Authors:
Yan Gong, M.D., Kun Zhang, Ph.D., Gideon Verwoerd, M.Med., Yanan Zhang, M.D., Weixin Liu, M.D., Wei Lai, M.D.
Abstract:
Objective
To investigate the effects of different growth hormone (GH) treatment protocols on steroid hormone and insulin-like growth factor (IGF) levels in follicle fluid (FF), hormone receptors in granulosa cells (GCs), and in vitro fertilization and embryo-transfer outcomes in poor ovarian responders.
Design
Prospectively randomized trial.
Setting
Reproductive medicine center.
Patient(s)
Two hundred thirty poor ovarian responders.
Intervention(s)
The patients were randomly assigned to 3 groups: group A, GH pretreatment (4 IU/d) from day 2 of the previous menstrual cycle until the trigger day; group B, GH treatment (4 IU/d) from day 2 of the menstrual cycle until the trigger day; group C, without GH treatment.
Main Outcome Measure(s)
The primary outcome was the live birth rate. The secondary outcomes were IGF and steroid hormone levels in FF and hormone receptors in GCs.
Result(s)
The live birth rate per treatment cycle started (27.03% vs. 11.43% vs. 5.33%) and per patient randomized (25.97% vs. 10.81% vs. 5.06%) was significantly increased in group A compared with groups B and C. The levels of estrogen (1488.30 ± 307.68 ng/mL vs. 1144.49 ± 461.42 ng/mL vs. 639.23 ± 229.80 ng/mL), progesterone (31.02 ± 9.79 μg/mL vs. 25.34 ± 10.83 μg/mL vs. 18.25 ± 8.42 μg/mL), testosterone (13.44 ± 5.01 ng/mL vs. 11.33 ± 3.89 ng/mL vs. 7.75 ± 4.58 ng/mL), GH (1.53 ± 0.61 ng/mL vs. 1.04 ± 0.33 ng/mL vs. 0.72 ± 0.28 ng/mL), and IGF-1 (100.42 ± 23.54 ng/mL vs. 75.00 ± 23.32 ng/mL vs. 42.24 ± 20.24 ng/mL) in FF and the mRNA levels of GH receptor, follicle-stimulating hormone receptor, and luteinizing hormone receptor in GCs were significantly different among the 3 groups, showing an increasing trend with the long GH treatment protocol.
Conclusion(s)
GH improved the levels of IGF-1 and steroid hormones in FF and hormone receptors in GCs, with an obvious uptrend in the long-course treatment protocol. GH pretreatment from the previous menstrual cycle improved the in vitro fertilization outcomes in poor ovarian responders.
Clinical Trial Registration Number
ChiCTR1800016106 (Chinese Clinical Trial Registry). (http://www.chictr.org.cn/edit.aspx?pid=27205&htm=4)
