生长激素对卵巢储备功能下降的不同年龄组患者受精及胚胎移植结局的影响：一项前瞻性队列研究。
The effects of growth hormone on the outcomes of fertilization and embryo transfer in age-grouped patients with decreased ovarian reserve: a prospective cohort study.
作者信息
Chen Jiexiu, Kong Xumei, Luan Zonghui, Qiu Yu, Chen Shiqi, Li Ling Jesse, Gong Yan
机构信息
Department of Clinical Pharmacy, Sichuan Provincial Women's and Children's Hospital, The Affiliated Women's and Children's Hospital of Chengdu Medical College, Chengdu, China.
Reproductive Medicine Center, Sichuan Provincial Women's and Children's Hospital, The Affiliated Women's and Children's Hospital of Chengdu Medical College, Chengdu, China.
出版信息
Front Endocrinol (Lausanne). 2025 Jan 14;15:1457866. doi: 10.3389/fendo.2024.1457866. eCollection 2024.
BACKGROUND
Growth hormone (GH) could improve the outcomes of fertilization and embryo transfer (IVF-ET) in patients with decreased ovarian reserve (DOR), but which age group will benefit the most has remained controversial. This study aims to explore the outcome of IVF-ET among differently aged patients with DOR treated with GH.
METHODS
A total of 846 patients with DOR undergoing IVF-ET from May 2018 to June 2023 at the Reproductive Medicine Center of Sichuan Provincial Women's and Children's Hospital were prospectively enrolled. The patients were divided into group A (< 35 year old, = 399), group B (35 ~ 40 year old, = 286), and group C (> 40 year old, = 161). Each group was sub-divided into the GH part and the control part, with the former receiving pretreatment with GH 4 IU/day on day 2 of the previous menstrual cycle before the injection of gonadotrophin (Gn) until the trigger day. The ovarian stimulation protocol was gonadotrophin-releasing hormone antagonist (GnRH-A) or long-acting GnRH agonist protocol. The quality of oocytes and embryos and the outcome of pregnancy were compared.
RESULTS
In group B, the number (1.16 ± 0.12 vs. 0.74 ± 0.09) and rate (34.27% vs. 23.90%) of high-quality cleavage embryos, rate of implantation (32.37% vs. 22.35%), clinical pregnancy (48.98% vs. 33.67%), and live birth (44.90% vs. 29.59%) were significantly higher, whereas the canceled oocyte retrieval rate was significantly lower (1.49% vs. 6.58%) in the GH part than those of the control part ( < 0.05). In group B, the duration and dose of Gn, number of oocyte retrieved, and rates of normal fertilization, cleavage embryo, blastocyst, high-quality blastocyst, and early miscarriage were not significantly different between the GH and control parts ( > 0.05). In groups A and C, no significant difference was detected in the quality of embryos and outcomes of embryo transfer with or without pretreatment ( > 0.05).
CONCLUSION
GH could improve the quality of embryos and live birth rate for patients with DOR aged 35-40 years old.
背景
生长激素（GH）可改善卵巢储备功能减退（DOR）患者的受精及胚胎移植（IVF-ET）结局，但哪个年龄组获益最大仍存在争议。本研究旨在探讨不同年龄的DOR患者接受GH治疗后的IVF-ET结局。
方法
前瞻性纳入2018年5月至2023年6月在四川省妇女儿童医院生殖医学中心接受IVF-ET的846例DOR患者。患者分为A组（<35岁，n = 399）、B组（35~40岁，n = 286）和C组（>40岁，n = 161）。每组再分为GH组和对照组，前者在注射促性腺激素（Gn）前的前一月经周期第2天开始接受GH 4 IU/天预处理，直至扳机日。促排卵方案为促性腺激素释放激素拮抗剂（GnRH-A）或长效GnRH激动剂方案。比较卵母细胞和胚胎质量及妊娠结局。
结果
在B组中，GH组优质卵裂胚的数量（1.16±0.12 vs. 0.74±0.09）和比率（34.27% vs. 23.90%）、着床率（32.37% vs. 22.35%）、临床妊娠率（48.98% vs. 33.67%）和活产率（44.90% vs. 29.59%）均显著更高，而取消取卵率显著更低（1.49% vs. 6.58%）（P<0.05）。在B组中，GH组和对照组之间的Gn使用时间和剂量、取卵数以及正常受精率、卵裂胚率、囊胚率、优质囊胚率和早期流产率均无显著差异（P>0.05）。在A组和C组中，有无预处理的胚胎质量和胚胎移植结局均无显著差异（P>0.05）。
结论
GH可提高35~40岁DOR患者的胚胎质量和活产率。
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