Low Dose Growth Hormone Adjuvant Treatment With Ultra-Long Ovarian Stimulation Protocol in Poor Responders Showed Non-inferior Pregnancy Outcome Compared With Normal Responders

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

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A double-blind cross-over controlled study to evaluate the effect of human biosynthetic growth hormone on ovarian stimulation in previous poor responders to in-vitro fertilization

Human Reproduction ◽

10.1093/oxfordjournals.humrep.a138301 ◽

1994 ◽

Vol 9 (1) ◽

pp. 13-18 ◽

Cited By ~ 33

Author(s):

S.M. Hughes ◽

Z.H. Huang ◽

I.D. Morris ◽

P.L. Matson ◽

P. Buck ◽

...

Keyword(s):

Growth Hormone ◽

In Vitro Fertilization ◽

Ovarian Stimulation ◽

Controlled Study ◽

Poor Responders ◽

Double Blind ◽

Vitro Fertilization

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Live Birth Rates in Poor Responders’ Group after Previous Treatment with Autologous Platelet-Rich Plasma and Low Dose Ovarian Stimulation Compared with Poor Responders Used Only Low Dose Ovarian Stimulation Before in Vitro Fertilization

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.825 ◽

2019 ◽

Vol 7 (19) ◽

pp. 3184-3188 ◽

Cited By ~ 4

Author(s):

Snezhana Stojkovska ◽

Gligor Dimitrov ◽

Nikoleta Stamenkovska ◽

Makuli Hadzi-Lega ◽

Zoran Petanovski

Keyword(s):

Live Birth ◽

Ovarian Stimulation ◽

Low Dose ◽

Platelet Rich Plasma ◽

Previous Treatment ◽

Poor Responders ◽

Birth Rates ◽

Live Birth Rates ◽

Autologous Platelet Rich Plasma

BACKGROUND: This prospective pilot study determined the efficacy of previous transvaginal intraovarian injection with autologous platelet-rich plasma (PRP) in poor ovarian responders (PORs) fulfilling the Bologna criteria before in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) with low dose ovarian stimulation. Current knowledge of efficient treatment for PORs is limited and often contradictory; also, LBRs of IVF remains disappointingly low. AIM: We assessed the live birth rates (LBRs) in PORs after previous ovarian treatment with PRP. METHODS: Overall, 40 patients undergoing IVF/ICSI between June 2017 ending December 2018 were included. A transvaginal intraovarian injection of PRP was performed on 20 patients. Both compered groups were balanced for all basic characteristics, and multivariate analysis was performed to adjust for all known confounders. RESULTS: Between the groups, a statistical significance in clinical pregnancies and LBR was not found. Clinical pregnancy and live birth rates were 33.33 ± 44.99 and 40.00 ± 50.71 in the PRP group and 10.71 ± 28.95 and 14.29 ± 36.31 in control group retrospectively. However, there is a trend towards higher implantation rates and LBRs in patients with previous treatment with PRP. Anyhow, the number of patients used in the research is insufficient to make a concrete conclusion, and more studies are needed in the future to confirm these results entirely. CONCLUSION: Even though the treatment of POR responders remains as a therapeutical challenge, the usage of intraovarian injection of autologous PRP in PORs before the IVF performance brings a glimpse of new hope in increasing the success of IVF defined by clinical pregnancy and LBRs.

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