Skip to main content
Erschienen in: Journal of Assisted Reproduction and Genetics 4/2008

01.04.2008 | Assisted Reproduction

Growth hormone co-treatment within a GnRH agonist long protocol in patients with poor ovarian response: a prospective, randomized, clinical trial

verfasst von: Tansu Kucuk, Hakan Kozinoglu, Ayten Kaba

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 4/2008

Einloggen, um Zugang zu erhalten

Abstract

Objective

The efficacy of growth hormone co-stimulation to long luteal GnRHa regimen in poor responders to COH for IVF was assessed.

Methods

This prospective, randomized, clinical trial was performed in a private assisted reproduction center. The study involved 61 patients who responded poorly to high dose gonadotropin treatment in their first cycles in the same center. Study group of 31 patients were given growth hormone co-treatment, daily subcutaneous injection of 4 mg from day 21 of preceding cycle along with GnRHa, until the day of hCG. Control group of 30 patients received the same treatment protocol except the growth hormone co-treatment. Primary end-point of the study was the number of oocytes fertilized whereas the pregnancy rate was the secondary end-point.

Results

Patients’ demographic characteristics did not differ significantly between the two groups. 2PNs in growth hormone co-treatment group was significantly higher than the control group (4.4 ± 1.8 vs 1.5 ± 0.9, p < 0.001). Although more pregnancies and more clinical pregnancies with fetal heart beat were achieved in growth hormone group (12/31), compared to the control group (6/30), the difference did not reach to statistical significance.

