Exploring the potential benefits of growth hormone co-treatment on embryo quality in IVF: a randomized controlled open-label trial.

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Yi Tang, Xiaofeng Li, Change Hu, Ruyi Guan, Zhimin Wang, Shunji Zhang, Guoping Tao, Jingfei Qu, Fei Gong
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Abstract

Research question: While growth hormone (GH) is hypothesized to potentially enhance embryo quality, results of current basic and clinical researches remain inconclusive. This study assesses the effect of GH supplementation on embryo quality and explores the relationship between baseline insulin-like growth factor-1 (IGF-1) levels and the efficacy of GH supplementation among Chinese patients undergoing in vitro fertilization (IVF).

Design: A randomized controlled Open-label trial was performed with 128 women experiencing poor embryonic development in IVF. Participants were allocated to the GH group (GH + Gonadotropin-Releasing Hormone [GnRH] antagonist protocol) and the Control group (GnRH antagonist protocol). The primary outcome was the number of high-quality embryos on Day 3.

Results: Patients in the GH group required significantly lower total doses of gonadotropin (2213 ± 667 IU vs. 2573 ± 630 IU, p = 0.0058) and shorter duration of controlled ovarian stimulation (10.1 ± 1.60 days vs. 10.6 ± 1.30 days, p = 0.0488). While there was no statistically significant overall increase in the number of high-quality embryos, subgroup analysis indicated that patients with lower baseline IGF-1 levels, especially those below the lowest quartile, might show a higher rate of high-quality embryos with GH supplementation (p = 0.0488). Additionally, the fresh embryo transfer clinical pregnancy rate was numerically higher in the GH supplementation group (46.2%) compared to the control group (38.5%), although not statistically significant.

Conclusions: This study suggests that GH co-treatment may enhance ovarian responsiveness in IVF patients with poor embryo quality, thereby reducing the dosage and duration of Gonadotropin (Gn) administration. Among individuals with lower IGF-1 levels, adding GH may improve the rate of high-quality embryos, highlighting the potential benefits of personalized treatment strategies in IVF.

Clinical trial registration: ClinicalTrials.gov ID: NCT03966339 (Registration time: 2019-05-24).

探索生长激素联合治疗对体外受精胚胎质量的潜在益处:一项随机对照开放标签试验。
研究问题:虽然生长激素(GH)被假设可能提高胚胎质量,但目前的基础和临床研究结果仍不确定。本研究评估了生长激素补充对胚胎质量的影响,并探讨了基线胰岛素样生长因子-1 (IGF-1)水平与中国体外受精(IVF)患者补充生长激素效果之间的关系。设计:一项随机对照开放标签试验对128名在体外受精中经历胚胎发育不良的妇女进行了研究。参与者被分配到GH组(GH +促性腺激素释放激素[GnRH]拮抗剂方案)和对照组(GnRH拮抗剂方案)。主要结果是第3天高质量胚胎的数量。结果:GH组患者需要较低的促性腺激素总剂量(2213±667 IU对2573±630 IU, p = 0.0058)和较短的控制卵巢刺激时间(10.1±1.60天对10.6±1.30天,p = 0.0488)。虽然高质量胚胎的数量总体上没有统计学上的显著增加,但亚组分析表明,基线IGF-1水平较低的患者,特别是低于最低四分位数的患者,在补充生长激素后可能显示出更高的高质量胚胎率(p = 0.0488)。此外,生长激素补充组的新鲜胚胎移植临床妊娠率(46.2%)高于对照组(38.5%),尽管没有统计学意义。结论:本研究提示GH联合治疗可提高胚胎质量差的IVF患者卵巢反应性,从而减少促性腺激素(Gonadotropin, Gn)给药剂量和持续时间。在IGF-1水平较低的个体中,添加生长激素可能提高高质量胚胎的比率,突出了试管婴儿个性化治疗策略的潜在益处。临床试验注册:ClinicalTrials.gov ID: NCT03966339(注册时间:2019-05-24)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Reproductive Biology and Endocrinology
Reproductive Biology and Endocrinology 医学-内分泌学与代谢
CiteScore
7.90
自引率
2.30%
发文量
161
审稿时长
4-8 weeks
期刊介绍: Reproductive Biology and Endocrinology publishes and disseminates high-quality results from excellent research in the reproductive sciences. The journal publishes on topics covering gametogenesis, fertilization, early embryonic development, embryo-uterus interaction, reproductive development, pregnancy, uterine biology, endocrinology of reproduction, control of reproduction, reproductive immunology, neuroendocrinology, and veterinary and human reproductive medicine, including all vertebrate species.
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