The Effects Of Growth Hormone On Embryo Quality And Pregnancy Outcomes In Poor Ovarian Response IVF/ICSI-ET Patients

Objective:In control ovary stimulate cycles of assisted reproductive technology,patients with poor ovarian response often show a decrease number in oocyte retrieval,poor oocyte quality,and poor pregnancy outcomes.There are many treatments were recommended to improve IVF-ET outcomes in patients with poor ovarian response currently,one of them is the addition of growth hormone to the treatments.The study investigated the effects of growth hormone on embryo quality and pregnancy outcomes of IVF-ET in patients with poor ovarian response,further clarified the effect on ovarian response and applicative value of growth hormone on ovarian response in poor ovarian response patients of different ages,and provided a theoretical basis for the treatment programs of poor ovarian response patients.Methods:1.Choose 72 cycles of undergoing IVF/ICSI-ET treatment of patients with poor ovarian response undergoing fresh cycle from January 2015 to December 2016 in our hospital reproductive medicine center as the research object,the stimulation protocols with growth hormone as the experimental group(32 cycles),the same stimulation protocols without growth hormone as the control group(40 cycles),and analyze the general data,oocyte quality,embryo quality and pregnancy outcomes of poor ovarian response patients.2.Poor ovarian response patients were divided into two groups according to the age,including<35 years old and ≥35 years old group,each group included growth hormone group and control group,the basic conditions,oocyte quality,embryo quality and pregnancy outcomes between growth hormone group and control group in different age groups were compared to investigate the effect of growth hormone and its applicative value on ovarian response to IVF-ET cycle in patients with premature ovarian failure.Results:1.Age,BMI,duration of infertility,type of infertility,basal hormone levels,antral follicles,days of Gn,total amount of Gn,endometrial thickness on HCG day,number of embryos transferred and way of fertilization between growth hormone group and control group had no significant statistical differences(P>0.05).However,the E2 level on HCG day(P=0.010)was significantly higher in the growth hormone group than that in the control group,and had significant statistical differences.2.Oocyte maturity rate,the rate of fertilization,the rate of cleavage,the rate of high quality embryo,the rate of implantation,the rate of clinical pregnancy and the rate of live birth between growth hormone group and control group had no significant statistical differences(P>0.05),however,the retrieved oocytes’ number(P=0.002)and the MII oocytes’ number(P=O.015)in growth hormone group were significantly higher than those in control group,and had significant statistical differences.3.There were no significantly differences on age,BMI,duration of infertility,basal hormone level,number of antral follicles,days of Gn,total amount of Gn,endometrial thickness and E2 level on HCG day(P>0.05)between the growth hormone group and control group in patients<35 years old;There were no significantly differences on age,BMI,duration of infertility,basal hormone level,number of antral follicles,days of Gn,total amount of Gn and thickness of endometrium on HCG day(P>0.05)between the growth hormone group and control group in patients ≥35 years old,but the E2 level on HCG day(P=0.005)was significantly higher in growth hormone group than in the control group,and had significant statistical differences.4.There were no significantly differences on retrieved oocytes’ number,MII oocytes’ number,the rate of oocyte maturity,the rate of fertilization,the rate of cleavage,the rate of high quality embryo,the rate of implantation and the rate of clinical pregnancy(P>0.05)between the growth hormone group and control group in patients<35 years old;There were no significantly differences on the rate of oocyte maturity,the rate of fertilization,the rate of cleavage,the rate of high quality embryo,the rate of implantation and the rate of clinical pregnancy(P>0.05)between the growth hormone group and control group in patients ≥35 years old,however,the retrieved oocytes’ number(P=0.001)and MII oocytes’ number(P=0.013)were significantly higher in growth hormone group than in the control group,and had significant statistical differences.Conclutions:1.The addition of growth hormone had no effect on the clinical pregnancy rate in patients with poor ovarian response undergoing IVF-ET,but it could significantly increase E2 level on HCG day,the number of oocytes and MII oocytes’ number in patients aged over 35 years older.2.The elderly poor ovarian response undergoing IVF-ET may benefit from the addition of growth hormone to ovulation-promoting program.