Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 5/2013

01.05.2013 | Reproductive Medicine

Adjuvant growth hormone therapy in antagonist protocol in poor responders undergoing assisted reproductive technology

verfasst von: Maryam Eftekhar, Abbas Aflatoonian, Farnaz Mohammadian, Tahereh Eftekhar

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 5/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The incidence of poor ovarian response in controlled ovarian stimulation (COH) has been reported in 9–24 % of IVF-ET cycles. Growth hormone augments the effect of gonadotropin on granulosa and theca cells, and plays an essential role in ovarian function, including follicular development, estrogen synthesis and oocyte maturation. The aim of this study was to assess IVF-ET cycle outcome after the addition of growth hormone in antagonist protocol in poor responders.

Materials and methods

Eighty-two poor responder patients selected for ART enrolled the study and were randomly divided into two groups. Group I (GH/HMG/GnRHant group, n = 40) received growth hormone/gonadotropin/GnRH antagonist protocol and group II (HMG/GnRHant group, n = 42) received gonadotropin/GnRH antagonist protocol.

Results

The number of retrieved oocytes was significantly higher in GH/HMG/GnRHant group than HMG/GnRHant group, 6.10 ± 2.90 vs. 4.80 ± 2.40 (p = 0.035) and the number of obtained embryos was also significantly higher in GH/HMG/GnRHant group than HMG/GnRHant group, 3.7 ± 2.89 as compared to 2.7 ± 1.29 (p = 0.018). There were no significant differences between groups regarding implantation, and chemical and clinical pregnancy rates.

