The effect of growth hormone supplementation in poor ovarian responders undergoing IVF or ICSI: a meta-analysis of randomized controlled trials

Peiwen Yang, Ruxing Wu, Hanwang Zhang, Peiwen Yang, Ruxing Wu, Hanwang Zhang

Abstract

Purpose: The aim of this meta-analysis was to evaluate the effect of growth hormone (GH) supplementation in poor responders undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

Methods: PubMed, MEDLINE and Cochrane Library databases were searched for the identification of relevant randomized controlled trials. Outcome measures were live birth rate, clinical pregnancy rate, miscarriage rate, cycle cancelation rate, number of retrieved oocytes and total dose of gonadotropin.

Results: Fifteen randomized controlled trails (RCTs) involving 1448 patients were eligible for the analysis. GH supplementation improved live birth rate (RR, 1.74; 95% CI, 1.19-2.54), clinical pregnancy rate (RR, 1.65; 95% CI, 1.31-2.08) and retrieved oocytes number (SMD, 0.72; 95% CI, 0.28-1.16), while reducing cancelled cycles rate (RR, 0.62; 95% CI, 0.44-0.85) and dose of Gonadotropin (SMD,-1.05 95% CI, - 1.62 - -0.49) for poor ovarian response patients. Besides, there was no significant difference in the miscarriage rate between GH group and control group.

Conclusions: Based on the limited available evidence, growth hormone supplementation seems to improve IVF/ICSI outcomes for poor ovarian responders. Further randomized controlled trials with large sample sizes are required to clarify the effect of GH adjuvant therapy in the treatment of women with poor ovarian response.

Keywords: Growth hormone; In vitro fertilization; Intracytoplasmic sperm injection; Poor ovarian response.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow Diagram
Fig. 2
Fig. 2
Quality control evaluations of included studies.? = unclear, + = low risk,–=high risk
Fig. 3
Fig. 3
Forest plot for primary outcomes. a live birth rate; b clinical pregnancy rate
Fig. 4
Fig. 4
Forest plot for secondary outcomes. a miscarriage rate; b cycle cancelation rate; c number of retrieved oocytes; d total dose of gonadotropin
Fig. 5
Fig. 5
Funnel plot of the studies represented in the meta-analysis

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