Effects of Growth Hormone Supplementation on Poor Ovarian Responders in Assisted Reproductive Technology: a Systematic R
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REVIEW
Effects of Growth Hormone Supplementation on Poor Ovarian Responders in Assisted Reproductive Technology: a Systematic Review and Meta-analysis Fen-Ting Liu 1 & Kai-Lun Hu 2 & Rong Li 1 Received: 18 April 2020 / Accepted: 11 August 2020 # Society for Reproductive Investigation 2020
Abstract To investigate whether additional growth hormone (GH) treatment can improve pregnancy outcomes in poor ovarian responders (POR), this systematic review and meta-analysis is prospectively designed and has been registered in PROSPERO (Registration number: CRD42019137866). Literature search was conducted in PubMed, EMBASE, Web of Science, and Cochrane Library from January 2010 to June 2019, and studies before 2010 were included based on a Cochrane review published in 2010. Only English articles and randomized clinical trial studies were included. A total of 12 studies were included for analysis. GH treatment in poor ovarian responders significantly increased the clinical pregnancy rate (odds ratio (OR) = 1.75 (1.23, 2.50)), and the live birth rate also tended to increase after GH treatment (OR = 1.51 (0.97, 2.35)). Other outcomes including the gonadotropin requirement, oocyte retrieval number, endometrium thickness, and the number of patients with available embryos for transfer were also improved by growth hormone treatment (weighted mean differences (WMD) = − 0.78 (− 1.23, − 0.33), 1.41 (0.72, 2.09), 0.36 (0.18, 0.53), OR = 2.67 (1.47, 4.68), respectively). Based on the current study, GH treatment in POR can increase clinical pregnancy rate and show a higher but not statistically significant likelihood of live birth rate. The effect is likely to be mediated by improving ovarian response and endometrium thickness. The effect of GH treatment on live birth rate should be tested by further studies with a larger sample size. Keywords Growth hormone . Poor ovarian responders . Assisted reproductive technology . Live birth rate . Systematic review . Meta-analysis
Fen-Ting Liu and Kai-Lun Hu contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s43032-020-00298-0) contains supplementary material, which is available to authorized users. * Rong Li [email protected] Fen-Ting Liu [email protected] Kai-Lun Hu [email protected] 1
Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology and Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, National Clinical Research Center for Obstetrics and Gynecology, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
2
Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
Introduction Infertility affects millions of couples in the world. Since the first baby born in 1978 through in vitro fertilization (IVF), assisted conception has largely been used to help infertile patients to get pregnant [1, 2]. IVF protocols are constantly updated in an attemp
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