Turkish Journal of Obstetrics and Gynecology最新文献

{"title":"True empty follicle syndrome is a subtype of oocyte maturation abnormalities.","authors":"Şafak Hatırnaz, Ebru Hatırnaz, Justin Tan, Samettin Çelik, Canan Soyer Çalışkan, Alper Başbuğ, Gerçek Aydın, Ali Bahadırlı, Mehmet Bülbül, Handan Çelik, Aşkı Ellibeş Kaya, Nur Dokuzeylül Güngör, Seang Lin Tan, Mingju Cao, Michael H Dahan, Sebati Sinan Ürkmez","doi":"10.4274/tjod.galenos.2024.84031","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2024.84031","url":null,"abstract":"<p><strong>Objective: </strong>To review the outcomes of in vitro maturation (IVM) and in vitro fertilization (IVF) in women with empty follicle syndrome (EFS). The study evaluated the genetic underpinnings of EFS by analyzing mutations.</p><p><strong>Materials and methods: </strong>This retrospective case series involving 17 women with EFS over at least 2 IVF cycles was conducted. The study also employed whole-exome sequencing to analyze the genetic mutations. The treatment approaches included letrozole-primed IVM, follicle-stimulating hormone (FSH)-human chorionic gonadotrophin (hCG)-primed IVM, and conventional IVF.</p><p><strong>Results: </strong>The average female age was 31.5±4.6 years, and the duration of infertility was 7.3±3.5 years. Four patients underwent IVF. IVM oocyte collections yielded oocytes in 12 of 13 subjects. Of these, 75% (9/12) yielded MII oocytes after 48 h of IVM media incubation. Six subjects had fertilized embryos, resulting in a 40.9% intracytoplasmic sperm injection (ICSI) fertilization rate (9 embryos/22 MII oocytes). Genetic analysis revealed mutations in seven patients. This study demonstrated the partial efficacy of letrozole-primed IVM plus growth hormone and FSH-hCG primed IVM protocols. No pregnancies or live births were recorded after IVM. One ongoing pregnancy post-IVF and one spontaneous live birth were observed.</p><p><strong>Conclusion: </strong>Inter-cycle variabilities were observed in women with oocyte maturation abnormalities (OMAs). Almost all patients with EFS had oocytes collected during IVM following IVF. These oocytes have limited potential for maturation, fertilization, and live birth, as demonstrated by the low rates observed after IVM culture and ICSI. These conditions are observed in OMAs due to defects in the oocyte machinery. The proposed flowchart provides a comprehensive classification approach for various forms of EFS.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of placental bed uterine in L-NAME-induced early-onset preeclampsia (EO-PE) like the rat model.","authors":"Fitriana Fitriana, Soetrisno Soetrisno, Sri Sulistyowati, Dono Indarto","doi":"10.4274/tjod.galenos.2024.99132","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2024.99132","url":null,"abstract":"<p><strong>Objective: </strong>Preeclampsia (PE) is the leading cause of maternal death worldwide and is associated with long-term morbidity in both mothers and newborns. Animal modeling is considered a functional source for understanding PE pathogenesis, diagnostic standards, and therapeutic approaches.</p><p><strong>Materials and methods: </strong>This study aimed to demonstrate and evaluate the use of N-nitro-L-arginine methyl ester (L-NAME) in a Wistar rat model under conditions similar to PE. A total of 12 rats were divided into 4 groups, each consisting of 3 members, including the pregnant control group and treatment groups administered low-dose (PE 25 mg/kg L-NAME/day), medium-dose (PE 50 mg/kg L-NAME/day), and high-dose L-NAME (PE 75 mg/kg L-NAME/day) L-NAME from gestational day 4 to 19. Measurements included blood pressure, creatinine, and proteinuria levels, placental histological changes, and placental tissue hypoxia-inducible factor 1-alpha, and plasma endothelial nitric oxide synthase levels.</p><p><strong>Results: </strong>The results showed that intervention with L-NAME at 75 mg/kg body weight/day (PE3) induced PE earlier than that with 50 mg/kg body weight/day L-NAME.</p><p><strong>Conclusion: </strong>The model conditions also support further research into PE pathogenesis.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Might retrigger with human chorionic gonadotropin be a solution for empty follicle syndrome after gonadotropin releasing hormone agonist trigger?","authors":"Zeynep Ece Utkan Korun, Ayşen Yücetürk, Özge Karaosmanoğlu, Yiğit Çakıroğlu, Bülent Tıraş","doi":"10.4274/tjod.galenos.2024.80439","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2024.80439","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine whether the use of human chorionic gonadotropin (hCG) as a trigger could offer a potential solution for addressing empty follicle syndrome following the administration of a trigger for gonadotropin-releasing hormone agonist.