| Under the increasingly heavy pressure of social competition, more and more women tend to postpone their gestational plan, thus the rate of infertility is gradually elevated. Especially, due to the effect of advanced maternal age, surgery, immune and environmental factors, the number of infertile patients with diminished ovary reserve increases. In the process of in vitro fertilization and embryo transfer, manifestations of declined ovary reserve include low ovarian response and decreased quality of ovum, which are both linked to poor outcome of IVF-ET. Nowadays, poor ovarian responder is one of the issues that bother clinicians most. And how to improve the ovarian response and IVF outcome become one of the focuses in research field. Many scholars stated that growth hormone (GH), to some extent, may improve the ovarian response. So we use the data in our Reproductive Medical Centre to illustrate whether GH functions or not.Objective:To discuss whether GH positively affect the IVF outcome of patients, thus to provide theoretical proof for clinical application.Methods: Two hundred and forty infertile patients with decreased ovarian reserve (basal FSH>10.0mIU/ml), admitted to the Reproductive Medical Centre of the First Affiliated Hospital of Zhengzhou University from January,2011 to February,2011, were enrolled into our study. They were divided in terms of age:171 patients under 35 years old and 69 patients equal to or above 35 years old. And both groups were further divided into two groups by having used GH in their cycles or not. Patients received GH were taken as the experimental group, while those didn't were taken as the control group. The group less than 35 years old included experimental group with 81 cases and control group with 90 cases. The group equals to or more than 35 years old included experimental group with 39 cases and control group with 30 cases. All the patients in this study had been down regulated according to the conventional long protocol in our centre. Use of GnRHa started from the midluteal phase of the menstrual cycle, with a daily injection of 0.1mg for about 14 days. After achieving the standard of down regulation, GnRHa was continued with a dosage of 0.05mg daily while Gn (Gonal-F, Merck Serono) was given for superovulation, till the day of HCG injection. The experimental group was given GH (Jintropin, Gensci, China) since the beginning of Gn,4.5IU daily for consecutive 5 days. The control group were not given GH. Ovarian response and outcome of IVF were observed in both groups. We use SPSS 13.0 Software to perform statistical analysis.Result:1.Effect of GH on patients under 35 years old with diminished ovarian reserve: No significantly difference was observed between the basic informations of the two groups, such as age, duration of infertility, basal FSH, AFC (all P>0.05). The dosage of Gn was lower, and its duration was shorter in the experimental group than those in the control groups. The level of estradiol, the number of retrieved ovum,2PN fertilization rate, good quality embryo rate, implantation rate and clinical rate were all higher in the control groups. But for all the above items, no significant differences were found (all P>0.05).2. Effect of GH on patients equals to or more than 35 years old with diminished ovarian reserve:No significantly difference was observed between the basic informations of the two groups, such as age, duration of infertility, basal FSH, AFC (all P>0.05). The dosage of Gn was significantly lower(P<0.05), and its duration was shorter in the experimental group than those in the control groups. The level of estradiol and the number of retrieved ovum were significantly higher(P<0.05) in the control groups.2PN fertilization rate, good quality embryo rate, implantation rate and clinical rate were all higher in the control group. But for all the above items, no significant differences were found (all P>0.05).Conclusions1. Growth hormone has no significant effect on the ovarian response and IVF outcome for the patients less than 35 years old with decreased ovarian reserve.2. Growth hormone may diminish the dosage of Gn, elevate the level of estradiol on the day of HCG injection and increase the number of ovum for the patients equal to or more than 35 years old with decreased ovarian reserve.3. In the clinical application of assisted reproductive technologies, the patients who are equal to or more than 35 years old with decreased ovarian reserve improve the ovarian response by having used GH. |
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