scholarly journals Growth Hormone Cotreatment for Low-Prognosis Patients According to the POSEIDON Criteria

2021 ◽  
Vol 12 ◽  
Author(s):  
Xueying Liu ◽  
Jingxiao Xu ◽  
Lixin Bi ◽  
Peihao Liu ◽  
Xue Jiao
Keyword(s):  
Growth Hormone ◽  
Ovarian Reserve ◽  
Ovarian Response ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Poor Ovarian Response ◽  
Assisted Reproduction Technology ◽  
Icsi Cycle ◽  
Subsequent Cycle

BackgroundPoor ovarian response (POR) remains one of the most challenging conditions in assisted reproduction technology. Previous studies seemed to indicate that growth hormone (GH) was a potential solution for the dilemma of POR; however, the role GH played on the low-prognosis patients diagnosed and stratified by the POSEIDON criteria remains indistinct.MethodsThis retrospective study was performed among women with POR according to the POSEIDON criteria who failed a previous in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycle, and the subsequent cycle was under GH cotreatment and conducted within 12 months. These participants were stratified into four groups according to the POSEIDON criteria. The comparison was implemented between the failed cycle and the cycle treated with GH. Generalized estimating equation (GEE) multivariate regression was applied for data analysis.ResultsA total of 428 low-prognosis women were included in this study. GH supplementation improved the live birth rates (47.66%, 28.33%, 45.45%, and 24.07%; in groups 1, 2, 3, and 4, respectively) and the clinical pregnancy rates (OR 19.16, 95% CI 7.87–46.63, p < 0.001; OR 7.44, 95% CI 1.65–33.55, p = 0.009; OR 10.19, 95% CI 2.39–43.52, p = 0.002; OR 27.63, 95% CI 4.46–171.11, p < 0.001; in groups 1, 2, 3, and 4, respectively) in all four POSEIDON groups. The number of oocytes retrieved was significantly elevated in the subgroups with normal ovarian reserve (IRR 1.47, 95% CI 1.36–1.59, p < 0.001; IRR 1.31, 95% CI 1.15–1.49, p < 0.001; in groups 1 and 2, respectively). The number of day-3 good-quality embryos was significantly elevated in the subgroups with either normal ovarian reserve or aged young (IRR 2.13, 95% CI 1.78–2.56, p < 0.001; IRR 1.54, 95% CI 1.26–1.89, p < 0.001; IRR 1.47, 95% CI 1.10–1.98, p = 0.010; in groups 1, 2, and 3, respectively).ConclusionGrowth hormone cotreatment could ameliorate the pregnancy outcome for women with POR under the POSEIDON criteria who failed a previous IVF/ICSI cycle. The application of growth hormone for low-prognosis women who experienced a failed cycle might be considered and further studied.

scholarly journals Effect of acupuncture on women with poor ovarian response: study protocol for a multicenter randomized controlled trial

2019 ◽  
Author(s):  
yigong Fang ◽  
huanfang Xu ◽  
chensi Zheng ◽  
liyun He ◽  
tongsheng Su ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Ovarian Reserve ◽  
Controlled Trial ◽  
Ovarian Response ◽  
Poor Ovarian Response ◽  
Cleavage Rate ◽  
Vitro Fertilization ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial

Abstract Background: Poor ovarian response (POR), a manifestation of low ovarian reserve and ovarian aging , leads to a significantly reduced pregnancy rate after in vitro fertilization-embryo transfer (IVF-ET) . Acupuncture is effective at improving ovarian reserve. The purpose of this study is to evaluate the effect of acupuncture on increasing the number of retrieved oocytes after controlled ovarian hyperstimulation (COH) in women with POR. Methods: This is a multicenter randomized controlled trial . A total of 140 women with POR will be randomly assigned to receive acupuncture or non-treatment for 12 weeks before COH. The primary outcome will be the number of retrieved oocytes. The secondary outcomes include antral follicle count (AFC), serum level of anti-müllerian hormone (AMH), basal serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) , the score of the self-rating anxiety scale (SAS), the fertilization rate, the cleavage rate, the available embryo rate and the high-quality embryo rate. The safety of acupuncture will also be assessed. Discussion: The results of this trial will identify the effectiveness of acupuncture in the treatment of POR. This will provide a new treatment option for POR patients and physicians.

The Use of Androgen Priming in Women with Reduced Ovarian Reserve Undergoing Assisted Reproductive Technology

2021 ◽  
Author(s):  
Alison Richardson ◽  
Kanna Jayaprakasan
Keyword(s):  
Ovarian Reserve ◽  
Ovarian Response ◽  
Reproductive Technology ◽  
Ivf Outcome ◽  
Poor Ovarian Response ◽  
Vitro Fertilization ◽  
Randomized Controlled ◽  
Meta Analyses

AbstractAndrogen priming with either dehydroepiandrosterone (DHEA) or testosterone has been suggested as an adjunct to improve in vitro fertilization (IVF) outcomes in women with diminished ovarian reserve (DOR). Numerous studies have investigated the effects of both DHEA and testosterone on IVF outcome. The results were inconsistent, and the quality of most studies is substandard. Meta-analyses have consistently reported that DHEA does appear to significantly improve IVF outcome in women with predicted or proven poor ovarian response (POR), but these have included some normal responders and/or nonrandomized studies. Our meta-analyses including randomized controlled trials (RCTs) incorporating only women with DOR or POR suggest that DHEA confers no benefit. While meta-analyses of RCTs on the use of testosterone in women with DOR or POR showed an improved IVF outcome, most studies included are of low quality with high risk of bias. When analysis of data from studies of only low-risk bias was performed, such a benefit with testosterone was not observed. Although recruitment may well be a challenge, a large, well-designed RCT is, however, still warranted to investigate whether or not androgen priming with either DHEA or testosterone should be recommended as an adjuvant treatment for women with DOR or POR undergoing IVF.

