The value of growth hormone co-treatment in IVF/ICSI cycles for “poor responders”
Ksenia Ob'edkova (RU), Dariko Niauri (RU), Liailia Dzhemlikhanova (RU), Valeria Muller (RU), Inna Krikhely (RU), Igor Kogan (RU), Irina Fedorova (RU), Elena Lesik (RU), Evgenia Komarova (RU), Alexander Gzgzyan (RU)
[Ob'edkova] FSBSI “The Research Institute of Obstetrics, Gynecology and Reproductology named after D. O. Ott”, [Niauri] St. Petersburg State University, [Dzhemlikhanova] FSBSI “The Research Institute of Obstetrics, Gynecology and Reproductology named after D. O. Ott”, [Muller] FSBSI “The Research Institute of Obstetrics, Gynecology and Reproductology named after D. O. Ott”, [Krikhely] FSBSI “The Research Institute of Obstetrics, Gynecology and Reproductology named after D. O. Ott”, [Kogan] FSBSI “The Research Institute of Obstetrics, Gynecology and Reproductology named after D. O. Ott”, [Fedorova] FSBSI “The Research Institute of Obstetrics, Gynecology and Reproductology named after D. O. Ott”, [Lesik] FSBSI “The Research Institute of Obstetrics, Gynecology and Reproductology named after D. O. Ott”, [Komarova] FSBSI “The Research Institute of Obstetrics, Gynecology and Reproductology named after D. O. Ott”, [Gzgzyan] FSBSI “The Research Institute of Obstetrics, Gynecology and
Context: The value of growth hormone (GH) co-treatment in IVF/ICSI cycles for “poor responders” Objective: to estimate the efficacy of GH co-treatment of antagonist IVF/ICSI cycles in “poor responders”. Methods: All patients underwent standard antagonist protocol with or without GH. Subcutaneous daily injections of 1,33 mg (equivalent to 4 IU) of GH were given from the day 1 of ovarian stimulation until the day of hCG. Serum concentration of GH, IGF-I and IGFBP-3 were analyzed on day 1 of ovarian stimulation and the day of oocyte retrieval. Mentioned markers were also determined in follicular fluid. Patients: The study involved 50 patients: GH group (n=25), gonadotropins only group (n=25). “Poor responders” were defined according to the Bologna consensus criteria. Intervention(s): no intervention(s) Main Outcome Measure(s): number of metaphase II oocytes retrieved and fertilized, high-quality transferred embryos, clinical pregnancy rate. Result(s): The day 3 FSH level was significantly higher in the GH group. However, the GH co-treatment significantly lowered the duration of ovarian stimulation and was associated with reduced IGFBP-3 level in serum and follicular fluid on the day of oocyte retrieval. The number of metaphase II stage oocytes (2 (1;6) vs. 1 (0;1) p=0,009), 2 pronucleus zygotes (2 (1;3) vs. 1 (1;2) p=0,019) and high-quality transferred embryos (1,5 (1;2) vs. 0 (0;1) p=0,018) was significantly higher in the GH group as compared to the second group. Only patients from GH group became pregnant; clinical pregnancy rate was 27,27 %. Conclusions: GH administration in IVF/ICSI cycles for “poor responders” raises ovarian sensitivity to the exogenous gonadotropins, increases number of high-quality embryos and, thereby, clinical pregnancy rate.