with improved pregnancy outcomes
Growth hormone co-treatment restored the pre-ovulatory down-regulation of granulosa cell receptor density of the largest follicles. This was associated with an improved pregnancy and live birth rate in older women.
Volume 110, Issue 7, Pages 1298–1310
Authors:
Sheena L.P. Regan, Ph.D., Phil G. Knight, Ph.D., John L. Yovich, M.D., Ph.D., Frank Arfuso, Ph.D., Arun Dharmarajan, Ph.D.
Abstract:
Objective
To study the effect of aging and granulosa cell growth hormone receptor (GHR) expression, and the effect of growth hormone (GH) co-treatment during IVF on receptor expression.
Design
Laboratory study.
Setting
University.
Patient(s)
A total of 445 follicles were collected from 62 women undergoing standard infertility treatment.
Intervention(s)
Preovulatory ovarian follicle biopsies of granulosa cells and follicular fluid.
Main Outcome Measure(s)
Older women with a poor ovarian reserve were co-treated with GH to determine the effect of the adjuvant during IVF on the granulosal expression density of FSH receptor (FSHR), LH receptor (LHR), bone morphogenetic hormone receptor (BMPR1B), and GHR. Ovarian reserve, granulosa cell receptor density, oocyte quality, and pregnancy and live birth rates were determined.
Result(s)
Growth hormone co-treatment increased the receptor density for granulosal FSHR, BMPR1B, LHR, and GHR compared with the non–GH-treated patients of the same age and ovarian reserve. Growth hormone co-treatment increased GHR density, which may increase GHR activity. The GH co-treatment was associated with a significant increase in pregnancy rate.
Conclusion(s)
Growth hormone co-treatment restored the preovulatory down-regulation of FSHR, BMPR1B, and LHR density of the largest follicles, which may improve the maturation process of luteinization in older patients with reduced ovarian reserve. The fertility of the GH-treated patients improved.
Comments
I totally confirm the work and the conclusion of the authors. We have already shown the positive effect of GH in polycystic ovaries supplying many dysmorphic oocytes but also in older women (Tesarik, J., A. Hazout, and Mendoza, C. ICSI in women aged> 40 years by ovarian co-stimulation with growth hormone Hum Reprod 2005; 20: 2536-2541) The question is, based on these results, why clinicians do not use GH as adjunct to stimulation in the cases evoked ?