Roger J Hart1, Luk Rombauts, Robert J Norman. 1. aSchool of Women's and Infants' Health, University of Western Australia, Perth bFertility Specialists of Western Australia, Bethesda Hospital, Claremont, Western Australia cWomen's Health, Monash Health dDepartment of Obstetrics and Gynaecology, Monash University, Clayton, Victoria eRobinson Institute, University of Adelaide, Fertility SA, Adelaide, South Australia, Australia.
Abstract
PURPOSE OF REVIEW: Growth hormone (GH) has been used as an adjunct in ovulation induction and IVF for 25 years, particularly as an adjunct to ovarian stimulation for women who had a previous poor response to stimulation in an IVF cycle. It does not have US Food and Drug Administration approval for this use. Unfortunately, due to the problems inherent with recruiting women who have undergone unsuccessful IVF treatment cycles and their inevitable low live birth rate per initiated cycle, many studies performed to date have been underpowered. RECENT FINDINGS: Previous meta-analyses of studies performed in populations of women with a poor response to ovarian stimulation, demonstrated an increase in the live birth rate for the use of GH. With the recent publication of three studies and the presentation of the Australian LIGHT study, we undertook an updated meta-analysis. SUMMARY: Meta-analysis demonstrated a benefit for the use of the adjunct GH, with a reduction in the duration of ovarian stimulation required for oocyte retrieval, the collection of a greater number of oocytes than placebo, and an improvement in many of the early clinical parameters; however, there was no evidence of an increased chance of a live birth for the use of GH.
PURPOSE OF REVIEW: Growth hormone (GH) has been used as an adjunct in ovulation induction and IVF for 25 years, particularly as an adjunct to ovarian stimulation for women who had a previous poor response to stimulation in an IVF cycle. It does not have US Food and Drug Administration approval for this use. Unfortunately, due to the problems inherent with recruiting women who have undergone unsuccessful IVF treatment cycles and their inevitable low live birth rate per initiated cycle, many studies performed to date have been underpowered. RECENT FINDINGS: Previous meta-analyses of studies performed in populations of women with a poor response to ovarian stimulation, demonstrated an increase in the live birth rate for the use of GH. With the recent publication of three studies and the presentation of the Australian LIGHT study, we undertook an updated meta-analysis. SUMMARY: Meta-analysis demonstrated a benefit for the use of the adjunct GH, with a reduction in the duration of ovarian stimulation required for oocyte retrieval, the collection of a greater number of oocytes than placebo, and an improvement in many of the early clinical parameters; however, there was no evidence of an increased chance of a live birth for the use of GH.
Authors: Kevin N Keane; Peter M Hinchliffe; Philip K Rowlands; Gayatri Borude; Shanti Srinivasan; Satvinder S Dhaliwal; John L Yovich Journal: Front Endocrinol (Lausanne) Date: 2018-01-31 Impact factor: 5.555