Abstract
Growth hormone (GH) is a peptide hormone secreted mainly by the anterior part of the pituitary gland and plays a critical role in cell growth, development, and metabolism throughout the body. GH can not only directly influence human oocytes and cumulus cells but also indirectly improve oocyte quality through activating synthesis of insulin-like growth factor-I or promoting follicle-stimulating hormone-induced ovarian steroidogenesis. Since GH can regulate female and male infertility, it has been applied in the management of infertility for many years, especially in patients with poor ovarian response or poor prognosis. During ovarian stimulation, GH administration might improve the success rate of in vitro fertilization (IVF) probably through the beneficial effects of GH on oocyte quality as indicated by a higher number of mature oocytes and embryos arriving at the transfer stage and a higher fertility rate in GH-treated patients. However, there is still great controversy in the application of GH in IVF. While some researchers showed that pregnancy, implantation and live birth rates could be increased by ovarian pretreatment with GH, others did not support GH as an effective adjuvant for infertility treatment because the live birth rate was not increased. This study reviewed and summarized recent advancements and benefits in clinical application of GH, trying to reach a just unbiased conclusion regarding the effect of GH therapy in IVF.
Highlights
As a peptide hormone secreted mainly by the anterior part of the pituitary gland in a pulsatile manner, growth hormone (GH) plays a critical role in cell growth, development and metabolism throughout the body with multifunctional effects ranging far beyond the effect on linear growth [1]
Since different opinions exist in the application and benefit of Growth hormone (GH) adjuvant therapy in in vitro fertilization (IVF), the present review aims to review and summarize recent advancements and benefits in clinical application of GH, trying to reach a just unbiased conclusion regarding the effect of GH adjuvant therapy in IVF based on the following aspects: theoretic bases of GH application, GH application in IVF, administration protocol and subjects and benefits of GH application (Table 1)
In another systematic review and meta-analysis including 22 eligible randomized controlled trials assessing interventions to improve the pregnancy rate in poor responders undergoing IVF [68], it was found that the only interventions that appear to increase the probability of pregnancy were the addition of GH to ovarian stimulation (OR for live birth: 5.22, 95% CI 1.09–24.99) and the performance of embryo transfer on day 2 compared with day 3
Summary
Reviewed by: Thor Haahr, Aarhus University, Denmark Himanshu Arora, University of Miami, United States. Application of Growth Hormone in in vitro Fertilization. GH can directly influence human oocytes and cumulus cells and indirectly improve oocyte quality through activating synthesis of insulin-like growth factor-I or promoting follicle-stimulating hormone-induced ovarian steroidogenesis. GH administration might improve the success rate of in vitro fertilization (IVF) probably through the beneficial effects of GH on oocyte quality as indicated by a higher number of mature oocytes and embryos arriving at the transfer stage and a higher fertility rate in GH-treated patients. There is still great controversy in the application of GH in IVF. This study reviewed and summarized recent advancements and benefits in clinical application of GH, trying to reach a just unbiased conclusion regarding the effect of GH therapy in IVF
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