Single-centre retrospective analysis of growth hormone supplementation in IVF patients classified as poor-prognosis

Abstract

Background: Patients undergoing in vitro fertilisation (IVF) receive various adjuvant therapies in order to enhance success rates, but the true benefit is actively debated. Growth hormone (GH) supplementation was assessed in poor-prognosis women undergoing fresh IVF transfer cycles.

Methods: Data were retrospectively analysed from 400 IVF cycles, where 161 women received GH and 239 did not.

Results: Clinical pregnancy, live birth rates and corresponding ORs and CIs were significantly greater with GH, despite patients being significantly older with lower ovarian reserve. Patient's age, quality of transferred embryo and GH were the only significant independent predictors of clinical pregnancy (OR: 0.90, 5.00 and 2.49, p<0.002, respectively) and live birth chance (OR: 0.91, 3.90 and 4.75, p<0.014, respectively). GH increased clinical pregnancy chance by 3.42-fold (95% CI 1.82 to 6.44, p<0.0005) and live birth chance by 6.16-fold (95% CI 2.83 to 13.39, p<0.0005) after adjustment for maternal age, antral follicle count and transferred embryo quality.

Conclusion: These data provided further evidence to indicate that GH may support more live births, particularly in younger women. It also appears that embryos generated under GH have a better implantation potential, but whether the biological mechanism is embryo-mediated or endometrium-mediated is unclear.

Keywords: adjuvants; embryo quality; in vitro fertilisation.

Figure 1

Flow diagram of data extraction. Data were extracted from the PIVET database and cases/cycles removed on the basis of cycle outcome (eg, cancelled/donor) and other adjuvant treatment (eg, DHEA/melatonin), cycle type (failed OPU, failed fertilisation or freeze all). To offset the bias of single patients receiving multiple treatment cycles, only the first in vitro fertilisation cycle with successful ovum pick-up and fresh embryo transfer for each patient within the study period was considered for analysis. DHEA, dehydroepiandrosterone; GH, growth hormone.