Does growth hormone-releasing factor assist follicular development in poor responder patients undergoing ovarian stimulation for in-vitro fertilization?
Treatment with growth hormone-releasing factor (GRF) has been reported to improve the ovarian response to gonadotrophins in women who respond poorly to ovarian stimulation during in-vitro fertilization (IVF). The efficacy and tolerability of GRF were studied in a randomized, double-blind, placebo-controlled trial involving 196 patients. Following down-regulation with a gonadotrophin-releasing hormone agonist (GnRHa), patients were randomized to receive GRF (500 microg twice daily; n = 96) or placebo (n = 100) in addition to follicle stimulating hormone (FSH); treatment was continued until human chorionic gonadotrophin was given, or for a maximum of 14 days. GRF had no significant effect on the mean number of follicles with a diameter of >/=16 mm (GRF: 3.26 +/- 2.29; placebo: 3.27 +/- 2.30; P = 0.95), the number of FSH ampoules required to achieve ovarian stimulation (GRF: 55.2 +/- 16. 4; placebo: 54.9 +/- 17.2; P = 0.50), or on secondary measures of ovarian response and treatment outcome. There were, however, significant increases in circulating growth hormone (GH) and insulin-like growth factor (IGF)-1 concentrations. GRF was well tolerated. It is concluded that, despite producing significant increases in GH and IGF-1, concomitant treatment with GRF does not improve the ovarian response to FSH in poorly responsive women undergoing IVF.
Howles
C M
CM
Ares-Serono International SA, 15 bis Chemin des Mines,CP 54, 1211 Geneva 20, Fertility Unit, CHUV, Lausanne, Switzerland.
Loumaye
E
E
Germond
M
M
Yates
R
R
Brinsden
P
P
Healy
D
D
Bonaventura
L M
LM
Strowitzki
T
T
D000293:Adolescent; D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D005307:Fertilization in Vitro; D013007:Growth Hormone-Releasing Hormone / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D006080:Ovarian Follicle / Q000187:drug effects; D010062:Ovulation Induction; D016896:Treatment Outcome
D006063:Chorionic Gonadotropin; D013007:Growth Hormone-Releasing Hormone