Du Xiao-Fang, Yang Xin-Hong, Li Jing, Hao Mengmeng, Guo Yi-Hong
Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, Jianshe Dong Road, Erqi District, Zhengzhou, Henan, China.
Arch Gynecol Obstet. 2016 Oct;294(4):877-83. doi: 10.1007/s00404-016-4163-1. Epub 2016 Aug 3.
The efficacy of growth hormone (GH) co-treatment within a GnRH agonist long regimen, in women with a normal ovarian response to controlled ovarian hyperstimulation (COH), for IVF was assessed.
This retrospective clinical trial was performed in a private-assisted reproduction centre. The study involved 1114 patients who responded normally to high-dose gonadotropin treatment. The study group of 556 patients was given in a daily subcutaneous injection of 4.5 IU of GH co-treatment, starting from the initial day of gonadotropin treatment and lasting for 5 days. The control group of 558 patients received the same treatment protocol without the GH co-treatment. The participants were further divided into two subgroups: age ≥35 years and age <35 years. The primary endpoint of the study was IVF-ET outcomes.
The demographic characteristics did not significantly differ between the groups. The implantation rate (36.7 vs. 20.4 %, P < 0.05) and clinical pregnancy rate (57.3 vs. 30.1 %, P < 0.05) were significantly higher in the study group than in the control group. An analysis using a multivariate logistic regression model showed that GH was a significant factor for predicting pregnancy outcomes (OR 3.125, 95 % CI 2.441-4.000). Furthermore, for the ≥35-year-old group, the endometrial thickness was significantly greater (11.99 ± 2.21 vs. 11.62 ± 2.45, P < 0.05) in the study group than in the control group; in contrast, for the <35-year-old group, the high-quality embryo rate was significantly higher (71.7 vs. 68.3 %, P < 0.05) in the study group than in the control group.
Our study showed that co-treatment with GH in a GnRH agonist long protocol in patients who responded normally while undergoing IVF-ET could increase the implantation and pregnancy rates.
评估在对控制性卵巢刺激（COH）有正常卵巢反应的女性中，生长激素（GH）联合促性腺激素释放激素（GnRH）激动剂长方案用于体外受精（IVF）的疗效。
这项回顾性临床试验在一家私立辅助生殖中心进行。该研究纳入了1114例对高剂量促性腺激素治疗反应正常的患者。556例患者的研究组从促性腺激素治疗首日起，每日皮下注射4.5 IU的GH进行联合治疗，持续5天。558例患者的对照组接受相同治疗方案，但不进行GH联合治疗。参与者进一步分为两个亚组：年龄≥35岁和年龄<35岁。该研究的主要终点是IVF-ET结局。
两组间人口统计学特征无显著差异。研究组的着床率（36.7%对20.4%，P<0.05）和临床妊娠率（57.3%对30.1%，P<0.05）显著高于对照组。使用多因素逻辑回归模型分析显示，GH是预测妊娠结局的重要因素（比值比3.125，95%置信区间2.441 - 4.000）。此外，对于≥35岁组，研究组的子宫内膜厚度显著大于对照组（11.99±2.21对11.62±2.45，P<0.05）；相反，对于<35岁组，研究组的优质胚胎率显著高于对照组（71.7%对68.3%，P<0.05）。
我们的研究表明，在接受IVF-ET且反应正常的患者中，GnRH激动剂长方案联合GH治疗可提高着床率和妊娠率。
