Study On The Application Of Growth Hormone In Patients With Poor Ovarian Response

Research background and purpose:Poor ovarian response(POR)is a pathological state in which the ovary responds poorly to external hormone stimulation,which seriously affects female reproductive function and the success rate of assisted reproductive technology.Growth hormone(GH)plays an important role in regulating reproduction and improving ovarian function.This study evaluated the effect of growth hormone pretreatment on in vitro fertilization of patients with low ovarian response;exploring hormone levels and related cytokines of growth hormone on follicular fluid Impact.Materials and Methods:Patients with low ovarian response were strictly included according to the Bologna diagnostic criteria,and were divided into 3 groups using random number table method:Group A began to use growth hormone(GH)4IU / d at the beginning of the menstrual period before the cycle started to inject human chorionic gonadotropin Hormone(human chorionic gonadotropin,HCG)day;Group B uses GH 4IU / d to HCG day on start-up day;Group C does not use GH.All patients underwent ovulation with standard antagonist regimen,shortly after in vitro fertilization or intracytoplasmic sperm injection(ICSI)fertilization,d3 embryos were transplanted,and the remaining embryos were frozen.Observe the total amount and days of gonadotropin(Gn),the number of eggs harvested,d3 available embryo rate,high-quality embryo rate,clinical pregnancy rate.Analyze the levels of sex hormones such as estrogen(E2),progesterone(P),and testosterone(T)in follicular fluid;detect insulin like growth factor-3(IGF-1)in follicular fluid),Insulin growth factor binding protein-3(Insulin like growth factor binding protein-3,IGFBP-3),growth hormone levels.Result:1.The general conditions of the three groups of patients,age,male age,infertility years,body mass index(BMI),follicle-stimulating hormone(FSH),luteinizinghormone(LH),Estrogen,anti-Müllerian hormone(AMH),AFC levels,the difference was not statistically significant(P> 0.05).2.Compared with the control group,the addition of growth hormone in patients with low ovarian response has no significant difference in total Gn,Gn days,normal fertilization rate,D3 high-quality embryo rate(P> 0.05),but ECG level on HCG day(A group is 1836.54 pg / ml,1264.66 pg / ml in group B),number of eggs harvested(3.50 in group A,3.26 in group B),D3 high-quality embryo rate(34.82% in group A,22.91%in group B),clinical pregnancy The rate(50% in group A and 42.11% in group B)was significantly higher than that in the control group(1005.04 pg / ml,3.11,16.41%,28.57%)(P <0.05).3.Compared with the use of GH in the menstrual cycle before the start of the cycle,there is no significant difference in the total Gn,the number of Gn days,the number of eggs harvested,the normal fertilization rate,and the D3 available embryo rate(P> 0.05);but the HCG daily E2 level(1836.54 pg / ml),D3 high-quality embryo rate(34.82%),clinical pregnancy rate(50.00%)in the menstrual cycle before the start of the cycle were significantly higher than the use of GH in the start cycle(respectively)1264.66 pg /ml,22.91%,42.11%)(P <0.05).4.Compared with the control group,the patients with low ovarian response added growth hormone.IGF-1(106.01 ng / mL in group A and 79.43 ng / mL in group B)and IGFBP3(3.02?g / mL,B in group A)Group 2.62?g / mL),GH(Group A 1.02 ng / mL,Group B 0.85 ng / mL)was significantly higher than the control group(43.37 ng / mL,1.54?g / mL,0.57 ng / mL,respectively)(P <0.05).Moreover,the levels of follicular fluid IGF-1,IGFBP3,and GH in patients using GH in the menstrual cycle before the start of the cycle were significantly higher than those using GH in the start cycle(P<0.05).5.Compared with the control group,the patients with low ovarian response added reproductive hormones.The follicular fluid E2(2172.94 pg / ml in group A,1581.59 pg/ ml in group B),P(36.87 ng / mL in group A,and B in group B)26.69 ng / mL),T(1.66 ng / mL in group A,1.33 ng / mL in group B)was significantly higher than the control group(557.15 pg / ml,17.19 ng / mL,0.80 ng / mL,respectively)(P < 0.05).Moreover,the E2,P,T levels of follicular fluid in patients who used GH in the menstrual cycle before the start of the cycle were significantly higher than those who used GH in the start cycle(P <0.05).Conclusion:in conclusion:1.The use of growth hormone can significantly increase the number of eggs harvested in vitro fertilization,D3 high-quality embryo rate and clinical pregnancy rate of patients with low ovarian response,and change the pregnancy outcome of patients.2.In patients with low ovarian response,the use of growth hormone can significantly increase the levels of follicular fluid IGF-1,IGFBP3,GH and follicular fluid E2,P,T,thereby improving the reproductive function of the ovary.3.In patients with low ovarian response,the IVF pregnancy outcome and follicular fluid hormone levels and ovarian function cytokine levels were significantly higher than the GH patients who used GH before the menstrual period before the start of the menstrual period.The effect of the previous menstrual period began to be better.