Growth hormone cotreatment for poor responders undergoing in vitro fertilization cycles: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 32553470 · doi:10.1016/j.fertnstert.2020.03.007
What was done
A systematic review and meta-analysis (PROSPERO CRD42020151681) evaluating growth hormone (GH) supplementation versus conventional controlled ovarian stimulation in poor ovarian responders undergoing a single IVF/ICSI cycle. The primary outcome was live birth rate. Secondary outcomes included clinical pregnancy rate, miscarriage rate, ongoing pregnancy rate, retrieved oocytes, mature (metaphase II) oocytes, and transferable embryos.
What was found
Twelve RCTs were included (586 women receiving GH, 553 controls). GH supplementation did not significantly increase live birth rate, miscarriage rate, or ongoing pregnancy rate. GH supplementation significantly increased clinical pregnancy rate (effect size not quantified in abstract), retrieved oocytes (mean difference: 1.62), mature MII oocytes (mean difference: 2.06), and available embryos for transfer (mean difference: 0.76).
Why it matters
While growth hormone cotreatment improves intermediate laboratory markers and clinical pregnancy rates in poor ovarian responders, current evidence does not demonstrate an improvement in the critical outcome of live birth.
Limits
The total sample size is relatively small across 12 trials (1,139 patients total). The abstract does not report confidence intervals, exact numerical effects for clinical pregnancy, or variations in GH dosage, timing, and poor responder definitions across the included studies.
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.