Keane Kevin N, Yovich John L, Hamidi Anahita, Hinchliffe Peter M, Dhaliwal Satvinder S
School of Biomedical Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
PIVET Medical Centre, Perth, Western Australia, Australia.
BMJ Open. 2017 Oct 8;7(10):e018107. doi: 10.1136/bmjopen-2017-018107.
Patients undergoing in vitro fertilisation (IVF) receive various adjuvant therapies in order to enhance success rates, but the true benefit is actively debated. Growth hormone (GH) supplementation was assessed in poor-prognosis women undergoing fresh IVF transfer cycles.
Data were retrospectively analysed from 400 IVF cycles, where 161 women received GH and 239 did not.
Clinical pregnancy, live birth rates and corresponding ORs and CIs were significantly greater with GH, despite patients being significantly older with lower ovarian reserve. Patient's age, quality of transferred embryo and GH were the only significant independent predictors of clinical pregnancy (OR: 0.90, 5.00 and 2.49, p<0.002, respectively) and live birth chance (OR: 0.91, 3.90 and 4.75, p<0.014, respectively). GH increased clinical pregnancy chance by 3.42-fold (95% CI 1.82 to 6.44, p<0.0005) and live birth chance by 6.16-fold (95% CI 2.83 to 13.39, p<0.0005) after adjustment for maternal age, antral follicle count and transferred embryo quality.
These data provided further evidence to indicate that GH may support more live births, particularly in younger women. It also appears that embryos generated under GH have a better implantation potential, but whether the biological mechanism is embryo-mediated or endometrium-mediated is unclear.
接受体外受精（IVF）的患者会接受各种辅助治疗以提高成功率，但真正的益处仍存在激烈争论。对预后不良且接受新鲜IVF移植周期的女性进行了生长激素（GH）补充治疗的评估。
对400个IVF周期的数据进行回顾性分析，其中161名女性接受了GH治疗，239名未接受。
尽管接受GH治疗的患者年龄明显更大且卵巢储备更低，但GH治疗组的临床妊娠率、活产率以及相应的OR值和CI值均显著更高。患者年龄、移植胚胎质量和GH是临床妊娠（OR值分别为0.90、5.00和2.49，p<0.002）和活产机会（OR值分别为0.91、3.90和4.75，p<0.014）的仅有的显著独立预测因素。在调整产妇年龄、窦卵泡计数和移植胚胎质量后，GH使临床妊娠机会增加了3.42倍（95%CI 1.82至6.44，p<0.0005），使活产机会增加了6.16倍（95%CI 2.83至13.39，p<0.0005）。
这些数据提供了进一步的证据，表明GH可能支持更多的活产，特别是在年轻女性中。此外，似乎在GH作用下产生的胚胎具有更好的着床潜力，但生物学机制是胚胎介导还是子宫内膜介导尚不清楚。
