The influence of different growth hormone addition protocols to poor ovarian responders on clinical outcomes in controlled ovary stimulation cycles: A systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 28328856 · doi:10.1097/MD.0000000000006443
What was done
A systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated growth hormone (GH) adjuvant therapy in poor ovarian responders undergoing in vitro fertilization and embryo transfer (IVF-ET). Databases were searched for RCTs reporting pregnancy rate, live birth rate, collected oocytes, fertilization rate, and implantation rate. Data were pooled using fixed-effects or Mantel-Haenszel random-effects models across 11 included studies.
What was found
GH addition significantly increased clinical pregnancy rate (RR 1.65, 95% CI 1.23 to 2.22), live birth rate (RR 1.73, 95% CI 1.25 to 2.40), collected oocyte count (SMD 1.09, 95% CI 0.54 to 1.64), mature (MII) oocyte count (SMD 1.48, 95% CI 0.84 to 2.13), and estradiol on hCG day (SMD 1.03, 95% CI 0.18 to 1.89). GH significantly reduced cycle cancellation rates (RR 0.65, 95% CI 0.45 to 0.94) and required gonadotropin dose (SMD -0.83, 95% CI -1.47 to -0.19). Subgroup analysis showed GH co-administered with gonadotropin significantly increased clinical pregnancy rate (RR 1.76, 95% CI 1.25 to 2.48) and live birth rate (RR 1.91, 95% CI 1.29 to 2.83).
Why it matters
This meta-analysis consolidates trial evidence indicating that adjuvant growth hormone improves oocyte yield and reproductive success in poor ovarian responders undergoing controlled ovarian stimulation.
Limits
The total number of randomized participants is not stated in the abstract. Protocol-level heterogeneity regarding the timing, dosage, and specific medication combinations of GH administration was present, and adverse effects were not reported.
Cited by
- supports The addition of human growth hormone (HGH) during ovarian stimulation protocols improves egg maturity and embryo development in poor-responder IVF patients.