Conclusion

Our study showed that co-treatment with growth hormone in antagonist protocol in patients with a history of poor response in previous IVF-ET cycles did not increase pregnancy rates.
Literatur
1.
Zurück zum Zitat Kyrou D, Kolibianakis EM, Venetis CA, Papanikolaou EG, Bontis J, Tarlatzis BC (2009) How to improve the probability of pregnancy in poor responders undergoing in vitro fertilization: a systematic review and meta-analysis. Fertil Steril 91(3):749–766PubMedCrossRef Kyrou D, Kolibianakis EM, Venetis CA, Papanikolaou EG, Bontis J, Tarlatzis BC (2009) How to improve the probability of pregnancy in poor responders undergoing in vitro fertilization: a systematic review and meta-analysis. Fertil Steril 91(3):749–766PubMedCrossRef
2.
Zurück zum Zitat Kolibianakis E, Venetis C, Diedrich K, Tarlatzis B, Griesinger G (2009) Addition of growth hormone to gonadotrophins in ovarian stimulation of poor responders treated by in vitro fertilization: a systematic review and meta-analysis. Human Reprod Update 15(6):613CrossRef Kolibianakis E, Venetis C, Diedrich K, Tarlatzis B, Griesinger G (2009) Addition of growth hormone to gonadotrophins in ovarian stimulation of poor responders treated by in vitro fertilization: a systematic review and meta-analysis. Human Reprod Update 15(6):613CrossRef
3.
Zurück zum Zitat Akande V, Fleming C, Hunt L, Keay S, Jenkins J (2002) Biological versus chronological ageing of oocytes, distinguishable by raised FSH levels in relation to the success of IVF treatment. Human Reprod 17(8):2003CrossRef Akande V, Fleming C, Hunt L, Keay S, Jenkins J (2002) Biological versus chronological ageing of oocytes, distinguishable by raised FSH levels in relation to the success of IVF treatment. Human Reprod 17(8):2003CrossRef
4.
Zurück zum Zitat Nargund G, Bromham D (1995) Comparison of endocrinological and clinical profiles and outcome of IVF cycles in patients with one ovary and two ovaries. J Assist Reprod Genet 12(7):458–460PubMedCrossRef Nargund G, Bromham D (1995) Comparison of endocrinological and clinical profiles and outcome of IVF cycles in patients with one ovary and two ovaries. J Assist Reprod Genet 12(7):458–460PubMedCrossRef
5.
Zurück zum Zitat Ragni G, De Lauretis Yankowski L, Piloni S, Vegetti W, Guermandi E, Colombo M et al. (2000) In vitro fertilization for patients with poor response and occult ovarian failure: a randomized trial. Reprod Technol 10(2):98–102 Ragni G, De Lauretis Yankowski L, Piloni S, Vegetti W, Guermandi E, Colombo M et al. (2000) In vitro fertilization for patients with poor response and occult ovarian failure: a randomized trial. Reprod Technol 10(2):98–102
6.
Zurück zum Zitat Kilic S, Yilmaz N, Zülfikaroglu E, Sar kaya E, Kose K, Topcu O et al. (2010) Obesity alters retrieved oocyte count and clinical pregnancy rates in high and poor responder women after in vitro fertilization. Arch Gynecol Obstet 282(1):89–96 Kilic S, Yilmaz N, Zülfikaroglu E, Sar kaya E, Kose K, Topcu O et al. (2010) Obesity alters retrieved oocyte count and clinical pregnancy rates in high and poor responder women after in vitro fertilization. Arch Gynecol Obstet 282(1):89–96
7.
Zurück zum Zitat Kucuk T, Kozinoglu H, Kaba A (2008) Growth hormone co-treatment within a GnRH agonist long protocol in patients with poor ovarian response: a prospective, randomized, clinical trial. J Assist Reprod Genet 25(4):123–127PubMedCrossRef Kucuk T, Kozinoglu H, Kaba A (2008) Growth hormone co-treatment within a GnRH agonist long protocol in patients with poor ovarian response: a prospective, randomized, clinical trial. J Assist Reprod Genet 25(4):123–127PubMedCrossRef
8.
Zurück zum Zitat Hellberg D, Waldenström U, Nilsson S (2004) Defining a poor responder in in vitro fertilization. Fertil Steril 82(2):488–490PubMedCrossRef Hellberg D, Waldenström U, Nilsson S (2004) Defining a poor responder in in vitro fertilization. Fertil Steril 82(2):488–490PubMedCrossRef
9.
Zurück zum Zitat Tarlatzis B, Zepiridis L, Grimbizis G, Bontis J (2003) Clinical management of low ovarian response to stimulation for IVF: a systematic review. Human Reprod Update 9(1):61CrossRef Tarlatzis B, Zepiridis L, Grimbizis G, Bontis J (2003) Clinical management of low ovarian response to stimulation for IVF: a systematic review. Human Reprod Update 9(1):61CrossRef
10.
Zurück zum Zitat Wiser A, Gonen O, Ghetler Y, Shavit T, Berkovitz A, Shulman A (2010) Addition of dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study. Human Reprod 25(10):2496CrossRef Wiser A, Gonen O, Ghetler Y, Shavit T, Berkovitz A, Shulman A (2010) Addition of dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study. Human Reprod 25(10):2496CrossRef
11.
Zurück zum Zitat Karimzadeh MA, Mashayekhy M, Mohammadian F, Moghaddam FM (2011) Comparison of mild and microdose GnRH agonist flare protocols on IVF outcome in poor responders. Arch Gynecol Obstet 1–6 Karimzadeh MA, Mashayekhy M, Mohammadian F, Moghaddam FM (2011) Comparison of mild and microdose GnRH agonist flare protocols on IVF outcome in poor responders. Arch Gynecol Obstet 1–6
12.
Zurück zum Zitat Sunkara SK, Pundir J, Khalaf Y (2011) Effect of androgen supplementation or modulation on ovarian stimulation outcome in poor responders: a meta-analysis. Reprod Biomed Online Sunkara SK, Pundir J, Khalaf Y (2011) Effect of androgen supplementation or modulation on ovarian stimulation outcome in poor responders: a meta-analysis. Reprod Biomed Online
13.
Zurück zum Zitat Papanikolaou EG, Polyzos NP, Humaidan P, Pados G, Bosch E, Tournaye H et al (2011) Aromatase inhibitors in stimulated IVF cycles. Reprod Biol Endocrinol 9(1):85PubMedCrossRef Papanikolaou EG, Polyzos NP, Humaidan P, Pados G, Bosch E, Tournaye H et al (2011) Aromatase inhibitors in stimulated IVF cycles. Reprod Biol Endocrinol 9(1):85PubMedCrossRef
14.
Zurück zum Zitat Kolibianakis E, Venetis C, Tarlatzis B (2011) DHEA administration in poor responders. Human Reprod 26(3):730CrossRef Kolibianakis E, Venetis C, Tarlatzis B (2011) DHEA administration in poor responders. Human Reprod 26(3):730CrossRef
15.
Zurück zum Zitat Howles CM, Loumaye E, Germond M, Yates R, Brinsden P, Healy D et al (1999) Does growth hormone-releasing factor assist follicular development in poor responder patients undergoing ovarian stimulation for in vitro fertilization? Human Reprod 14(8):1939–1943CrossRef Howles CM, Loumaye E, Germond M, Yates R, Brinsden P, Healy D et al (1999) Does growth hormone-releasing factor assist follicular development in poor responder patients undergoing ovarian stimulation for in vitro fertilization? Human Reprod 14(8):1939–1943CrossRef