Predictors of poor ovarian response in in vitro fertilization: a prospective study comparing basal markers of ovarian reserve

2002 ◽  
Vol 77 (2) ◽  
pp. 328-336 ◽  
Author(s):  
László F.J.M.M Bancsi ◽  
Frank J.M Broekmans ◽  
Marinus J.C Eijkemans ◽  
Frank H de Jong ◽  
J.Dik F Habbema ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Prospective Study ◽  
Ovarian Reserve ◽  
Ovarian Response ◽  
Poor Ovarian Response ◽  
Vitro Fertilization ◽  
A Prospective Study

scholarly journals IN-VITRO ACTIVATION OF OVARIAN FOLLICULAR RESIDUAL RESERVE

2020 ◽  
pp. 25-28
Author(s):  
E. Girsh ◽  
A. Harlev ◽  
L. Grin
Keyword(s):  
Ovarian Reserve ◽  
Preliminary Data ◽  
Ovarian Response ◽  
Ovarian Follicles ◽  
Fertility Treatment ◽  
Poor Ovarian Response ◽  
Promising Technique ◽  
Ovarian Insufficiency ◽  
In Vitro Activation

The newly developed in-vitro activation (IVA) method provides a novel fertility treatment for patients with premature ovarian insufficiency. The IVA method pretends to promote growth of residual ovarian follicles at early stages of their development. Based on preliminary data, poor ovarian response (POR) patients with decreased ovarian reserve (DOR) who have multiple secondary follicles, IVA is a promising technique to promote growth of secondary follicle as well.

scholarly journals Human growth hormone use in poor ovarian response – caution and opportunities

2021 ◽  
Vol 15 ◽  
pp. 263349412199942
Author(s):  
Robert J. Norman ◽  
Roger J. Hart
Keyword(s):  
Growth Hormone ◽  
Human Growth Hormone ◽  
Live Birth ◽  
Cell Function ◽  
Cumulus Cell ◽  
Human Growth ◽  
Ovarian Response ◽  
Randomised Trials ◽  
Poor Ovarian Response ◽  
Oocyte Maturity

Human growth hormone has found favour as a co-gonadotrophin in assisted reproduction particularly in the circumstances of a poor response to stimulation. Its use has been based on animal studies suggesting insulin-like growth factor-1 enhances granulosa and cumulus cell function and possibly oocyte quality. While there is limited ovarian cellular information in women, the use of human growth hormone is alleged to improve egg numbers, embryo quality, clinical pregnancies and live birth in women with a poor ovarian response. A number of cohort studies have claimed these benefits compared with prior nil treatment, but there are a limited number of quality randomised controlled studies. The few good randomised trials indicate an enhanced ovarian response in terms of oestradiol secretion and oocyte maturity with controversial improvement in ongoing pregnancy and live birth. Given the cost of the medication, the lack of convincing data on enhanced clinical outcomes and the theoretical possibility of side effects, we propose it is still too early to determine human growth hormone’s true cost-benefit for widespread use. However, a number of emerging randomised trials may tilt the equation to a positive outlook in the future. Meanwhile, the hormone should only be used after full informed consent from the patient as to its effectiveness and efficacy.

scholarly journals Stage 2 Acupuncture for Poor Ovarian Response: A Randomized Controlled Trial

2021 ◽  
Vol 10 (10) ◽  
pp. 2182
Author(s):  
Jihyun Kim ◽  
Hoyoung Lee ◽  
Tae-Young Choi ◽  
Joong Il Kim ◽  
Byoung-Kab Kang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Ovarian Response ◽  
Controlled Ovarian Hyperstimulation ◽  
University Hospital ◽  
Ovarian Hyperstimulation ◽  
Poor Ovarian Response ◽  
Vitro Fertilization ◽  
Randomized Controlled

Acupuncture is believed to improve ovarian reserve and reproductive outcomes in women undergoing in vitro fertilization (IVF). This study was conducted to evaluate the effect of network-optimized acupuncture followed by IVF on the oocyte yield in women showing a poor ovarian response. This study was an exploratory randomized controlled trial conducted from June 2017 to January 2020 at the Pusan National University Hospital. Women diagnosed with poor ovarian response were enrolled and randomly divided into two groups: IVF alone and Ac + IVF groups (16 acupuncture sessions before IVF treatment). Eight acupoints with high degree centrality and betweenness centrality were selected using network analysis. Among the participants, compared with the IVF treatment alone, the acupuncture + IVF treatment significantly increased the number of retrieved mature oocytes in women aged more than 37 years and in those undergoing more than one controlled ovarian hyperstimulation cycle. The negative correlation between the number of retrieved mature oocytes and consecutive controlled ovarian hyperstimulation cycles was not observed in the Ac + IVF group irrespective of the maternal age. These findings suggest that physicians can consider acupuncture for the treatment of women with poor ovarian response and aged > 37 years or undergoing multiple IVF cycles.

Sign in / Sign up

Export Citation Format

Share Document