Does growth hormone supplementation improve oocyte yield and pregnancy outcome in patients with poor ovarian reserve undergoing in vitro fertilization: A prospective randomized trial

Abstract

Context: Poor ovarian reserve (POR) results in poor ovarian response to controlled ovarian stimulation (COS) in in vitro fertilization (IVF) cycles. Despite various strategies, clinical pregnancy rates (PRs) remain low in patients with POR. Aims: This study aims to assess if growth hormone (GH) supplementation in POR patients improves oocyte yield and PR in IVF-intracytoplasmic sperm injection (ICSI) cycles. Settings and Design: Prospective, randomized controlled study. Materials and Methods: Patients with anti-mullerian hormone ≤1.1 (ng/ml) and total antral follicle count ≤6 undergoing IVF-ICSI were enrolled in the study. Gonadotropin (GT) stimulation with GT-releasing hormone antagonist protocol was used for IVF. Patients were randomly divided into two groups: group A (n = 30) received recombinant GH 4 IU from the day of COS till the day of human chorionic gonadotropin trigger. Group B (n = 32) received COS and no GH. Statistical Analysis Used: The unpaired t-test and Mann–Whitney test was used. Categorical variables were analyzed using either the Chi-square test or Fisher's exact test. Results: Total dose of GT injections used were significantly less in GH group (Group A) compared to no GH group (Group B) (3000.89 ± 742.20), P = 0.009). There was no statistically significant difference in number of oocytes retrieved (OR), total days of stimulation, mean estradiol levels on the day of trigger and fertilization rates between the two groups. There was a nonsignificant increase in the clinical PR and chemical PR in the GH group. Conclusions: GH cotreatment with antagonist protocol decreased the amount of GTs required for COS but did not improve the oocytes yield, fertilization or PR significantly in POR patients.