</p><p><strong>Materials and methods: </strong>A retrospective cohort analysis was conducted using data extracted from the hospital database pertaining to 415 patients who underwent in vitro fertilization (IVF) with an antagonist protocol triggered by a gonadotropin-releasing hormone (GnRH) agonist between December 2019 and January 2023 at the Acıbadem Maslak Hospital Assisted Reproductive Technologies Unit. All cases that failed to obtain oocytes and required rescue were analyzed.</p><p><strong>Results: </strong>This study analyzed 415 women who underwent IVF using GnRH agonist-triggered antagonist protocols. Among them, 6 (1.4%) had empty folicle syndrome (EFS). Patients with EFS had lower luteinizing hormone levels and fewer oocytes, embryos, and blastocysts, resulting in lower oocyte utilization rate. However, pregnancy rates were similar, with no biochemical or ectopic pregnancies observed in the EFS group.</p><p><strong>Conclusion: </strong>Use of an hCG retrigger in hyperresponders with no oocytes after GnRHa trigger may prevent cycle cancelation. Although the rates of egg utilization may decrease, oocyte maturity remains comparable. Frozen embryo transfer following hCG retrigger administration yields similar positive pregnancy test results and live birth rates.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Mir-499, Mir-27a, and Mir-146a polymorphisms and their susceptibility to recurrent spontaneous abortion; <i>in silico</i> analysis.","authors":"Gholamreza Bahari, Mohsen Taheri, Mojgan Mokhtari, Mahdiyeh Moudi, Mahdi Majidpour, Hossein Shahraki Ghadimi","doi":"10.4274/tjod.galenos.2024.74419","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2024.74419","url":null,"abstract":"<p><strong>Objective: </strong>Recurrent spontaneous abortion (RSA) is defined as two or more pregnancy losses before 24 gestational weeks, accounting for 1-3% of fertile couples. A vast majority of single-nucleotide polymorphisms (SNPs) in some <i>microRNA</i> (<i>miRNA</i>) genes can change the miRNA-mRNA interaction and are associated with the risk of RSA. This study was designed to better elucidate the association between miR-27a, miR-499, and miR-146a polymorphisms and RSA risk.</p><p><strong>Materials and methods: </strong>SNP genotyping of miR-27a (rs895819), miR-499 (rs3746444), and miR-146a (rs2910164) was performed using polymerase chain reaction (PCR)-restriction fragment length polymorphism and tetra amplification-refractory mutation system PCR in 98 patients with RSA and 105 healthy subjects.</p><p><strong>Results: </strong>Our results showed that the miR-499 rs3746444 and miR-27a rs895819 polymorphisms were significantly associated with RSA risk, whereas no significant differences were observed between the rs2910164 polymorphism and RSA susceptibility.</p><p><strong>Conclusion: </strong>We proposed that the miR-499 rs3746444 and miR-27a rs895819 polymorphisms were correlated with RSA in our population, but the miR-146a rs2910164 variant was not associated with the risk of RSA.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymph node evaluation and nodal metastasis prediction in epithelial ovarian cancers: A retrospective study.","authors":"Pallavi Verma, Anupama Bahadur, Shalini Rajaram, Rajkumar Kottayasamy Seenivasagam, Jaya Chaturvedi, Rajlaxmi Mundhra, Amrita Gaurav, Shalinee Rao, Ipshita Sahoo, Ayush Heda","doi":"10.4274/tjod.galenos.2024.50980","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2024.50980","url":null,"abstract":"<p><strong>Objective: </strong>To identify consensus regarding lymph node (LN) evaluation in epithelial ovarian cancer (EOC). The objective of the present study was to evaluate surgico-pathological findings, LN involvement, and the prediction of LN metastasis via preoperative imaging and intraoperative assessment in women with EOC.</p><p><strong>Materials and methods: </strong>Women with EOC who underwent cytoreductive surgery (CRS) between Jan 2019 to June 2022 were included. The distribution of histology, stage, and LN metastasis was studied. The predictive value of serum cancer antigen (CA)-125, instead of and radiologically and surgically enlarged LNs with final LN histopathology was studied.</p><p><strong>Results: </strong>A total of 96 women with EOCs underwent CRS. Fifty women (52%) underwent primary CRS and 46 women (48%) underwent interval CRS. Seventy-five women (78.13%) with EOC underwent pelvic and/or para-aortic lymphadenectomy, out of which 23 (30.67%) were histologically positive. High-grade serous carcinoma was the commonest (n=55, 73.33%) histology. The majority of women, 56 (74.67%) were stage III or IV at presentation. Complete cytoreduction was achieved in 59 (78.66%) patients. The receiver operating characteristics curve showed a cutoff for CA-125 of 1360 U/mL (area under the curve 0.702, p=0.002) for LN metastases. Both radiologically and surgically enlarged LNs significantly predicted LN metastasis on histopathology (p=0.02 and 0.006 respectively). The combined sensitivity, specificity, positive predictive value and negative predictive value of both contrast enhanced computed tomography (CECT) and surgically enlarged LNs were 78.26%, 57.69%, 45%, and 85.71%, respectively.