16.
Zurück zum Zitat Bachelot A, Monget P, Imbert-Bollore P, Coshigano K, Kopchick JJ, Kelly PA et al (2002) Growth hormone is required for ovarian follicular growth. Endocrinology 143(10):4104PubMedCrossRef Bachelot A, Monget P, Imbert-Bollore P, Coshigano K, Kopchick JJ, Kelly PA et al (2002) Growth hormone is required for ovarian follicular growth. Endocrinology 143(10):4104PubMedCrossRef
17.
Zurück zum Zitat Mendoza C, Ruiz-Requena E, Ortega E, Cremades N, Martinez F, Bernabeu R et al (2002) Follicular fluid markers of oocyte developmental potential. Human Reprod 17(4):1017CrossRef Mendoza C, Ruiz-Requena E, Ortega E, Cremades N, Martinez F, Bernabeu R et al (2002) Follicular fluid markers of oocyte developmental potential. Human Reprod 17(4):1017CrossRef
18.
Zurück zum Zitat Mendoza C, Cremades N, Ruiz-Requena E, Martinez F, Ortega E, Bernabeu S et al (1999) Relationship between fertilization results after intracytoplasmic sperm injection, and intrafollicular steroid, pituitary hormone and cytokine concentrations. Human Reprod 14(3):628CrossRef Mendoza C, Cremades N, Ruiz-Requena E, Martinez F, Ortega E, Bernabeu S et al (1999) Relationship between fertilization results after intracytoplasmic sperm injection, and intrafollicular steroid, pituitary hormone and cytokine concentrations. Human Reprod 14(3):628CrossRef
19.
Zurück zum Zitat Spiliotis BE (2003) Growth hormone insufficiency and its impact on ovarian function. Ann NY Acad Sci 997(1):77–84PubMedCrossRef Spiliotis BE (2003) Growth hormone insufficiency and its impact on ovarian function. Ann NY Acad Sci 997(1):77–84PubMedCrossRef
20.
21.
Zurück zum Zitat Yoshimura Y, Iwashita M, Karube M, Oda T, Akiba M, Shiokawa S et al (1994) Growth hormone stimulates follicular development by stimulating ovarian production of insulin-like growth factor-I. Endocrinology 135(3):887PubMedCrossRef Yoshimura Y, Iwashita M, Karube M, Oda T, Akiba M, Shiokawa S et al (1994) Growth hormone stimulates follicular development by stimulating ovarian production of insulin-like growth factor-I. Endocrinology 135(3):887PubMedCrossRef
22.
Zurück zum Zitat Yoshimura Y, Nakamura Y, Koyama N, Iwashita M, Adachi T, Takeda Y (1993) Effects of growth hormone on follicle growth, oocyte maturation, and ovarian steroidogenesis. Fertil Steril 59(4):917PubMed Yoshimura Y, Nakamura Y, Koyama N, Iwashita M, Adachi T, Takeda Y (1993) Effects of growth hormone on follicle growth, oocyte maturation, and ovarian steroidogenesis. Fertil Steril 59(4):917PubMed
23.
Zurück zum Zitat Eckery D, Moeller C, Nett T, Sawyer H (1997) Localization and quantification of binding sites for follicle-stimulating hormone, luteinizing hormone, growth hormone, and insulin-like growth factor I in sheep ovarian follicles. Biol Reprod 57(3):507PubMedCrossRef Eckery D, Moeller C, Nett T, Sawyer H (1997) Localization and quantification of binding sites for follicle-stimulating hormone, luteinizing hormone, growth hormone, and insulin-like growth factor I in sheep ovarian follicles. Biol Reprod 57(3):507PubMedCrossRef
24.
Zurück zum Zitat Mason H, Martikainen H, Beard R, Anyaoku V, Franks S (1990) Direct gonadotrophic effect of growth hormone on oestradiol production by human granulosa cells in vitro. J Endocrinol 126(3):R1PubMedCrossRef Mason H, Martikainen H, Beard R, Anyaoku V, Franks S (1990) Direct gonadotrophic effect of growth hormone on oestradiol production by human granulosa cells in vitro. J Endocrinol 126(3):R1PubMedCrossRef
25.
Zurück zum Zitat Davis S, Smith J, Gluckman P (1990) Effects of growth hormone injections on ovulation rate in ewes. Reprod Fertil Develop 2(2):173–178CrossRef Davis S, Smith J, Gluckman P (1990) Effects of growth hormone injections on ovulation rate in ewes. Reprod Fertil Develop 2(2):173–178CrossRef
26.
Zurück zum Zitat Danilovich NA, Bartke A, Winters TA (2000) Ovarian follicle apoptosis in bovine growth hormone transgenic mice. Biol Reprod 62(1):103PubMedCrossRef Danilovich NA, Bartke A, Winters TA (2000) Ovarian follicle apoptosis in bovine growth hormone transgenic mice. Biol Reprod 62(1):103PubMedCrossRef
27.
Zurück zum Zitat Harper K, Proctor M, Hughes E (2003) Growth hormone for in vitro fertilization. Cochrane Database Syst Rev (Online) (3):CD000099 Harper K, Proctor M, Hughes E (2003) Growth hormone for in vitro fertilization. Cochrane Database Syst Rev (Online) (3):CD000099
28.
Zurück zum Zitat Dor J, Seidman D, Amudai E, Bider D, Levran D, Mashiach S (1995) Adjuvant growth hormone therapy in poor responders to in vitro fertilization: a prospective randomized placebo-controlled double-blind study. Human Reprod 10(1):40CrossRef Dor J, Seidman D, Amudai E, Bider D, Levran D, Mashiach S (1995) Adjuvant growth hormone therapy in poor responders to in vitro fertilization: a prospective randomized placebo-controlled double-blind study. Human Reprod 10(1):40CrossRef
29.
Zurück zum Zitat Sugaya S, Suzuki M, Fujita K, Kurabayashi T, Tanaka K (2003) Effect of cotreatment with growth hormone on ovarian stimulation in poor responders to in vitro fertilization. Fertil Steril 79(5):1251–1253. doi:10.1016/S0015-0282(02)04959-2 Sugaya S, Suzuki M, Fujita K, Kurabayashi T, Tanaka K (2003) Effect of cotreatment with growth hormone on ovarian stimulation in poor responders to in vitro fertilization. Fertil Steril 79(5):1251–1253. doi:10.​1016/​S0015-0282(02)04959-2
30.
Zurück zum Zitat Tesarik J, Hazout A, Mendoza C (2005) Improvement of delivery and live birth rates after ICSI in women aged > 40 years by ovarian co-stimulation with growth hormone. Human Reprod 20(9):2536CrossRef Tesarik J, Hazout A, Mendoza C (2005) Improvement of delivery and live birth rates after ICSI in women aged > 40 years by ovarian co-stimulation with growth hormone. Human Reprod 20(9):2536CrossRef
Metadaten
Titel
Adjuvant growth hormone therapy in antagonist protocol in poor responders undergoing assisted reproductive technology
verfasst von
Maryam Eftekhar
Abbas Aflatoonian
Farnaz Mohammadian
Tahereh Eftekhar
Publikationsdatum
01.05.2013
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 5/2013
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-012-2655-1

