ADJUVANT GROWTH-HORMONE THERAPY IN POOR RESPONDERS TO IN-VITRO FERTILIZATION - A PROSPECTIVE RANDOMIZED PLACEBO-CONTROLLED DOUBLE-BLIND-STUDY

The objective of the study was to assess the effect of growth hormone (GH) supplementation to a combined gonadotrophin-releasing hormone ago nist/human menopausal gonadotrophin (GnRHa/HMG) treatment protocol on ovarian response in ''poor responders'' undergoing in-vitro fertilizat ion (IVF). GH or a placebo were administered in a prospective randomiz ed double-blind manner, A total of 14 poor-responder patients (oestrad iol <500 pg/ml, less than three oocytes retrieved in two previous IVF cycles) were randomly allocated to a combined treatment of either GnRH a/HMG/ GH (18 IU on alternate days, total dose 72 IU) or GnRHa/ HMG pl acebo, No difference was found between the study and control groups in the number of HMG ampoules used, the number of follicles (>14 mm) and serum oestradiol concentrations on the day of administration of human chorionic gonadotrophin (HCG), the number of oocytes retrieved and fe rtilized, and the number of embryos transferred, The GH group (n = 7) did not show a better ovulatory response in the study cycles; mean +/- SD serum oestradiol on day of HCG 411 +/- 124 versus 493 +/- 291 pg/m l, aspirated oocytes 2.2 +/- 1.5 versus 1.9 +/- 2.0, Interestingly, wh en the above results for the placebo group were compared with their pr evious cycles (serum oestradiol 403 +/- 231 pg/ml; 0.4 +/- 0.5 aspirat ed oocytes), a non-specific effect was found, Follicular recruitment, oestradiol secretion by mature follicles and the number of oocytes ret rieved in poor responders were not improved by GH supplementation.