Growth Hormone (GH) Improvement of Ovarian Responses and Pregnancy Outcome in Poor Ovarian Responders: A Randomized Study

Recent evidence has emphasized growth hormone benefits in increasing the ovarian response and improving thepregnancy rate in poor responders (POR), caused by aging, ovarian surgery, chemotherapy and other reasons, undergoingIVF/ICSI. The most important factor in the treatment of POR patients is the quality and quantity of oocytes followingovarian stimulation; thus, efforts should be made to provide opportunities for young patients to improve their fertilityand ovarian responses. The use of GH in these patients may offer a promising aid to successful fertility.In the presentsingle-blinded clinical trial, POR patients were randomly assigned to receive one of three regimens: (A) Gonadotropin,a GnRH antagonist and GH from the eighth day of the cycle for about 5 days (n = 34); (B) Gonadotropin, a GnRHantagonist and GH from the third day of the previous cycle for about 20 days (n = 32); and (C) Gonadotropin, a GnRHantagonist, and a placebo from the eight day of the cycle for about 5 days (n = 26). Oocyte quality and pregnancy rateswere compared across the three groups. A significantly lower number of collected oocytes, MII oocytes, fertilizedoocytes, transferred embryos, and clinical pregnancy rate in the placebo group was noted as compared to the twoexperimental groups receiving GH. Live clinical pregnancies in B group were significantly greater than in the othergroups. Our results together indicate that GH may play an important role in recruitment of dominant follicles andenhance follicular survival and the cell proliferation leading to high- quality embryos. Accordingly,