</p><p><strong>Conclusion: </strong>Serous histology, high-grade tumors, highCA-125 levels, and suspicious LNs on CECT or during surgery were significantly associated with LN metastasis. However, considering the false-negative rate of 21.74%, the combination of radiologically and surgically enlarged LNs cannot be used as the sole surrogate marker for lymphadenectomy.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High serum progesterone levels on the day of embryo transfer in patients undergoing artificial frozen-thawed blastocyst transfer: Is there a ceiling effect?","authors":"Yusuf Aytac Tohma, Berfu Demir, Betul Dundar, Fazilet Kubra Boynukalin, Necati Findikli, Mustafa Bahceci, Gurkan Bozdag","doi":"10.4274/tjod.galenos.2024.38364","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2024.38364","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the potential ceiling effect of high serum progesterone levels on the day of embryo transfer for pregnancy outcomes in patients undergoing artificial frozen-thawed blastocyst transfer (FET) cycles.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 595 patients who underwent artificial FET cycles. We evaluated progesterone levels and found that 40.6 ng/mL corresponded to the 90th percentile and 23.9 ng/mL corresponded to the 50th percentile. Based on these findings, we categorized progesterone levels as <20 ng/mL (n=220, 37.0%), 20-40 ng/mL (n=312, 52.4%), and ≥40 ng/mL (n=63, 10.6%). The primary outcome measures were the clinical pregnancy rate (CPR) and live birth rate (LBR).</p><p><strong>Results: </strong>Blastocyst morphology grades, including expansion, trophectoderm, and inner cell mass grades, were significantly associated with clinical pregnancy (p<0.001 for all). Progesterone levels between 20 and 40 ng/mL were associated with higher CPR (p=0.043). In the multivariate analysis, only blastocyst expansion and inner cell mass grades were independently and significantly associated with CPR [p=0.011, odds ratio (OR)=1.6, (confidence interval) CI 95%=1.13-2.39, and p=0.007, OR=1.65, CI 95%=1.14-2.39, respectively]. The progesterone level and trophectoderm grade were not statistically significant. Regarding LBR, only blastocyst expansion grades 4 and trophectoderm grades A or B were significantly associated.</p><p><strong>Conclusion: </strong>Based on these data, we speculate that if serum progesterone levels exceed 40 ng/mL on the day of embryo transfer in patients undergoing artificial FET cycles, there is no need to reduce the progesterone dose.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum.","authors":"","doi":"10.4274/tjod.galenos.2024.c001","DOIUrl":"10.4274/tjod.galenos.2024.c001","url":null,"abstract":"","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How safe is high-intensity focused ultrasound? An intriguing solution for obstetric and gynecological diseases: A systematic review.","authors":"Mostafa Maged Ali, Chileshe Raphael Mpehle, Esther Olusola, Phuti Khomotso Ratshabedi, Ebtehal Ali Helal Farag","doi":"10.4274/tjod.galenos.2024.55058","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2024.55058","url":null,"abstract":"<p><p>High-intensity focused ultrasound (HIFU) is a non-surgical and noninvasive treatment modality that depends on external ultrasound energy sources that induce focused mass ablation and protein degeneration in the treatment area via thermal energy penetration under the intact skin. We aim in our study to collectively evaluate the safety of HIFU for the treatment of different obstetric and gynecological diseases in the literature. We searched PubMed, Scopus, and Science Direct databases, without restriction on date or language, from the inception of these databases until January 20, 2024. We also examined the references of the included studies in the Mendeley archive for eligible articles. We found a total of 706 studies. After the screening and selection process, 56 participants were included. Our dichotomous outcomes were pooled in our single-arm meta-analysis as risk ratio (RR) and with 95% confidence interval (CI) while our continuous outcomes were pooled as mean change and 95% CIs. Fixed- or random-effects models were applied depending on the heterogeneity detected. Our systematic review and meta-analysis included 56 studies including 11.740 patients. Depending on the Society of Interventional Radiology (SIR) classification for adverse effects. The results of this meta-analysis for the type A category that did not require clinical intervention found that pain in the treatment site estimated RR with 95% CI: 0.61 (0.33, 0.89), abnormal vaginal discharge 0.16 (0.073, 0.24), low-grade fever (<38 °C) 0.005 (0.002, 0.009). Sensory abnormalities of the lower limbs were examined in 3390 individuals and observed in only 19 patients who experienced gradual relief of symptoms within one month after treatment. Regarding SIR type B, 99 of a total of 6.437 patients had small vesicles and superficial burns with pooled RR