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在非低反应患者的 IVF/PGT-A 周期中,卵巢刺激期间补充生长激素可改善卵母细胞和胚胎结局。

Growth hormone supplementation during ovarian stimulation improves oocyte and embryo outcomes in IVF/PGT-A cycles of women who are not poor responders.

机构信息

Women's Health Department, Dell Medical School, UT Austin, Medical Park Tower, 1301 W. 38th Street, Suite 705, Austin, Texas, 78705, USA.

Fora Fertility, 715 W 34th St, Austin, TX, 78705, USA.

出版信息

J Assist Reprod Genet. 2021 May;38(5):1055-1060. doi: 10.1007/s10815-021-02088-2. Epub 2021 Feb 3.

Abstract

PURPOSE

To determine the effect of human growth hormone (GH) supplementation during ovarian stimulation in women undergoing IVF/PGT-A cycles, who do not meet the Bologna criteria for poor ovarian response (POR).

METHODS

This is a retrospective cohort study of 41 women with suboptimal outcomes in their first cycle of IVF/PGT-A including lower than expected number of MII oocytes, poor blastulation rate, and/or lower than expected number of euploid embryos for their age, who underwent a subsequent IVF/PGT-A cycle with the same fixed dose gonadotropin protocol and adjuvant GH treatment. Daily cotreatment with GH started with first gonadotrophin injection. The IVF cycle outcomes were compared between the control and GH cycle using the Wilcoxon-Signed Rank test.

RESULTS

The total number of biopsied blastocysts (mean ± SD; 2.0 ± 1.6 vs 3.5 ± 3.2, p = 0.009) and euploid embryos (0.8 ± 1.0 vs 2.0 ± 2.8, p = 0.004) were significantly increased in the adjuvant GH cycle compared to the control cycle. The total number of MII oocytes also trended to be higher in the GH cycle (10.2 ± 6.3 vs 12.1 ± 8.3, p = 0.061). The overall blastulation and euploidy rate did not differ between the control and treatment cycle.

CONCLUSION

Our study uniquely investigated the use of adjuvant GH in IVF/PGT-A cycles in women without POR and without a priori suspicion for poor outcome based on their clinical parameters. Our study presents preliminary evidence that GH supplementation in these women is beneficial and is associated with an increased number of blastocysts for biopsy and greater number of euploid embryos for transfer.

摘要

目的

确定在接受 IVF/PGT-A 周期的女性中,在不符合博洛尼亚卵巢反应不良 (POR) 标准的情况下,在卵巢刺激期间补充人生长激素 (GH) 对 IVF/PGT-A 周期的影响。

方法

这是一项回顾性队列研究,共纳入 41 名在首次 IVF/PGT-A 周期中结局不佳的女性,这些女性的表现为获得的 MII 卵母细胞数量低于预期、囊胚发育率差和/或与年龄相比,获得的整倍体胚胎数量低于预期,她们随后接受了相同固定剂量促性腺激素方案和辅助 GH 治疗的后续 IVF/PGT-A 周期。每日联合 GH 治疗从第一次促性腺激素注射开始。使用 Wilcoxon 符号秩检验比较对照周期和 GH 周期的 IVF 周期结局。

结果

与对照周期相比,辅助 GH 周期的活检囊胚总数(平均值±标准差;2.0±1.6 与 3.5±3.2,p=0.009)和整倍体胚胎数(0.8±1.0 与 2.0±2.8,p=0.004)显著增加。GH 周期的 MII 卵母细胞总数也呈增加趋势(10.2±6.3 与 12.1±8.3,p=0.061)。对照周期和治疗周期的总体囊胚形成率和整倍体率无差异。

结论

我们的研究独特地调查了在没有 POR 且根据其临床参数没有预先怀疑不良结局的情况下,在 IVF/PGT-A 周期中使用辅助 GH。我们的研究初步表明,在这些女性中补充 GH 是有益的,与活检的囊胚数量增加和可移植的整倍体胚胎数量增加有关。

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