探索生长激素联合治疗对体外受精胚胎质量的潜在益处：一项随机对照开放标签试验。
Exploring the potential benefits of growth hormone co-treatment on embryo quality in IVF: a randomized controlled open-label trial.
作者信息
Tang Yi, Li Xiaofeng, Hu Change, Guan Ruyi, Wang Zhimin, Zhang Shunji, Tao Guoping, Qu Jingfei, Gong Fei
机构信息
NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha, Hunan, China.
Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-XIANGYA, Changsha, Hunan, China.
出版信息
Reprod Biol Endocrinol. 2025 Mar 15;23(1):42. doi: 10.1186/s12958-025-01374-3.
RESEARCH QUESTION
While growth hormone (GH) is hypothesized to potentially enhance embryo quality, results of current basic and clinical researches remain inconclusive. This study assesses the effect of GH supplementation on embryo quality and explores the relationship between baseline insulin-like growth factor-1 (IGF-1) levels and the efficacy of GH supplementation among Chinese patients undergoing in vitro fertilization (IVF).
DESIGN
A randomized controlled Open-label trial was performed with 128 women experiencing poor embryonic development in IVF. Participants were allocated to the GH group (GH + Gonadotropin-Releasing Hormone [GnRH] antagonist protocol) and the Control group (GnRH antagonist protocol). The primary outcome was the number of high-quality embryos on Day 3.
RESULTS
Patients in the GH group required significantly lower total doses of gonadotropin (2213 ± 667 IU vs. 2573 ± 630 IU, p = 0.0058) and shorter duration of controlled ovarian stimulation (10.1 ± 1.60 days vs. 10.6 ± 1.30 days, p = 0.0488). While there was no statistically significant overall increase in the number of high-quality embryos, subgroup analysis indicated that patients with lower baseline IGF-1 levels, especially those below the lowest quartile, might show a higher rate of high-quality embryos with GH supplementation (p = 0.0488). Additionally, the fresh embryo transfer clinical pregnancy rate was numerically higher in the GH supplementation group (46.2%) compared to the control group (38.5%), although not statistically significant.
CONCLUSIONS
This study suggests that GH co-treatment may enhance ovarian responsiveness in IVF patients with poor embryo quality, thereby reducing the dosage and duration of Gonadotropin (Gn) administration. Among individuals with lower IGF-1 levels, adding GH may improve the rate of high-quality embryos, highlighting the potential benefits of personalized treatment strategies in IVF.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov ID: NCT03966339 (Registration time: 2019-05-24).
研究问题
虽然有假说认为生长激素（GH）可能会提高胚胎质量，但目前基础研究和临床研究的结果仍无定论。本研究评估了补充GH对胚胎质量的影响，并探讨了中国体外受精（IVF）患者的基线胰岛素样生长因子-1（IGF-1）水平与补充GH疗效之间的关系。
设计
对128名IVF胚胎发育不良的女性进行了一项随机对照开放标签试验。参与者被分配到GH组（GH + 促性腺激素释放激素 [GnRH] 拮抗剂方案）和对照组（GnRH拮抗剂方案）。主要结局是第3天高质量胚胎的数量。
结果
GH组患者所需的促性腺激素总剂量显著更低（2213 ± 667 IU对2573 ± 630 IU，p = 0.0058），且控制性卵巢刺激的持续时间更短（10.1 ± 1.60天对10.6 ± 1.30天，p = 0.0488）。虽然高质量胚胎的数量总体上没有统计学显著增加，但亚组分析表明，基线IGF-1水平较低的患者，尤其是那些低于最低四分位数的患者，补充GH后可能显示出更高的高质量胚胎率（p = 0.0488）。此外，补充GH组的新鲜胚胎移植临床妊娠率在数值上高于对照组（46.2%对38.5%），尽管没有统计学显著性。
结论
本研究表明，联合使用GH可能会提高胚胎质量较差的IVF患者的卵巢反应性，从而减少促性腺激素（Gn）的给药剂量和持续时间。在IGF-1水平较低的个体中，添加GH可能会提高高质量胚胎率，凸显了IVF个性化治疗策略的潜在益处。
临床试验注册
ClinicalTrials.gov标识符：NCT03966339（注册时间：2019年5月24日）。
Zotero 插件