Objective: To investigate the role of CC-highly purified Human
Menopausal Gonadotropin (hpHMG) and Growth Hormone (GH)
in mini-stimulation protocol to improve outcome in poor ovarian
responders (POR).
Method: All patients were given clomiphene citrate 150 mg from day
3 to day 7 of menstrual cycle followed by 150 IU hpHMG daily from
day 8 until ovulation trigger. Two groups were observed where one
group received GH and the other arm did not. In the GH group, 8
IU of GH were given from day 1 of stimulation until stimulation was
stopped. GnRH antagonist was used to suppress ovulation.
Result: Among 51 eligible women, 29 patients with GH and 22
patients without GH, no difference was observed in the number of
oocytes retrieved (2.21 versus 2.64) and the number of embryos
transferred (1.24 versus 1.68) in the GH group versus the group
without GH, respectively. Total clinical pregnancy rate was 17.6%.
No significant difference in pregnancy and ongoing pregnancy rate in
both groups (17.2% versus 18.2%) and (13.8% versus 13.6%), respectively.
In patients older than 40 years old, GH showed a 4-fold
likelihood in producing top quality embryos (44.8% vs 13.6%,
OR=3.6, p=0.05).
Conclusion: CC-HMG regimen in mini-stimulation protocol is an
effective option in poor responders. Additional GH in ministimulation
program provided a higher number of top quality
embryos in women older than 40 years old, although there were no
difference in clinical or ongoing pregnancy rate.
Keywords: CC-HMG, growth hormone, IVF, mini-stimulation protocol,
poor ovarian responders
CC-Human Menopausal Gonadotropin Combined with Growth Hormone in Mini-stimulation Protocol could Improve Clinical Outcome in Poor Ovarian Responders