Weitere Artikel der Ausgabe 5/2013

Archives of Gynecology and Obstetrics 5/2013 Zur Ausgabe

Ambulantisierung: Erste Erfahrungen mit dem Hybrid-DRG

02.05.2024 DCK 2024 Kongressbericht

Die Hybrid-DRG-Verordnung soll dazu führen, dass mehr chirurgische Eingriffe ambulant durchgeführt werden, wie es in anderen Ländern schon länger üblich ist. Die gleiche Vergütung im ambulanten und stationären Sektor hatten Niedergelassene schon lange gefordert. Aber die Umsetzung bereitet ihnen doch Kopfzerbrechen.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Harninkontinenz: Netz-Op. erfordert über lange Zeit intensive Nachsorge

30.04.2024 Harninkontinenz Nachrichten

Frauen mit Belastungsinkontinenz oder Organprolaps sind nach einer Netz-Operation keineswegs beschwerdefrei. Vielmehr scheint die Krankheitslast weiterhin hoch zu sein, sogar höher als von harninkontinenten Frauen, die sich nicht haben operieren lassen.

Welche Übungen helfen gegen Diastase recti abdominis?

30.04.2024 Schwangerenvorsorge Nachrichten

Die Autorinnen und Autoren einer aktuellen Studie aus Griechenland sind sich einig, dass Bewegungstherapie, einschließlich Übungen zur Stärkung der Bauchmuskulatur und zur Stabilisierung des Rumpfes, eine Diastase recti abdominis postpartum wirksam reduzieren kann. Doch vieles ist noch nicht eindeutig belegt.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.