Chongqing Health Center for Women and Children, Chongqing Reproduction and Genetics Institute, Chongqing, China.
Gynecol Endocrinol. 2022 Mar;38(3):231-237. doi: 10.1080/09513590.2021.2000963. Epub 2021 Nov 12.
To evaluate the effectiveness of Growth hormone (GH) co-treatment during fertilization (IVF) cycles in women of different ages who manifest unexplained poor embryonic development.
This cohort study included a total of 2647 patients with unexplained poor embryonic development in their previous IVF procedures: 872 women received GH co-treatment and 1775 untreated women served as a control group. Patients were divided into 6 groups according to treatment and stratified by age (<35 years of age, A-GH group and A-control group; 35-40 years, B-GH group and B-control group; and ≥40 years, C-GH group and C-control group). The primary outcome was the oocyte-cleavage rate and the clinical pregnancy rate (CPR).
The oocyte-cleavage rates among the three age groups were significantly higher in the GH group compared to the same-aged control group. In both group A and group B, there was no significant difference in clinical pregnancy rate between the GH group and controls. However, in patients ≥40 years of age, the clinical pregnancy rate in the GH group was significantly higher than in the control group (31.8% vs. 13.7%, = 0.019). In the three age groups, there was no significant difference in the live birth rate between the GH group and controls. In the multivariate logistic regression analysis model, in both group A and group B, the number of cleaved embryos was independent predictors for CPR (OR = 1.464, 95% CI: 1.311-1.634; respectively, OR = 1.336, 95% CI: 1.126-1.586); Besides, in both group B and group C, age was independent predictors for CPR (OR = 0.657, 95%CI: 0.555-0.778; respectively, OR = 0.622, 95%CI: 0.391-0.989). However, only in group C, supplementation GH increased CPR as compared with not supplementation GH (OR = 2.339, 95%CI: 1.182-6.670).
For patients with unexplained poor embryonic development, supplementation with GH increased the oocyte-cleavage rates in all three age groups, and the clinical pregnancy rate gradually improved commensurate with increasing age. There was no difference in the clinical pregnancy rate in group A and group B, but group C improved significantly. Therefore, compared with patients under 40 years of age, patients ≥40 may benefit more from GH supplementation.
评估在不同年龄段表现为不明原因胚胎发育不良的女性中，在受精（IVF）周期中联合使用生长激素（GH）治疗的效果。
这项队列研究共纳入 2647 名在之前的 IVF 过程中表现为不明原因胚胎发育不良的患者：872 名患者接受 GH 联合治疗，1775 名未接受治疗的患者作为对照组。患者根据治疗方法分为 6 组，并按年龄分层（<35 岁，A-GH 组和 A-对照组；35-40 岁，B-GH 组和 B-对照组；≥40 岁，C-GH 组和 C-对照组）。主要结局是卵母细胞的卵裂率和临床妊娠率（CPR）。
三个年龄组的 GH 组卵母细胞的卵裂率均明显高于同年龄的对照组。在 A 组和 B 组中，GH 组与对照组的临床妊娠率无显著差异。然而，在≥40 岁的患者中，GH 组的临床妊娠率明显高于对照组（31.8% vs. 13.7%，= 0.019）。在三个年龄组中，GH 组与对照组的活产率无显著差异。多因素逻辑回归分析模型显示，在 A 组和 B 组中，卵裂胚胎数是 CPR 的独立预测因素（OR=1.464，95%CI：1.311-1.634；OR=1.336，95%CI：1.126-1.586）；此外，在 B 组和 C 组中，年龄是 CPR 的独立预测因素（OR=0.657，95%CI：0.555-0.778；OR=0.622，95%CI：0.391-0.989）。然而，只有在 C 组中，与不补充 GH 相比，补充 GH 可提高 CPR（OR=2.339，95%CI：1.182-6.670）。
对于不明原因胚胎发育不良的患者，GH 补充可提高所有三个年龄组的卵母细胞卵裂率，且临床妊娠率随年龄的增长而逐渐提高。A 组和 B 组的临床妊娠率无差异，但 C 组显著改善。因此，与<40 岁的患者相比，≥40 岁的患者可能从 GH 补充中获益更多。
