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Reprod Biomed Online. 2019 Jun;38(6):908-915. doi: 10.1016/j.rbmo.2019.02.003. Epub 2019 Feb 27.

Human growth hormone for poor responders: a randomized placebo-controlled trial provides no evidence for improved live birth rate.

Author information

1
University of Adelaide, Robinson Research Institute, North Adelaide, SA 5006, Australia; , Fertility SA, 431 King William Road, Adelaide, SA 5000, Australia. Electronic address: robert.norman@adelaide.edu.au.
2
University of Adelaide, Robinson Research Institute, North Adelaide, SA 5006, Australia.
3
University of Adelaide, Robinson Research Institute, North Adelaide, SA 5006, Australia; South Australian Health and Medical Research Institute, Robinson Research Institute, North Adelaide, SA 5006; Monash University, Clayton, VIC 3800, Australia.
4
Fertility Specialists of Western Australia, Claremont, WA 6010; The University of Western Australia, Crawley, WA 6009, Australia.
5
Adelaide Health Technology Assessment, School of Public Health, The University of Adelaide, Adelaide, SA 5006; Quality Use of Medicines Pharmacy Research Centre, University of South Australia, Adelaide, SA 5001, Australia.
6
Monash IVF, Monash Surgical Private Hospital, Clayton, VIC 3168, Australia.

Abstract

RESEARCH QUESTION:

Does the addition of human growth hormone (HGH) to an IVF cycle improve the live birth rate in previously documented poor responders to FSH?

DESIGN:

Double-blind, placebo-controlled, randomized clinical trial comparing HGH to placebo in maximal stimulation in an IVF cycle. The study was stopped after 4 years. Women receiving ovarian stimulation in one IVF cycle, having failed to produce more than 5 eggs in a previous cycle with more than 250 IU/day of FSH were included. Basal FSH was ≤15 IU/l, body mass index <33 kg/m2, age <41 years. HGH or placebo were added from the start of the cycle in a double-blinded manner. The primary outcome was live birth rate.

MAIN RESULTS:

The live birth rates following an IVF cycle were 9/62 (14.5%) for growth hormone and 7/51 (13.7%) for the placebo group (risk difference 0.8%, 95% confidence interval [CI] -12.1 to 13.7%; odds ratio [OR] 1.07, 95% CI 0.37-3.10). There was a greater odds of oocyte retrieval with growth hormone (OR 5.67, 95% CI 1.54-20.80) but no better chance of embryo transfer (OR 1.42, 95% CI 0.50-4.00). Birth weights were comparable.

CONCLUSIONS:

Planned participant numbers were not reached. It was not possible to demonstrate an increase in live birth rate from the addition of growth hormone in women with a previous poor ovarian response to IVF.

KEYWORDS:

Human growth hormone; IVF; Live birth; Poor responders; Randomized controlled trial

PMID:
30954433
DOI:
10.1016/j.rbmo.2019.02.003

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