IVIRMA, IVI Foundation, Health Research Institute La Fe, Valencia, Spain; Universidad Rey Juan Carlos, Móstoles, Madrid, Spain; Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.
Universidad Rey Juan Carlos, Móstoles, Madrid, Spain; Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil; Department of Reproductive Medicine, Mater Prime, São Paulo, Brazil.
Fertil Steril. 2020 Jul;114(1):97-109. doi: 10.1016/j.fertnstert.2020.03.007. Epub 2020 Jun 16.
To evaluate the effectiveness of growth hormone (GH) supplementation in improving the in vitro fertilization (IVF) outcomes of poor responders.
Systematic review and meta-analysis.
Not applicable.
PATIENT(S): Poor ovarian responders undergoing conventional IVF or intracytoplasmic sperm injection (ICSI).
INTERVENTION(S): Randomized controlled trials (RCTs) of poor ovarian responders undergoing a single IVF/ICSI cycle with GH supplementation versus conventional controlled ovarian stimulation. This review was registered in the PROSPERO database before starting data extraction (CRD42020151681).
MAIN OUTCOME MEASURE(S): Primary outcome was live birth rate. Clinical pregnancy rate, miscarriage rate, ongoing pregnancy rate, number of oocytes, number of mature (metaphase II [MII]) oocytes and the number of embryos available to transfer were considered as secondary outcomes.
RESULT(S): Twelve RCTs were included; 586 women were assigned to the intervention group and 553 to the control group. The analysis revealed that patients receiving GH supplementation did not show an increased live birth rate, miscarriage rate, or ongoing pregnancy rate. However, GH supplementation in poor responders increased clinical pregnancy rate, number of oocytes retrieved (mean difference 1.62), number of MII oocytes (mean difference 2.06), and number of embryos available to transfer (mean difference 0.76). Sensitivity and subgroup analyses did not provide statistical changes to pooled results.
CONCLUSION(S): The present meta-analysis provides evidence that GH supplementation may improve some reproductive outcomes in poor responders, but not live birth rates.
评估生长激素（GH）补充对改善卵巢反应不良患者体外受精（IVF）结局的有效性。
系统评价和荟萃分析。
不适用。
接受常规体外受精（IVF）或胞浆内单精子注射（ICSI）的卵巢反应不良患者。
对接受单次 IVF/ICSI 周期的卵巢反应不良患者进行 GH 补充与常规控制性卵巢刺激的随机对照试验（RCT）。本综述在开始提取数据前在 PROSPERO 数据库中进行了注册（CRD42020151681）。
主要结局为活产率。临床妊娠率、流产率、持续妊娠率、获卵数、成熟（MII）卵数和可移植胚胎数被视为次要结局。
纳入 12 项 RCT，586 名患者被分配至干预组，553 名患者被分配至对照组。分析结果显示，接受 GH 补充的患者并未显示出活产率、流产率或持续妊娠率的增加。然而，GH 补充可增加卵巢反应不良患者的临床妊娠率、获卵数（平均差异 1.62）、MII 卵数（平均差异 2.06）和可移植胚胎数（平均差异 0.76）。敏感性和亚组分析并未对汇总结果产生统计学变化。
本荟萃分析提供了证据表明，GH 补充可能改善卵巢反应不良患者的一些生殖结局，但不能提高活产率。
