Santibáñez-Morales A, Durán-Boullosa E, Colín-Licea E O
Ginecol Obstet Mex. 2016 Sep;84(9):567-72.
Ovarian stimulation is the cornerstone in fertility treatments, it produces multifolicular development and in consequence, a greater pregnancy rate. Poor responder patients have bad outcomes in IVF, several medical approaches have been proposed in managing these patients, including Growth Hormone.
To report our results with the use of growth hormone and review published data.
Case series conducted from January 2013 to May 2015 in patients to Centro de Reproducción PROCREA, Mexico City, poor responders according to the criteria of consensus Bologna cycles in fresh stimulation protocol Flare up, application of growth hormone as adjuvant, complete cycles of stimulation (stimulation, oocyte capture, and embryo transfer pregnancy test) and complete records. For statistical analysis, averages and percentages were used.
40 cases were analyzed. Age and BMI were 39.1 ± 2.1 years and 24.6 ± 2.8 kg/m2, respectively. Total gonadotrophin dose was 2128.6 ± 1078.9 UI, retrieved oocytes and fertilized eggs were 7.1 ± 4.0 y 5.4 ± 2.8 respectively. Fertilization rate was 76.3% and pregnancy rate was 59.5%.
There is insufficient evidence for prescribing GH in all patients requiring IVF, nevertheless, in poor responder patients, there seems to be an improvement in egg quality leading to better fertilization and pregnancy rate, with no adverse effects.
卵巢刺激是生育治疗的基石,它能促使多个卵泡发育,从而提高妊娠率。反应不良的患者在体外受精(IVF)中预后不佳,针对这类患者的管理已提出了多种医学方法,包括使用生长激素。
报告我们使用生长激素的结果并回顾已发表的数据。
2013年1月至2015年5月在墨西哥城生殖中心PROCREA对患者进行病例系列研究,根据博洛尼亚共识标准,在新鲜刺激方案“激发”中,将患者作为反应不良者,应用生长激素作为辅助药物,记录完整的刺激周期(刺激、取卵、胚胎移植及妊娠检测)。统计分析采用均值和百分比。
分析了40例病例。年龄和体重指数分别为39.1±2.1岁和24.6±2.8kg/m²。促性腺激素总剂量为2128.6±1078.9国际单位,获卵数和受精卵数分别为7.1±4.0个和5.4±2.8个。受精率为76.3%,妊娠率为59.5%。
对于所有需要体外受精的患者,尚无足够证据支持使用生长激素,但对于反应不良的患者,生长激素似乎能改善卵子质量,提高受精率和妊娠率,且无不良影响。