Clinical applications of growth hormone for ovarian stimulation

The realization of the existence of an intra-ovarian regulatingmechanism involving insulin-like growth factor-I (IGF-I), amediator of growth hormone (GH) action that augments the ovarianresponse to gonado-trophins, has prompted a number of clinicaltrials exploring the use of GH as an adjuvant for ovarian stimulationwith human menopausal gonadotrophin. A critical review of thesestudies pinpoints a select group of infertile patients who maybenefit from this co-treatment, particularly those who havea surgical, pathological or medically induced dysfunction ofGH kinetics. The mechanism of this action, the effective doseneeded and the implications regarding the interface of GH, IGF-Iand ovarian physiology and pathology are now becoming clearer.A greater understanding of GH action on the ovary may in futurebenefit patients afflicted by anovulatory infertility and thoserequiring ovulation induction for in-vitro fertilization.