Keane Kevin N, Hinchliffe Peter M, Rowlands Philip K, Borude Gayatri, Srinivasan Shanti, Dhaliwal Satvinder S, Yovich John L
School of Pharmacy and Biomedical Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
PIVET Medical Centre, Perth, WA, Australia.
Front Endocrinol (Lausanne). 2018 Jan 31;9:14. doi: 10.3389/fendo.2018.00014. eCollection 2018.
fertilization (IVF) patients receive various adjuvant therapies to enhance success rates, but the true benefit is actively debated. Growth hormone (GH) and dehydroepiandrosterone (DHEA) supplementation were assessed in women undergoing fresh IVF transfer cycles and categorized as poor prognosis from five criteria.
Data were retrospectively analyzed from 626 women undergoing 626 IVF cycles, where they received no adjuvant, GH alone, or GH-DHEA in combination. A small group received DHEA alone. The utilization of adjuvants was decided between the attending clinician and the patient depending on various factors including cost.
Despite patients being significantly older with lower ovarian reserve, live birth rates were significantly greater with GH alone (18.6%) and with GH-DHEA (13.0%) in comparison to those with no adjuvant ( < 0.003). No significant difference was observed between the GH groups ( = 0.181). Overall, patient age, quality of the transferred embryo, and GH treatment were the only significant independent predictors of live birth chance. Following adjustment for patient age, antral follicle count, and quality of transferred embryo, GH alone and GH-DHEA led to a 7.1-fold and 5.6-fold increase in live birth chance, respectively ( < 0.000).
These data indicated that GH adjuvant may support more live births, particularly in younger women, and importantly, the positive effects of GH treatment were still observed even if DHEA was also used in combination. However, supplementation with DHEA did not indicate any potentiating benefit or modify the effects of GH treatment. Due to the retrospective design, and the risk of a selection bias, caution is advised in the interpretation of the data.
体外受精（IVF）患者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。对接受新鲜IVF移植周期的女性补充生长激素（GH）和脱氢表雄酮（DHEA）进行了评估，并根据五项标准将其归类为预后不良。
对626名接受626个IVF周期的女性的数据进行回顾性分析，她们未接受辅助治疗、仅接受GH或联合使用GH-DHEA。一小部分女性仅接受DHEA。辅助治疗的使用由主治医生和患者根据包括费用在内的各种因素决定。
尽管患者年龄明显较大且卵巢储备较低，但与未接受辅助治疗的患者相比（<0.003），仅使用GH（18.6%）和使用GH-DHEA（13.0%）的活产率显著更高。GH组之间未观察到显著差异（=0.181）。总体而言，患者年龄、移植胚胎质量和GH治疗是活产机会的仅有的显著独立预测因素。在对患者年龄、窦卵泡计数和移植胚胎质量进行调整后，仅使用GH和使用GH-DHEA分别使活产机会增加了7.1倍和5.6倍（<0.000）。
这些数据表明，GH辅助治疗可能支持更多活产，尤其是在年轻女性中，重要的是，即使联合使用DHEA，仍观察到GH治疗的积极效果。然而，补充DHEA并未显示出任何增强益处或改变GH治疗的效果。由于采用回顾性设计以及存在选择偏倚的风险，建议在解释数据时谨慎。
