Effect Of Pregnancy Outcome On Growth Hormone Treatment In Luteal Phase For Frozen Thawed Embryo Transfer

Objective and background:There are few studies on the effect of luteal growth hormone(GH)on the pregnancy rate of frozen thawed embryo transfer(FET).In the past decade,the beneficial effect of growth hormone on embryo quality has been confirmed by many studies,but the effect of growth hormone on luteal endometrial receptivity and embryo implantation is still unclear.To assess this,we retrospectively analyzed the effect of luteal growth hormone therapy on the pregnancy rate of frozen embryo transfer.Objective: To investigate the effect of luteal growth hormone on the pregnancy rate of frozen embryo transfer(FET).Materials and methods:Data of 1548 patients who underwent FET transfer at the reproductive center of the First Affiliated Hospital of Hainan Medical College,was collected from September2019 to June 2020.There were 334 cases in GH treatment group and 1214 in control group.The final results were got by matching the patients with the method of propensity score matching(PSM)according to the clinical characteristics of the two groups.The matching parameters were: age,number of transplantation cycles,infertility duration,infertility causes,body mass index(BMI),infertility type,endometrial preparation plan,estradiol level,progesterone level,endometrial thickness,drugs used for maintenance of luteal phase,number of embryos transferred and embryo quality.After PSM,292 patients(146 patients in each group)were matched successfully,and then they were statistically analyzed.Results:1.The serum h CG level of the GH group on the test pregnancy day was higher than that of the control group,with a statistically significant difference(average338.25 vs 180.87 ml U/ml,p<0.006)respectively.2.The positive rate of h CG in the GH group and the control group(82.2% vs 61.6%,p <0.000),embryo implantation rate(61.7% vs 37.6%,p <0.000)and clinical pregnancy rate(61.0% vs 35.6%,p <0.000)respectively.The GH group was significantly higher than the control group.3.The delivery rate of GH group was significantly higher than that of the control group(52.1% vs 28.8%,p <0.000).4.4.The biochemical pregnancy rate of the GH group was lower than that of the control group with a significant statistical difference(20.5% and 24.0%,p<0.052).5.However,the Ectopic pregnancy(0.7% vs 2.1%,P < 0.314)and abortion rates >12weeks(1.4% vs 2.7%,P < 0.409)between the two groups were not significant.But abortion rates <12weeks(7.5% vs 4.1%,P < 0.038)were significantly lower in the growth hormone group.6.Growth hormone therapy improved the pregnancy rate(p <0.005 and p <0.006),implantation rate(p <0.020 and p <0.009),clinical pregnancy rate(p <0.010 and p <0.004)and delivery rate(p <0.019 and p <0.002),respectively in patients with adenomyosis and pelvic inflammatory disease.7.GH supplementation in luteal phase improved the pregnancy rate(p <0.052 and p<0.006),embryo implantation rate(p <0.002 and p <0.004),clinical pregnancy rate(p <0.001 and p <0.000)and delivery rate(p <0.002 and p <0.002)of ovulation induction and hormone replacement therapy regimens.Conclusion:1.GH Supplementation during the luteal phase increased the serum h CG level,implantation rate,clinical pregnancy rate and delivery rate of FET patients.The occurrence of biochemical pregnancy was reduced.2.GH supplementation in luteal phase improved the serum h CG level,embryo implantation rate,clinical pregnancy rate and delivery rate of patients with adenomyosis and pelvic inflammatory disease.It had obvious effect on ovulation induction and hormone replacement therapy,but had no help on natural cycle and down regulation cycle.