title: Ovarian response to combined growth hormone-gonadotropin treatment in patients resistant to induction of superovulation.
abstract: The efficacy of combined growth hormone (GH)-gonadotropin treatment has been studied in patients previously resistant to sole gonadotropins for induction of superovulation. Eleven patients (aged 26-41) with a mechanical cause of infertility were treated. All were given the same dosage of gonadotropins as in previous cancelled cycles (6-17 ampules/cycle of menofollitropin; 34-80 ampules/cycle of human menopausal gonadotropin) plus a standard dosage of GH (0.1 IU per kg body weight, daily). Younger patients (n = 6, age 26-36) showed a considerable improvement of ovarian response in terms of number of mature follicles aspirated by laparoscopy (performed on day 11-13). Older patients (n = 5, age 39-41) did not show any significant improvement of ovarian response with combined treatment and all had their stimulatory cycle cancelled. Follicular fluid (FF) levels of GH, 17 beta-estradiol (E2) and progesterone (P) were significantly higher in the group of younger GH-treated patients (n = 53 follicles) than in 4 controls treated with gonadotropins only (n = 32 follicles). FF insulin-like growth factor-I (IGF-I) did not significantly differ between the two groups. A significant positive linear correlation has been found between FF GH and IGF-I in the GH-treated group. In conclusion, GH-gonadotropin combined treatment considerably improves ovarian response in protocols for superovulation induction in younger gonadotropin-resistant patients. A local action of GH and IGF-I in the ovaries may be hypothesized.
authors.affiliation: Department of Obstetrics and Gynecology, University of Modena, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Volpe
authors.forename: G
authors.initials: G
authors.lastname: Coukos
authors.forename: A
authors.initials: A
authors.lastname: Barreca
authors.forename: P G
authors.initials: PG
authors.lastname: Artini
authors.forename: F
authors.initials: F
authors.lastname: Minuto
authors.forename: G
authors.initials: G
authors.lastname: Giordano
authors.forename: A R
authors.initials: AR
authors.lastname: Genazzani
mesh_terms: D000328:Adult; D004958:Estradiol / Q000097:blood; D005260:Female; D013006:Growth Hormone / Q000032:analysis / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007986:Luteinizing Hormone / Q000627:therapeutic use; D008596:Menotropins / Q000627:therapeutic use*; D006080:Ovarian Follicle / Q000032:analysis; D010053:Ovary / Q000187:drug effects*; D010060:Ovulation; D011374:Progesterone / Q000032:analysis; D013480:Superovulation
chemical_list: D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D007334:Insulin-Like Growth Factor I; D007986:Luteinizing Hormone; D013006:Growth Hormone