Conclusion

Poor responder women undergoing repeated assisted reproduction treatment and co-stimulated with GH achieve more oocytes, higher fertilization rate if growth hormone started in the luteal phase of previous cycle, as compared with women of the same status treated with GnRHa long protocol. The study was unable to show that clinical pregnancy rate was increased significantly.
Literatur
1.
Zurück zum Zitat Hellberg D, Waldenstrom U, Nilsson S. Defining a poor responder in in vitro fertilization. Fertil Steril 2004;82:488–90.PubMedCrossRef Hellberg D, Waldenstrom U, Nilsson S. Defining a poor responder in in vitro fertilization. Fertil Steril 2004;82:488–90.PubMedCrossRef
2.
Zurück zum Zitat Ubaldi FM, Rienzi L, Ferrero S, Baroni E, Sapienza F, Cobellis L, et al. Management of poor responders in IVF. Reprod Biomed Online 2005;10:235–46.PubMedCrossRef Ubaldi FM, Rienzi L, Ferrero S, Baroni E, Sapienza F, Cobellis L, et al. Management of poor responders in IVF. Reprod Biomed Online 2005;10:235–46.PubMedCrossRef
3.
Zurück zum Zitat Homburg R, Eshel A, Abdulla HI, Jacobs HS. Growth hormone facilitates ovulation induction by gonadotrophins. Clin Endocrinol 1988;29:113–8.CrossRef Homburg R, Eshel A, Abdulla HI, Jacobs HS. Growth hormone facilitates ovulation induction by gonadotrophins. Clin Endocrinol 1988;29:113–8.CrossRef
4.
Zurück zum Zitat Hsu C, Hammond J. Concomitant effects of growth hormone on secretion of insulin-like growth factor I and progesterone by cultured porcine granulosa cells in vitro. Endocrinology 1988;120:198–207.CrossRef Hsu C, Hammond J. Concomitant effects of growth hormone on secretion of insulin-like growth factor I and progesterone by cultured porcine granulosa cells in vitro. Endocrinology 1988;120:198–207.CrossRef
5.
Zurück zum Zitat Barecca A, Artini PG, Del Monte P, Ponzani P, Pasquini P, Cariola G. In vivo and in vitro effect of growth hormone on estradiol secretion by granulosa cells. J Clin Endocrinol Metab 1993;77:61–7.CrossRef Barecca A, Artini PG, Del Monte P, Ponzani P, Pasquini P, Cariola G. In vivo and in vitro effect of growth hormone on estradiol secretion by granulosa cells. J Clin Endocrinol Metab 1993;77:61–7.CrossRef
6.
Zurück zum Zitat Dor J, Seidman DS, Amudai E, Bider D, Levran D, Mashiach S. Adjuvant growth hormone therapy in poor responders to in-vitro fertilization: a prospective randomized placebo-controlled double-blind study. Hum Reprod 1995;10:40–3.PubMedCrossRef Dor J, Seidman DS, Amudai E, Bider D, Levran D, Mashiach S. Adjuvant growth hormone therapy in poor responders to in-vitro fertilization: a prospective randomized placebo-controlled double-blind study. Hum Reprod 1995;10:40–3.PubMedCrossRef
7.
Zurück zum Zitat Potashnik G, Lunenfeld E, Shwartz I, Glezerman M, Roberts CT, LeRoith D, et al. Endocrinology: endogenous plasma growth hormone and the occurrence of pregnancies in patients undergoing in-vitro fertilization and embryo transfer with ovarian stimulation. Hum Reprod 1995;10:1065–9.PubMed Potashnik G, Lunenfeld E, Shwartz I, Glezerman M, Roberts CT, LeRoith D, et al. Endocrinology: endogenous plasma growth hormone and the occurrence of pregnancies in patients undergoing in-vitro fertilization and embryo transfer with ovarian stimulation. Hum Reprod 1995;10:1065–9.PubMed
8.
Zurück zum Zitat Harper K, Proctor M, Hughes E. Growth hormone for in vitro fertilization. Cochrane Database Syst Rev 2003;3:CD000099.PubMed Harper K, Proctor M, Hughes E. Growth hormone for in vitro fertilization. Cochrane Database Syst Rev 2003;3:CD000099.PubMed
9.
Zurück zum Zitat Tesarik J, Hazout A, Mendoza C. Improvement of delivery and live birth rates after ICSI in women aged >40 years by ovarian co-stimulation with growth hormone. Hum Reprod 2005;20:2536–41.PubMedCrossRef Tesarik J, Hazout A, Mendoza C. Improvement of delivery and live birth rates after ICSI in women aged >40 years by ovarian co-stimulation with growth hormone. Hum Reprod 2005;20:2536–41.PubMedCrossRef
10.
Zurück zum Zitat Hughes SM, Huang ZH, Morris ID, Matson PL, Buck P, Lieberman BA. A double-blind cross-over controlled study to evaluate the effect of human biosynthetic growth hormone on ovarian stimulation in previous poor responders to in-vitro fertilization. Hum Reprod 1994;9:13–8.PubMed Hughes SM, Huang ZH, Morris ID, Matson PL, Buck P, Lieberman BA. A double-blind cross-over controlled study to evaluate the effect of human biosynthetic growth hormone on ovarian stimulation in previous poor responders to in-vitro fertilization. Hum Reprod 1994;9:13–8.PubMed
11.
Zurück zum Zitat Kotarba D, Kotarba J, Hughes E. Growth hormone for in vitro fertilization. Cochrane Database Syst Rev 2000;2:CD000099.PubMed Kotarba D, Kotarba J, Hughes E. Growth hormone for in vitro fertilization. Cochrane Database Syst Rev 2000;2:CD000099.PubMed
