The effects of growth hormone supplementation in poor ovarian responders undergoing In vitro fertilization or Intracytoplasmic sperm injection: A systematic review and meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 39228251 · doi:10.4274/tjod.galenos.2024.59944
What was done
Authors conducted a systematic review and meta-analysis of 18 randomized controlled trials comprising 1,870 poor ovarian responders undergoing in vitro fertilization or intracytoplasmic sperm injection. Databases searched included PubMed, Scopus, Clinicaltrials.gov, Google Scholar, and Cochrane Library. Outcomes assessed included live birth rate, clinical pregnancy rate, cycle cancelation rate, retrieved oocyte count, transferred embryo count, total gonadotropin dose, treatment duration, and peak estradiol level. Meta-regression evaluated potential linear relationships between stimulation outcomes and assisted reproduction success.
What was found
Growth hormone supplementation significantly increased retrieved oocyte count (SMD 0.65, 95% CI 0.29 to 1.00), transferred embryos (SMD 0.80, 95% CI 0.39 to 1.21), and peak estradiol level (SMD 1.20, 95% CI 0.59 to 1.81). It significantly decreased total gonadotropin dose (SMD -0.82, 95% CI -1.25 to -0.39) and gonadotropin duration (SMD -0.63, 95% CI -1.04 to -0.22). Meta-regression found no linear relationship between clinical pregnancy, live birth rate, or cycle cancelation rate and the measured stimulation outcomes (p > 0.1). Pooled effect sizes and numbers for live birth and clinical pregnancy rates were not reported in the abstract.
Why it matters
Adjuvant growth hormone improves surrogate markers of ovarian response and reduces gonadotropin requirements in poor ovarian responders undergoing assisted reproduction.
Limits
The abstract does not provide pooled effect sizes or statistical findings for key clinical endpoints such as live birth rate or clinical pregnancy rate. Variations in growth hormone dosing protocols, patient response criteria, and cost-effectiveness considerations were not described.
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.