生长激素补充是否能提高胚胎发育不良患者的卵母细胞能力和 IVF 结局？一项随机对照试验。
Does growth hormone supplementation improve oocyte competence and IVF outcomes in patients with poor embryonic development? A randomized controlled trial.
机构信息
Chongqing Key Laboratory of Human Embryo Engineering, Chongqing Reproduction and Genetics Institute, Chongqing Health Center for Women and Children, No.64 Jin Tang Street, Yu Zhong District, Chongqing, 400013, China.
出版信息
BMC Pregnancy Childbirth. 2020 May 20;20(1):310. doi: 10.1186/s12884-020-03004-9.
BACKGROUND
Many studies have demonstrated the benefits of the addition of growth hormone (GH) to the controlled ovarian stimulation protocol in vitro fertilization (IVF) cycles in poor-respond patients, but the effect of GH on patients with poor embryonic development remain unclear. This paper was designed to investigate the efficacy of GH co-treatment during IVF for the patients with poor embryonic development.
METHOD
A randomized controlled trial including 158 patients with poor embryo development was conducted between July 2017 and February 2019. One hundred and seven patients were randomized for GH treatment (GH group) and 51 patients for untreated (control group). The primary end-points were the clinical pregnancy and live birth rates in the two groups. The oocyte competence were assessed through calculating the mitochondrial DNA (mtDNA) copy number in corresponding cumulus granulosa cells (CGCs). Quantitative PCR were used for calculation of mtDNA copy number.
RESULTS
Relative to the control group, GH co-treatment resulted in a significantly higher number of retrieved oocytes (10.29 ± 5.92 versus 8.16 ± 4.17, P = 0.023) and cleaved embryos (6.73 ± 4.25 versus 5.29 ± 3.23, P = 0.036). The implantation rate, clinical pregnancy rates per cycle, and live birth rate per cycle were higher in the GH group than in the control group (36.00% versus 17.86%, P = 0.005; 43.93% versus 19.61%, P = 0.005; 41.12% versus 17.65%, P = 0.006). CGCs of the GH group had significantly higher mtDNA copy numbers than CGCs of the control group (252 versus 204, P < 0.001).
CONCLUSIONS
These data provided further evidence to indicate that GH supplementation may support more live births during IVF, in patients with poor embryonic development. It also appears that oocytes generated under GH co-treatment have a better developmental competence.
TRIAL REGISTRATION
ChiCTR1900021992 posted March 19, 2019 (retrospectively registered).
背景
许多研究表明，在体外受精（IVF）周期中，添加生长激素（GH）对卵巢刺激控制性反应不良的患者有益，但 GH 对胚胎发育不良患者的影响尚不清楚。本文旨在研究 GH 联合治疗对胚胎发育不良患者 IVF 的疗效。
方法
本研究为一项随机对照试验，纳入了 2017 年 7 月至 2019 年 2 月期间 158 名胚胎发育不良患者。107 名患者被随机分为 GH 治疗组（GH 组）和 51 名未治疗组（对照组）。主要终点为两组的临床妊娠率和活产率。通过计算相应的卵丘颗粒细胞（CGC）中线粒体 DNA（mtDNA）拷贝数来评估卵母细胞的活力。使用定量 PCR 计算 mtDNA 拷贝数。
结果
与对照组相比，GH 联合治疗组获得的卵母细胞数显著增加（10.29±5.92 个 vs. 8.16±4.17 个，P=0.023）和分裂胚胎数（6.73±4.25 个 vs. 5.29±3.23 个，P=0.036）。GH 组的着床率、每周期临床妊娠率和每周期活产率均高于对照组（36.00% vs. 17.86%，P=0.005；43.93% vs. 19.61%，P=0.005；41.12% vs. 17.65%，P=0.006）。GH 组的 CGCs 中的 mtDNA 拷贝数明显高于对照组（252 比 204，P<0.001）。
结论
这些数据进一步表明，GH 补充可能支持胚胎发育不良患者在 IVF 中获得更多的活产。此外，GH 联合治疗下产生的卵母细胞具有更好的发育能力。
试验注册
ChiCTR1900021992 于 2019 年 3 月 19 日发布（回溯注册）。
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