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生长激素在受精中的应用。

Application of Growth Hormone in Fertilization.

作者信息

Xu Yue-Ming, Hao Gui-Min, Gao Bu-Lang

机构信息

Department of Reproductive Medicine, The Second Hospital, Hebei Medical University, Shijiazhuang, China.

Department of Medical Research, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang, China.

出版信息

Front Endocrinol (Lausanne). 2019 Jul 23;10:502. doi: 10.3389/fendo.2019.00502. eCollection 2019.

Abstract

Growth hormone (GH) is a peptide hormone secreted mainly by the anterior part of the pituitary gland and plays a critical role in cell growth, development, and metabolism throughout the body. GH can not only directly influence human oocytes and cumulus cells but also indirectly improve oocyte quality through activating synthesis of insulin-like growth factor-I or promoting follicle-stimulating hormone-induced ovarian steroidogenesis. Since GH can regulate female and male infertility, it has been applied in the management of infertility for many years, especially in patients with poor ovarian response or poor prognosis. During ovarian stimulation, GH administration might improve the success rate of fertilization (IVF) probably through the beneficial effects of GH on oocyte quality as indicated by a higher number of mature oocytes and embryos arriving at the transfer stage and a higher fertility rate in GH-treated patients. However, there is still great controversy in the application of GH in IVF. While some researchers showed that pregnancy, implantation and live birth rates could be increased by ovarian pretreatment with GH, others did not support GH as an effective adjuvant for infertility treatment because the live birth rate was not increased. This study reviewed and summarized recent advancements and benefits in clinical application of GH, trying to reach a just unbiased conclusion regarding the effect of GH therapy in IVF.

摘要

生长激素(GH)是一种主要由垂体前叶分泌的肽类激素,在全身细胞生长、发育和代谢中起关键作用。生长激素不仅可以直接影响人类卵母细胞和颗粒细胞,还可以通过激活胰岛素样生长因子-I的合成或促进促卵泡激素诱导的卵巢类固醇生成来间接改善卵母细胞质量。由于生长激素可以调节女性和男性的不孕症,多年来它一直被应用于不孕症的治疗,尤其是卵巢反应不良或预后较差的患者。在卵巢刺激过程中,生长激素的给药可能会提高体外受精(IVF)的成功率,这可能是因为生长激素对卵母细胞质量有有益影响,表现为到达移植阶段的成熟卵母细胞和胚胎数量增加,以及接受生长激素治疗的患者生育率更高。然而,生长激素在体外受精中的应用仍存在很大争议。虽然一些研究人员表明,通过生长激素进行卵巢预处理可以提高妊娠、着床和活产率,但另一些人并不支持将生长激素作为不孕症治疗的有效辅助手段,因为活产率并未提高。本研究回顾并总结了生长激素临床应用的最新进展和益处,试图就生长激素治疗在体外受精中的效果得出公正无偏的结论。

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