12.
Zurück zum Zitat European and Australian Multicenter Study. Cotreatment with growth hormone and gonadotropin for ovulation induction in hypogonadotropic patients: a prospective, randomized, placebo-controlled, dose-response study. Fertil Steril 1995;64:917–23. European and Australian Multicenter Study. Cotreatment with growth hormone and gonadotropin for ovulation induction in hypogonadotropic patients: a prospective, randomized, placebo-controlled, dose-response study. Fertil Steril 1995;64:917–23.
13.
Zurück zum Zitat Mendoza C, Cremades N, Ruiz-Requena E, Martinez F, Ortega E, Bernabeu S, et al. Relationship between fertilization results after intracytoplasmic sperm injection, and intrafollicular steroid, pituitary hormone and cytokine concentrations. Hum Reprod 1999;14:628–35.PubMedCrossRef Mendoza C, Cremades N, Ruiz-Requena E, Martinez F, Ortega E, Bernabeu S, et al. Relationship between fertilization results after intracytoplasmic sperm injection, and intrafollicular steroid, pituitary hormone and cytokine concentrations. Hum Reprod 1999;14:628–35.PubMedCrossRef
14.
Zurück zum Zitat Mason HD, Martkaninen H, Beard RW, Anyaoku V, Franks S. Direct gonadotropin effect of growth hormone on estradiol production by human granulosa cells. J Endocrinol 1990;126:R1–4.PubMedCrossRef Mason HD, Martkaninen H, Beard RW, Anyaoku V, Franks S. Direct gonadotropin effect of growth hormone on estradiol production by human granulosa cells. J Endocrinol 1990;126:R1–4.PubMedCrossRef
15.
Zurück zum Zitat Lanzone A, Fortini A, Fulghesu AM, Soranna L, Caruso A, Mancuso S. Growth hormone enhances estradiol production follicle-stimulating hormone-induced in the early stage of the follicular maturation. Fertil Steril 1996;66:948–53.PubMed Lanzone A, Fortini A, Fulghesu AM, Soranna L, Caruso A, Mancuso S. Growth hormone enhances estradiol production follicle-stimulating hormone-induced in the early stage of the follicular maturation. Fertil Steril 1996;66:948–53.PubMed
16.
Zurück zum Zitat Mendoza C, Ruiz-Requena E, Ortega E, Cremades N, Martinez F, Bernabeu R. Follicular fluid markers of oocyte developmental potential. Hum Reprod 2002;17:1017–22.PubMedCrossRef Mendoza C, Ruiz-Requena E, Ortega E, Cremades N, Martinez F, Bernabeu R. Follicular fluid markers of oocyte developmental potential. Hum Reprod 2002;17:1017–22.PubMedCrossRef
17.
Zurück zum Zitat Bachelot A, Monget P, Imbert-Bollore P, Coshigano K, Kopchick JJ, Kelly PA, et al. Growth hormone is required for ovarian follicular growth. Endocrinology 2002;143:4104–12.PubMedCrossRef Bachelot A, Monget P, Imbert-Bollore P, Coshigano K, Kopchick JJ, Kelly PA, et al. Growth hormone is required for ovarian follicular growth. Endocrinology 2002;143:4104–12.PubMedCrossRef
18.
Zurück zum Zitat Zhao J, Taverne MA, van den Weijden GC, Bevers MM, van den Hurk R. Immunohistochemical localisation of growth hormone (GH), GH receptor (GHR), insulin-like growth factor I (IGF-I) and type I IGF-I receptor, and gene expression of GH and GHR in rat pre-antral follicles. Zygote 2002;10:85–94.PubMedCrossRef Zhao J, Taverne MA, van den Weijden GC, Bevers MM, van den Hurk R. Immunohistochemical localisation of growth hormone (GH), GH receptor (GHR), insulin-like growth factor I (IGF-I) and type I IGF-I receptor, and gene expression of GH and GHR in rat pre-antral follicles. Zygote 2002;10:85–94.PubMedCrossRef
19.
Zurück zum Zitat Spiliotis BE. Growth hormone insufficiency and its impact on ovarian function. Ann NY Acad Sci 2003;997:77–84.PubMedCrossRef Spiliotis BE. Growth hormone insufficiency and its impact on ovarian function. Ann NY Acad Sci 2003;997:77–84.PubMedCrossRef
20.
Zurück zum Zitat Moreira F, Badinga L, Burnley C, Thatcher WW. Bovine somatotropin increases embryonic development in superovulated cows and improves post-transfer pregnancy rates when given to lactating recipient cows. Theriogenology 2002;57:1371–8.PubMedCrossRef Moreira F, Badinga L, Burnley C, Thatcher WW. Bovine somatotropin increases embryonic development in superovulated cows and improves post-transfer pregnancy rates when given to lactating recipient cows. Theriogenology 2002;57:1371–8.PubMedCrossRef
Metadaten
Titel
Growth hormone co-treatment within a GnRH agonist long protocol in patients with poor ovarian response: a prospective, randomized, clinical trial
verfasst von
Tansu Kucuk
Hakan Kozinoglu
Ayten Kaba
Publikationsdatum
01.04.2008
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 4/2008
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-008-9212-7

Weitere Artikel der Ausgabe 4/2008

Journal of Assisted Reproduction and Genetics 4/2008 Zur Ausgabe

Update Gynäkologie

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