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Meta-Analysis
. 2025 Mar;42(3):721-736.
doi: 10.1007/s10815-025-03389-6. Epub 2025 Jan 25.

Growth hormone improves the pregnancy outcomes in poor ovarian responders undergoing in vitro fertilization: an umbrella review

Yongmei Liu  1   2 , Fengxing Ding  1   2 , Yuan Yang  3 , Bin Ma  2
Affiliations
Meta-Analysis

Growth hormone improves the pregnancy outcomes in poor ovarian responders undergoing in vitro fertilization: an umbrella review

Yongmei Liu et al. J Assist Reprod Genet. 2025 Mar.

Abstract

Poor ovarian response (POR) significantly impacts the success of assisted reproductive technology (ART), and growth hormone (GH) has been proposed as an adjuvant treatment to improve outcomes in POR patients undergoing in vitro fertilization (IVF). A systematic review and meta-analysis were conducted to evaluate the effectiveness of GH in enhancing pregnancy outcomes, registering a protocol on PROSPERO and searching multiple databases up to September 2023. Twelve systematic reviews/meta-analysis and 20 randomized controlled trials (RCTs) involving 1984 patients were included. Quality assessment was performed using AMSTAR 2, GRADE, and RoB tools. The meta-analysis revealed that GH significantly increased live birth rates [OR=1.80, 95% CI (1.22, 2.64)] and clinical pregnancy rates [OR=1.92, 95% CI (1.51, 2.43)] compared to the control group. Subgroup analysis indicated that administering 5-10 IU/d of GH combined with a long protocol during the middle and late follicular stages maximized these benefits. Despite these promising findings, most outcome indicators exhibited low-quality evidence, highlighting the need for improved research standards to ensure solid evidence supports treatment strategies for POR, thereby promoting reliable application of GH in IVF treatments.

Keywords: AMSTAR-2; GH; GRADE; IVF-ET; POR; UR.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Flow chart of study selection
Fig. 2
Fig. 2
Risk of bias assessment
Fig. 3
Fig. 3
Forest plots of GH co-treatment versus conventional IVF intervention (control): A live birth rate and B clinical pregnancy rate
Fig. 4
Fig. 4
Forest plots of GH co-treatment versus conventional IVF intervention (control): A number of collected oocytes and B number of embryos transferred
Fig. 5
Fig. 5
Forest plots of GH co-treatment versus conventional IVF intervention (control): endometrial thickness
Fig. 6
Fig. 6
Funnel plots of primary outcomes in poor responders: A live birth rate and B clinical pregnancy rate
See this image and copyright information in PMC

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