Amirkhanloo Fatemeh, Javanbakht Mohammad, Lotfi Sarah, Sahraiyan Ghazal, Akbari Razieh, Feizabad Elham, Rahimi Shima, Ebrahimi Mahbod, Akbari Asbagh Firouzeh, Davari Tanha Fateme
Department of Obstetrics and Gynecology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Nephrology and Urology Research Center, Clinical Science Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Iran J Pharm Res. 2024 Dec 16;23(1):e153636. doi: 10.5812/ijpr-153636. eCollection 2024 Jan-Dec.
The positive effects of growth hormone (GH) on the endometrium, including increased endometrial blood supply and enhanced expression of cytokines associated with endometrial receptivity, have been noted. However, data on the effect of GH on the endometrium remain limited.
This study aimed to investigate the effect of intrauterine administration of GH on the IVF success rate in women with recurrent implantation failure (RIF).
This randomized double-blind clinical trial was conducted on 60 infertile women under 40 years old with a Body Mass Index (BMI) below 30 kg/m², all diagnosed with RIF-defined as at least three failed pregnancies after transferring a minimum of four good-quality embryos due to unknown causes. Women with uterine malformations, Asherman syndrome, cavity-distorting lesions, severe endometriosis, or other underlying diseases were excluded. After six days of estrogen therapy, transvaginal ultrasound (TVS) was performed to measure and compare the thickness and quality of the endometrium. Participants were divided into two groups. In the intervention group, 10 units of GH were administered using an IUI catheter positioned one centimeter above the cervical os. Study outcomes included changes in endometrial thickness (ET) and quality, as well as pregnancy rates. Primary endpoints were changes in ET and quality, while secondary endpoints were pregnancy rates. Adverse drug responses were also evaluated.
The mean age was 34.96 ± 4.04 years, and the mean BMI was 24.89 ± 2.91 kg/m², with no significant differences in baseline variables between the study groups. The average ET on the 8th day of the cycle was 5.38 ± 0.96 mm in the intervention group and 5.20 ± 0.80 mm in the control group, showing no significant difference (P = 0.467). The ET on the day of initiating progesterone was 7.60 ± 1.03 mm in the intervention group and 7.40 ± 0.60 mm in the control group, with no significant difference (P = 0.264). The odds ratio for achieving a high-quality endometrium was 2.37 (95% CI 0.80 - 6.98, P = 0.116) for the GH group compared to the non-GH group. The odds ratio for achieving a clinical pregnancy was 3.06 (95% CI 0.54 - 17.37, P = 0.205) for the GH group compared to the non-GH group. Two cases of cervicitis were reported in the GH group.
Intrauterine administration of GH appears to enhance endometrial receptivity in women with RIF.
生长激素（GH）对子宫内膜具有积极作用，包括增加子宫内膜血供以及增强与子宫内膜容受性相关的细胞因子表达，这一点已得到证实。然而，关于GH对子宫内膜影响的数据仍然有限。
本研究旨在探讨宫腔内注射GH对反复种植失败（RIF）女性体外受精成功率的影响。
本随机双盲临床试验纳入了60名40岁以下、体重指数（BMI）低于30kg/m²的不孕女性，她们均被诊断为RIF，即因不明原因在移植至少4个优质胚胎后至少经历3次妊娠失败。排除患有子宫畸形、阿谢曼综合征、宫腔变形性病变、重度子宫内膜异位症或其他基础疾病的女性。在进行6天的雌激素治疗后，通过经阴道超声（TVS）测量并比较子宫内膜的厚度和质量。参与者被分为两组。干预组使用置于宫颈口上方1厘米处的宫内人工授精（IUI）导管给予10单位GH。研究结局包括子宫内膜厚度（ET）和质量的变化以及妊娠率。主要终点是ET和质量的变化，次要终点是妊娠率。还评估了药物不良反应。
平均年龄为34.96±4.04岁，平均BMI为24.89±2.91kg/m²，研究组间基线变量无显著差异。干预组在周期第8天的平均ET为5.38±0.96mm，对照组为5.20±0.80mm，差异无统计学意义（P = 0.467）。干预组在开始使用黄体酮当天的ET为7.60±1.03mm，对照组为7.40±0.60mm，差异无统计学意义（P = 0.264）。与非GH组相比，GH组获得高质量子宫内膜的优势比为2.37（95%CI 0.80 - 6.98，P = 0.116）。与非GH组相比，GH组实现临床妊娠的优势比为3.06（95%CI 0.54 - 17.37，P = 0.205）。GH组报告了2例宫颈炎病例。
宫腔内注射GH似乎可增强RIF女性的子宫内膜容受性。
