Use of growth hormone-releasing factor in ovulation induction in poor responders.
OBJECTIVE
To evaluate the effect of growth hormone-releasing factor (GRF), given in addition to follicle-stimulating hormone (FSH), after pituitary down-regulation, on follicular development in poor responders. GRF was added in a prospective, randomized manner to an existing stimulation protocol.


METHODS
Forty-two women, demonstrated to be poor responders in previous attempts at induction of ovulation, were included in the study. Follicular stimulation with FSH was started after pituitary downregulation obtained using gonadotropin-releasing hormone agonist (GnRH-a). GRF, 1,000 mg/day, was given in addition to FSH to 22 patients randomly chosen until human chorionic gonadotropin administration.


RESULTS
The number of ampules of FSH needed to obtain follicular growth was significantly reduced in the group of women who received GRF. Also, the number of follicles obtained was higher and the days of treatment generally reduced. However, a greatly beneficial effect for some women was observed, while a second subgroup did not have any. No differences were observed in follicular steroid and insulin growth factor 1 (IGF-1) between GRF patients and controls or in serum IGF-1 between the two subgroups of patients who received GRF.


CONCLUSIONS
In vivo administration of GRF with FSH after pituitary down-regulation may be beneficial for some poor responders, although prognostic criteria could not be established. However, the use of GRF does not seem to influence the chance of obtaining pregnancy; it remains low in these patients.
Busacca
M
M
Department of Obstetrics and Gynecology, Istituti Clinici di Perfezionamento and Istituto Scientifico San Raffaele, Milan, Italy.
Fusi
F M
FM
Brigante
C
C
Bonzi
V
V
Gonfiantini
C
C
Vignali
M
M
Ferrari
A
A
D000328:Adult; D005260:Female; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D013007:Growth Hormone-Releasing Hormone / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000188:drug therapy*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D017211:Treatment Failure
D007334:Insulin-Like Growth Factor I; D005640:Follicle Stimulating Hormone; D013007:Growth Hormone-Releasing Hormone