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Meta-Analysis
. 2010 Jan 20;2010(1):CD000099.
doi: 10.1002/14651858.CD000099.pub3.

Growth hormone for in vitro fertilization

James Mn Duffy  1 , Gaity Ahmad, Lamiya Mohiyiddeen, Luciano G Nardo, Andrew Watson
Affiliations
Meta-Analysis

Growth hormone for in vitro fertilization

James Mn Duffy et al. Cochrane Database Syst Rev. .

Update in

  • Growth hormone for in vitro fertilisation (IVF).
    Sood A, Mohiyiddeen G, Ahmad G, Fitzgerald C, Watson A, Mohiyiddeen L. Sood A, et al. Cochrane Database Syst Rev. 2021 Nov 22;11(11):CD000099. doi: 10.1002/14651858.CD000099.pub4. Cochrane Database Syst Rev. 2021. PMID: 34808697 Free PMC article.

Abstract

Background: In an effort to improve outcomes of in-vitro fertilisation cycles the use of growth hormone has been considered. Improving the outcomes of in-vitro fertilisation is especially important for subfertile women who are considered 'poor responders'.

Objectives: To assess the effectiveness of adjuvant growth hormone in in-vitro fertilisation protocols.

Search strategy: We searched the Cochrane Menstrual Disorders and Subfertility Groups trials register (June 2009), the Cochrane Central Register of Controlled Trials (Cochrane Library Issue 2, 2009), MEDLINE (1966 to June 2009), EMBASE (1988 to June 2009) and Biological Abstracts (1969 to June 2009).

Selection criteria: All randomised controlled trials were included if they addressed the research question and provided outcome data for intervention and control participants.

Data collection and analysis: Assessment of trial risk of bias and extraction of relevant data was performed independently by two reviewers.

Main results: Ten studies (440 subfertile couples) were included. Results of the meta-analysis demonstrated no difference in outcome measures and adverse events in the routine use of adjuvant growth hormone in in-vitro fertilisation protocols. However, meta-analysis demonstrated a statistically significant difference in both live birth rates and pregnancy rates favouring the use of adjuvant growth hormone in in-vitro fertilisation protocols in women who are considered poor responders without increasing adverse events, OR 5.39, 95% CI 1.89 to 15.35 and OR 3.28, 95% CI 1.74 to 6.20 respectively.

Authors' conclusions: Although the use of growth hormone in poor responders has been found to show a significant improvement in live birth rates, we were unable to identify which sub-group of poor responders would benefit the most from adjuvant growth hormone. The result needs to be interpreted with caution, the included trials were few in number and small sample size. Therefore, before recommending growth hormone adjuvant in in-vitro fertilisation further research is necessary to fully define its role.

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Conflict of interest statement

None known

Figures

1
1
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
2
2
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
3
3
Forest plot of comparison: 1 Growth hormone versus placebo: Routine use, outcome: 1.1 Live birth rate per woman randomised.
4
4
Forest plot of comparison: 1 Growth hormone versus placebo: Routine use, outcome: 1.2 Pregnancy rate per woman randomised.
5
5
Forest plot of comparison: 1 Growth hormone versus placebo: Routine use, outcome: 1.3 Number of women with at least one oocyte retrieved per woman randomised.
6
6
Forest plot of comparison: 1 Growth hormone versus placebo: Routine use, outcome: 1.4 Embryo transfer per woman randomised.
7
7
Forest plot of comparison: 1 Growth hormone versus placebo: Routine use, outcome: 1.5 Mean number of ampoules of gonadotrophin used per woman.
8
8
Forest plot of comparison: 1 Growth hormone versus placebo: Routine use, outcome: 1.6 Adverse Events.
9
9
Forest plot of comparison: 2 Growth hormone versus placebo: Poor responder as defined by the study, outcome: 2.1 Live birth rate per woman randomised.
10
10
Forest plot of comparison: 2 Growth hormone versus placebo: Poor responder as defined by the study, outcome: 2.2 Pregnancy rate per woman randomised.
11
11
Forest plot of comparison: 3 Growth hormone versus placebo: Poor responder as demonstrated by previous sub‐optimal response following controlled ovarian stimulation, outcome: 3.3 Number of women with at least one oocyte retrieved per woman randomised.
12
12
Forest plot of comparison: 3 Growth hormone versus placebo: Poor responder as demonstrated by previous sub‐optimal response following controlled ovarian stimulation, outcome: 3.4 Embryo transfer per woman randomised.
13
13
Forest plot of comparison: 3 Growth hormone versus placebo: Poor responder as demonstrated by previous sub‐optimal response following controlled ovarian stimulation, outcome: 3.5 Adverse Events.
14
14
Forest plot of comparison: 3 Growth hormone versus placebo: Poor responder as demonstrated by previous sub‐optimal response following controlled ovarian stimulation, outcome: 3.1 Live birth rate per woman randomised.
15
15
Forest plot of comparison: 3 Growth hormone versus placebo: Poor responder as demonstrated by previous sub‐optimal response following controlled ovarian stimulation, outcome: 3.2 Pregnancy rate per woman randomised.
1.1
1.1. Analysis
Comparison 1 Growth hormone versus placebo: Routine use, Outcome 1 Live birth rate per woman randomised.
1.2
1.2. Analysis
Comparison 1 Growth hormone versus placebo: Routine use, Outcome 2 Pregnancy rate per woman randomised.
1.3
1.3. Analysis
Comparison 1 Growth hormone versus placebo: Routine use, Outcome 3 Number of women with at least one oocyte retrieved per woman randomised.
1.4
1.4. Analysis
Comparison 1 Growth hormone versus placebo: Routine use, Outcome 4 Embryo transfer per woman randomised.
1.5
1.5. Analysis
Comparison 1 Growth hormone versus placebo: Routine use, Outcome 5 Mean number of ampoules of gonadotrophin used per woman.
1.6
1.6. Analysis
Comparison 1 Growth hormone versus placebo: Routine use, Outcome 6 Adverse Events.
2.1
2.1. Analysis
Comparison 2 Growth hormone versus placebo: Poor responder as defined by the study, Outcome 1 Live birth rate per woman randomised.
2.2
2.2. Analysis
Comparison 2 Growth hormone versus placebo: Poor responder as defined by the study, Outcome 2 Pregnancy rate per woman randomised.
3.1
3.1. Analysis
Comparison 3 Growth hormone versus placebo: Poor responder as demonstrated by previous sub‐optimal response following controlled ovarian stimulation, Outcome 1 Live birth rate per woman randomised.
3.2
3.2. Analysis
Comparison 3 Growth hormone versus placebo: Poor responder as demonstrated by previous sub‐optimal response following controlled ovarian stimulation, Outcome 2 Pregnancy rate per woman randomised.
3.3
3.3. Analysis
Comparison 3 Growth hormone versus placebo: Poor responder as demonstrated by previous sub‐optimal response following controlled ovarian stimulation, Outcome 3 Number of women with at least one oocyte retrieved per woman randomised.
3.4
3.4. Analysis
Comparison 3 Growth hormone versus placebo: Poor responder as demonstrated by previous sub‐optimal response following controlled ovarian stimulation, Outcome 4 Embryo transfer per woman randomised.
3.5
3.5. Analysis
Comparison 3 Growth hormone versus placebo: Poor responder as demonstrated by previous sub‐optimal response following controlled ovarian stimulation, Outcome 5 Adverse Events.
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References

References to studies included in this review

Bergh 1994 {published data only}
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Hazout 2003 8 IU {published data only}
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References to studies excluded from this review

Blumenfeld 1994 {published data only}
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