Growth hormone treatment strategies in assisted reproduction for the poor responder patients

Liailia Kh. Dzhemlikhanova; Ksenia V. Ob’edkova; Dariko A. Niauri; Igor Yu. Kogan; Maria A. Mazilina; Inna O. Krikheli; Irina D. Mekina; Elena A. Lesik; Evgenia M. Komarova

doi:10.21638/spbu11.2019.205

Authors

Liailia Kh. Dzhemlikhanova St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation ; Department of Assisted Reproduction Technologies, FSBI D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya liniya, St. Petersburg, 199034, Russian Federation
Ksenia V. Ob’edkova St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation ; Department of Assisted Reproduction Technologies, FSBI D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya liniya, St. Petersburg, 199034, Russian Federation
Dariko A. Niauri St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation ; Department of Assisted Reproduction Technologies, FSBI D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya liniya, St. Petersburg, 199034, Russian Federation
Igor Yu. Kogan St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation ; Department of Assisted Reproduction Technologies, FSBI D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya liniya, St. Petersburg, 199034, Russian Federation
Maria A. Mazilina St. Petersburg State University, 7–9, Universitetskaya nab., St. Petersburg, 199034, Russian Federation ; Department of Assisted Reproduction Technologies, FSBI D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya liniya, St. Petersburg, 199034, Russian Federation
Inna O. Krikheli Department of Assisted Reproduction Technologies, FSBI D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya liniya, St. Petersburg, 199034, Russian Federation
Irina D. Mekina Department of Assisted Reproduction Technologies, FSBI D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya liniya, St. Petersburg, 199034, Russian Federation
Elena A. Lesik Department of Assisted Reproduction Technologies, FSBI D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya liniya, St. Petersburg, 199034, Russian Federation
Evgenia M. Komarova Department of Assisted Reproduction Technologies, FSBI D. O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 3, Mendeleevskaya liniya, St. Petersburg, 199034, Russian Federation

DOI:

https://doi.org/10.21638/spbu11.2019.205

Abstract

The goal of the study was to estimate the efficacy of growth hormone (GH) co-treatment to the antagonist protocol in IVF/ ICSI cycles in poor responders. A prospective observational study involved 75 patients. All patients underwent standard antagonist protocol with or without GH co-treatment. GH additional was given a daily subcutaneous injection of 1.33 mg (equivalent to 4 IU) of GH from day 1 of ovarian stimulation until the day of human chorionic gonadotropin (hCG). Concentrations of GH, insulin-like growth factor I (IGF-I) and IGF binding protein-3 (IGFBP-3) in serum and follicular fluid were analyzed. The GH co-treatment significantly lowered effective dose of gonadotropins, duration of stimulation, IGFBP-3 level in serum and follicular fluid day of oocytes retrieval. The number of oocytes recovered, metaphase II stage (MII) oocytes, 2 pronucleus (2 pn) zygote, good-quality transferred embryos were significantly higher in the GH+ group. Only patients GH+ group became pregnant. Positive correlation was found between IGF-I level in follicular fluid, dynamics of IGFBP-3 level changes during stimulation protocol and number of good-quality transferred embryos in the GH+ group. GH administration in IVF/ICSI cycles for poor responders raises ovarian sensitivity to the gonadotropin exogenous influence, this way, increasing number of high-quality embryos and the probability of pregnancy.

Keywords:

growth hormone; poor ovarian response; in vitro fertilization (IVF); assisted reproductive technologies (ART)

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