Double-blind placebo controlled study: human biosynthetic growth hormone for assisted reproductive technology.
OBJECTIVE
To study whether the effect of cotreatment with human biosynthetic GH improves the outcome of poor IVF responders.


METHODS
A double-blind placebo-controlled study using a GnRH agonist (GnRH-a) and gonadotropin in a "boost" flare-up protocol for ovarian stimulation together with either placebo, 4, or 12 IU of human GH followed by oocyte retrieval and IVF-ET.


METHODS
Twenty-two patients with previously demonstrated poor responses in at least two assisted reproductive technology cycles were recruited.


METHODS
Pretreatment and post-treatment blood samples and daily morning blood samples during ovarian stimulation were collected after an overnight fast. Human GH or placebo and GnRH-a were administered SC; gonadotropin was administered IM. Oocytes were collected by ultrasound-guided transvaginal aspiration of follicles. Embryos were cultured in vitro and transferred transcervically.


METHODS
Serum E2, FSH, GH, insulin-like growth factor-I (IGF-1), IGF binding protein 1 (IGFBP-1), and IGFBP-3 concentrations. Number of FSH ampules, follicles, oocytes, embryos, and pregnancies.


RESULTS
No improvement in cycle outcome was demonstrated with daily adjuvant human GH administration with either 4 or 12 IU. Serum IGF-I levels were highest in the 12 IU human GH group and lowest in the placebo group. Serum IGFBP-3 levels increased 2 days after IGF-I levels in the 12 IU human GH group only. Serum IGFBP-1 levels were unchanged in all groups.


CONCLUSIONS
Poor IVF responders do not benefit from cotreatment with human GH during their ovarian stimulation.
Suikkari
A
A
Monash In Vitro Fertilization, Monash University, Clayton, Victoria, Australia.
MacLachlan
V
V
Koistinen
R
R
Seppälä
M
M
Healy
D
D
D000328:Adult; D002985:Clinical Protocols; D004311:Double-Blind Method; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D013006:Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000628:therapy*; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D011247:Pregnancy; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use
D018970:Insulin-Like Growth Factor Binding Protein 1; D018972:Insulin-Like Growth Factor Binding Protein 3; D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone