Abstract
BackgroundMany studies have demonstrated the benefits of the addition of growth hormone (GH) to the controlled ovarian stimulation protocol in vitro fertilization (IVF) cycles in poor-respond patients, but the effect of GH on patients with poor embryonic development remain unclear. This paper was designed to investigate the efficacy of GH co-treatment during IVF for the patients with poor embryonic development.MethodA randomized controlled trial including 158 patients with poor embryo development was conducted between July 2017 and February 2019. One hundred and seven patients were randomized for GH treatment (GH group) and 51 patients for untreated (control group). The primary end-points were the clinical pregnancy and live birth rates in the two groups. The oocyte competence were assessed through calculating the mitochondrial DNA (mtDNA) copy number in corresponding cumulus granulosa cells (CGCs). Quantitative PCR were used for calculation of mtDNA copy number.ResultsRelative to the control group, GH co-treatment resulted in a significantly higher number of retrieved oocytes (10.29 ± 5.92 versus 8.16 ± 4.17, P = 0.023) and cleaved embryos (6.73 ± 4.25 versus 5.29 ± 3.23, P = 0.036). The implantation rate, clinical pregnancy rates per cycle, and live birth rate per cycle were higher in the GH group than in the control group (36.00% versus 17.86%, P = 0.005; 43.93% versus 19.61%, P = 0.005; 41.12% versus 17.65%, P = 0.006). CGCs of the GH group had significantly higher mtDNA copy numbers than CGCs of the control group (252 versus 204, P < 0.001).ConclusionsThese data provided further evidence to indicate that GH supplementation may support more live births during IVF, in patients with poor embryonic development. It also appears that oocytes generated under GH co-treatment have a better developmental competence.Trial registrationChiCTR1900021992 posted March 19, 2019 (retrospectively registered).
Highlights
Many studies have demonstrated the benefits of the addition of growth hormone (GH) to the controlled ovarian stimulation protocol in vitro fertilization (IVF) cycles in poor-respond patients, but the effect of GH on patients with poor embryonic development remain unclear
cumulus granulosa cells (CGCs) of the GH group had significantly higher mitochondrial DNA (mtDNA) copy numbers than CGCs of the control group (252 versus 204, P < 0.001). These data provided further evidence to indicate that GH supplementation may support more live births during IVF, in patients with poor embryonic development
It appears that oocytes generated under GH co-treatment have a better developmental competence
Summary
Many studies have demonstrated the benefits of the addition of growth hormone (GH) to the controlled ovarian stimulation protocol in vitro fertilization (IVF) cycles in poor-respond patients, but the effect of GH on patients with poor embryonic development remain unclear. This paper was designed to investigate the efficacy of GH co-treatment during IVF for the patients with poor embryonic development. Poor embryonic development is a major cause of in vitro fertilization (IVF) failure, especially in patients with normal ovarian response. In the period following fertilization, no transcription occurs in the newly formed embryo [3, 4]; early embryonic development is controlled by maternally derived information until the oocyte-to-embryo transition (OET) occurs. Maternal stores of mRNAs, proteins, and mitochondria are essential for fertilization, early embryonic development, and implantation [5, 6]. Several factors have been investigated in relation to reductions in oocyte developmental competence, including advanced age [7], an immature cytoplasm [8], abnormal maternal protein expression [9], and insufficient mitochondria [10]. To date, no treatment has successfully improved the clinical outcomes in patients with poor embryonic development
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