Adjuvant growth hormone treatment during in vitro fertilization: a randomized, placebo-controlled study.
OBJECTIVE
To explore the effect of recombinant, human GH on follicular development and oocyte retrieval after gonadotropin stimulation with the addition of GH or placebo to a standard IVF treatment regimen. Further, to investigate whether GH is a more effective adjuvant if the standard treatment regimen is preceded by GH injections.


METHODS
A randomized, double-blind, parallel, placebo-controlled study.


METHODS
The IVF unit at university hospital.


METHODS
Forty normally ovulating women, age 25 to 38 years, with infertility because of tubal factors and being classified as "poor responders" with at least two previously performed and failed IVF attempts.


METHODS
Human, recombinant GH (Genotropin, Kabi Pharmacia, Uppsala, Sweden) or placebo (0.1 IU/kg body weight per day) was given SC as pretreatment during down regulation with GnRH and during stimulation with hMG according to the randomized protocol.


METHODS
Number of oocytes retrieved after stimulation, total amount of gonadotropin used, time required for stimulation, number of follicles developing, rate of fertilization, and cleavage in vitro. Further, the quality of embryos, development of the endometrium, rate of clinical pregnancy, and serum and follicular fluid (FF) concentrations of insulin-like growth factor I (IGF-I), insulin-like growth factor binding protein-1 (IGFBP-1), and IGFBP-3 were estimated.


RESULTS
The number of oocytes retrieved did not differ significantly between the groups, nor did the amount of hMG required for stimulation. The fertilization rate increased in patients who had received GH. Growth hormone caused a significant increase in serum and FF levels of IGF-I. An increase in serum IGFBP-3 could also be recorded in patients who had received GH.


CONCLUSIONS
Although certain beneficial effects were noted in GH-treated patients, the overall results did not support GH as a clinically useful adjuvant treatment.
Bergh
C
C
Department of Obstetrics and Gynecology, University of Göteborg, Sahlgrenska Hospital, Sweden.
Hillensjö
T
T
Wikland
M
M
Nilsson
L
L
Borg
G
G
Hamberger
L
L
D000277:Adjuvants, Pharmaceutic / Q000627:therapeutic use; D000328:Adult; D001769:Blood / Q000378:metabolism; D002352:Carrier Proteins / Q000378:metabolism; D002970:Cleavage Stage, Ovum; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000378:metabolism; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D018970:Insulin-Like Growth Factor Binding Protein 1; D018969:Insulin-Like Growth Factor Binding Proteins; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D010053:Ovary / Q000187:drug effects; D010919:Placebos; D011994:Recombinant Proteins / Q000627:therapeutic use*; D013002:Somatomedins / Q000378:metabolism
D000277:Adjuvants, Pharmaceutic; D002352:Carrier Proteins; D018970:Insulin-Like Growth Factor Binding Protein 1; D018969:Insulin-Like Growth Factor Binding Proteins; D010919:Placebos; D011994:Recombinant Proteins; D013002:Somatomedins; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone