Research and Clinical Center for Infertility, Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Science, Yazd, Iran.
Arch Gynecol Obstet. 2013 May;287(5):1017-21. doi: 10.1007/s00404-012-2655-1. Epub 2012 Dec 4.
The incidence of poor ovarian response in controlled ovarian stimulation (COH) has been reported in 9-24 % of IVF-ET cycles. Growth hormone augments the effect of gonadotropin on granulosa and theca cells, and plays an essential role in ovarian function, including follicular development, estrogen synthesis and oocyte maturation. The aim of this study was to assess IVF-ET cycle outcome after the addition of growth hormone in antagonist protocol in poor responders.
Eighty-two poor responder patients selected for ART enrolled the study and were randomly divided into two groups. Group I (GH/HMG/GnRHant group, n = 40) received growth hormone/gonadotropin/GnRH antagonist protocol and group II (HMG/GnRHant group, n = 42) received gonadotropin/GnRH antagonist protocol.
The number of retrieved oocytes was significantly higher in GH/HMG/GnRHant group than HMG/GnRHant group, 6.10 ± 2.90 vs. 4.80 ± 2.40 (p = 0.035) and the number of obtained embryos was also significantly higher in GH/HMG/GnRHant group than HMG/GnRHant group, 3.7 ± 2.89 as compared to 2.7 ± 1.29 (p = 0.018). There were no significant differences between groups regarding implantation, and chemical and clinical pregnancy rates.
Our study showed that co-treatment with growth hormone in antagonist protocol in patients with a history of poor response in previous IVF-ET cycles did not increase pregnancy rates.
在控制性卵巢刺激（COH）中，卵巢反应不良的发生率为 9-24%，已在体外受精-胚胎移植（IVF-ET）周期中报道。生长激素增强了促性腺激素对颗粒细胞和膜细胞的作用，在卵巢功能中发挥着重要作用，包括卵泡发育、雌激素合成和卵母细胞成熟。本研究旨在评估在拮抗剂方案中添加生长激素对卵巢反应不良患者的 IVF-ET 周期结局的影响。
选择 82 名接受 ART 的卵巢反应不良患者进行研究，并将其随机分为两组。第 1 组（GH/HMG/GnRHant 组，n=40）接受生长激素/促性腺激素/GnRH 拮抗剂方案，第 2 组（HMG/GnRHant 组，n=42）接受促性腺激素/GnRH 拮抗剂方案。
GH/HMG/GnRHant 组的获卵数明显多于 HMG/GnRHant 组，分别为 6.10±2.90 个和 4.80±2.40 个（p=0.035），获得的胚胎数也明显多于 HMG/GnRHant 组，分别为 3.7±2.89 个和 2.7±1.29 个（p=0.018）。两组在着床率、生化妊娠率和临床妊娠率方面无显著差异。
本研究表明，在拮抗剂方案中联合使用生长激素治疗既往 IVF-ET 周期卵巢反应不良的患者并不能提高妊娠率。