and 95% CI: 0.012 (0.007, 0.018). In terms of groin or perianal and lower abdominal pain, our RRs with 95% CIs were 0.1 (0.067, 0.13) and 0.38 (0.25, 0.51). However, vaginal bleeding was detected in only 32 out of a total of 3.017. Major adverse events like lumber disc herniation, thrombocytopenia, and renal failure, were unmentionable. Additionally, our included studies did not record any deaths. HIFU, either alone or in combination with oxytocin or any other enhancing agent, is safe for patients with different gynecological and obstetric diseases. In terms of efficacy, it showed promising results compared with traditional treatment lines. To our knowledge, we are the first and most comprehensive meta-analysis in the literature that has studied the different safety outcomes related to HIFU as a treatment modality for different obstetric and gynecological diseases with a very large sample size, making our evidence strong and less attributed to errors.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative effects of ethanol on ovarian reserve and endometrium thickness: An animal study.","authors":"Enes Karaman, Mehmet Emin Ayağ","doi":"10.4274/tjod.galenos.2024.89439","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2024.89439","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the effect of ethanol on the ovarian reserve and endometrium of rats by evaluating anti-Müllerian hormone (AMH) levels and follicle counts.</p><p><strong>Materials and methods: </strong>We performed histological follicle counting and AMH measurements to evaluate ovarian reserve. The study included 16 Wistar albino rats evenly distributed into two groups of eight rats each. The rats in the intervention group (group 1) were administered ethanol at a daily dose of 2.5 g/kg via oral gastric lavage for 30 days, whereas the control group (group 2) received water as a placebo via oral gastric lavage for the same period. At the end of 30 days, the animals were sacrificed, and 2 mL blood samples were collected for AMH measurements. Laparotomy was performed to remove the ovaries and uterus.</p><p><strong>Results: </strong>Despite the lack of a meaningful distinction in the quantity of primordial and primary follicles between the two groups, a substantial disparity was observed in the overall follicle count and AMH levels. Specifically, the intervention group exhibited significantly lower total follicle counts and AMH levels than the control group (p≤0.001). The researchers also found that the endometrium of ethanol-treated rats was significantly thinner than that of control rats (p≤0.001).</p><p><strong>Conclusion: </strong>This study concluded that ethanol consumption can negatively affect reproductive ability and the success of in vitro fertilization treatment by reducing ovarian reserve and thinning the endometrium.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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.","authors":"Faezeh Zakerinasab, Qumars Behfar, Reza Parsaee, Fariba Arbab Mojeni, Arina Ansari, Niloofar Deravi, Reza Khademi","doi":"10.4274/tjod.galenos.2024.59944","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2024.59944","url":null,"abstract":"<p><p>To evaluate the effect of growth hormone (GH) supplementation on outcomes of in vitro fertilization (IVF) or Intracytoplasmic sperm injection (ICSI) for women with poor ovarian response. Relevant randomized controlled trials (RCTs) were obtained through search in several databases including PubMed, Scopus, Clinicaltrials.gov, Google Scholar, and Cochrane Library. Outcome measures included live birth rate, clinical pregnancy rate, cycle cancelation rate, number of retrieved oocytes, number of transferred embryos, total dose of gonadotropin, duration of gonadotropin treatment, and peak estradiol level. Additionally, a meta-regression analysis was carried out to determine any potential linear relationships between these outcomes and IVF success. After analyzing 18 RCTs comprising of 1870 patients, the study found that GH supplementation improved the number of retrieved oocytes [standardized mean difference (SMD), 0.65; 95% confidence interval (CI), 0.29-1.00] and transferred embryos group (SMD, 0.80, 95% CI, 0.39, 1.21) as well as peak E2 level (SMD, 1.20; 95% CI, 0.59, 1.81). While reduced the total dose and duration of gonadotropin treatment (SMD, -0.82, 95% CI, -1.25, -0.39, and SMD, -0.63, 95% CI, -1.04, -0.22, respectively). The meta-regression analysis found no linear relationship between clinical pregnancy, live birth rate, or cycle cancelation rate and the outcomes measured (p>0.1). Based on the available evidence, GH supplementation appears to improve the outcomes of IVF or ICSI in women with poor response. However, there is a need for further RCTs with larger sample sizes to determine the cost-effectiveness of adding GH to conventional protocols of IVF/ICSI for treating infertility in women with poor ovarian response.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}