Liu Yongmei, Ding Fengxing, Yang Yuan, Ma Bin
The First Clinical Medical College, Lanzhou University, Lanzhou, China.
Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
J Assist Reprod Genet. 2025 Mar;42(3):721-736. doi: 10.1007/s10815-025-03389-6. Epub 2025 Jan 25.
Poor ovarian response (POR) significantly impacts the success of assisted reproductive technology (ART), and growth hormone (GH) has been proposed as an adjuvant treatment to improve outcomes in POR patients undergoing in vitro fertilization (IVF). A systematic review and meta-analysis were conducted to evaluate the effectiveness of GH in enhancing pregnancy outcomes, registering a protocol on PROSPERO and searching multiple databases up to September 2023. Twelve systematic reviews/meta-analysis and 20 randomized controlled trials (RCTs) involving 1984 patients were included. Quality assessment was performed using AMSTAR 2, GRADE, and RoB tools. The meta-analysis revealed that GH significantly increased live birth rates [OR=1.80, 95% CI (1.22, 2.64)] and clinical pregnancy rates [OR=1.92, 95% CI (1.51, 2.43)] compared to the control group. Subgroup analysis indicated that administering 5-10 IU/d of GH combined with a long protocol during the middle and late follicular stages maximized these benefits. Despite these promising findings, most outcome indicators exhibited low-quality evidence, highlighting the need for improved research standards to ensure solid evidence supports treatment strategies for POR, thereby promoting reliable application of GH in IVF treatments.
卵巢低反应（POR）显著影响辅助生殖技术（ART）的成功率，生长激素（GH）已被提议作为一种辅助治疗方法，以改善接受体外受精（IVF）的POR患者的治疗结果。我们进行了一项系统评价和荟萃分析，以评估GH在提高妊娠结局方面的有效性，在PROSPERO上注册了一项方案，并检索了截至2023年9月的多个数据库。纳入了12项系统评价/荟萃分析和20项随机对照试验（RCT），涉及1984例患者。使用AMSTAR 2、GRADE和RoB工具进行质量评估。荟萃分析显示，与对照组相比，GH显著提高了活产率[OR=1.80，95%CI（1.22，2.64）]和临床妊娠率[OR=1.92，95%CI（1.51，2.43）]。亚组分析表明，在卵泡期中期和晚期给予5-10IU/d的GH联合长方案可使这些益处最大化。尽管有这些有前景的发现，但大多数结局指标的证据质量较低，这突出表明需要提高研究标准，以确保有确凿的证据支持POR的治疗策略，从而促进GH在IVF治疗中的可靠应用。
