ADJUVANT GROWTH-HORMONE TREATMENT DURING IN-VITRO FERTILIZATION - A RANDOMIZED, PLACEBO-CONTROLLED STUDY

Objectives: To explore the effect of recombinant, human GH on follicul ar development and oocyte retrieval after gonadotropin stimulation wit h the addition of GH or placebo to a standard IVF treatment regimen. F urther, to investigate whether GH is a more effective adjuvant if the standard treatment regimen is preceded by GH injections. Design: A ran domized, double-blind, parallel, placebo-controlled study. Setting: Th e IVF unit at university hospital. Patients: Forty normally ovulating women, age 25 to 38 years, with infertility because of tubal factors a nd being classified as ''poor responders'' with at least two previousl y performed and failed IVF attempts. Interventions: Human, recombinant GH (Genotropin, Kabi Pharmacia, Uppsala, Sweden) or placebo (0.1 IU/k g body weight per day) was given SC as pretreatment during down regula tion with GnRH and during stimulation with hMG according to the random ized protocol. Main Outcome Measures: Number of oocytes retrieved afte r stimulation, total amount of gonadotropin used, time required for st imulation, number of follicles developing rate of fertilization, and c leavage in vitro. Further, the quality of embryos, development of the endometrium, rate of clinical pregnancy, and serum and follicular flui d (FF) concentrations of insulin-like growth factor I (TGF-I), insulin -like growth factor binding protein-1 (IGFBP-1), and IGFBP-3 were esti mated. Results: The number of oocytes retrieved did not differ signifi cantly between the groups, nor did the amount of hMG required for stim ulation. The fertilization rate increased in patients who had received GH. Growth hormone caused a significant increase in serum and FF leve ls of IGF-I. An increase in serum IGFBP-3 could also be recorded in pa tients who had received GH. Conclusion: Although certain beneficial ef fects were noted in GH-treated patients, the overall results did not s upport GH as a clinically useful adjuvant treatment.