Improvement of delivery and live birth rates after ICSI in women aged >40 years by ovarian co-stimulation with growth hormone.
BACKGROUND
Growth hormone (GH) is required for ovarian follicular development, and its administration during ovarian stimulation improves pregnancy rate in cow and sheep. Data on the use of exogenous GH in human assisted reproduction treatment are inconsistent. This prospective randomized study evaluates the usefulness of GH administration in women of >40 years undergoing ovarian stimulation for assisted reproduction treatment.


METHODS
One hundred women of >40 years undergoing assisted reproduction treatment were randomized between a GH treatment group and a placebo group. Assisted reproduction treatment outcomes were evaluated.


RESULTS
In patients of the GH treatment group, a similar number of oocytes, embryos and pregnancies was achieved as compared with the placebo group. However, the patients treated with GH suffered fewer pregnancy losses, resulting in higher delivery and live birth rates. These patients also showed higher peak serum estradiol concentration and higher concentrations of GH and estradiol in pre-ovulatory follicular fluid as compared with the placebo group.


CONCLUSIONS
Administration of GH during ovarian stimulation alleviates age-related decrease in assisted reproduction treatment efficiency. This effect appears to be mainly due to an improvement of oocyte developmental potential, but GH action on the uterus cannot be excluded.
Tesarik
Jan
J
MAR&Gen, Molecular Assisted Reproduction and Genetics, Granada, Spain.
Hazout
André
A
Mendoza
Carmen
C
D000328:Adult; D000367:Age Factors; D010064:Embryo Implantation / Q000187:drug effects; D005260:Female; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D009865:Oocytes / Q000187:drug effects; D006080:Ovarian Follicle / Q000166:cytology / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D020554:Sperm Injections, Intracytoplasmic
D019382:Human Growth Hormone