ANOTHER LOOK AT CO-TREATMENT WITH GROWTH-HORMONE AND HUMAN MENOPAUSALGONADOTROPINS IN POOR OVARIAN RESPONDERS

The objective of this study was to evaluate whether a combined human g rowth hormone (HGH) and human menopausal gonadotrophin (HMG) treatment can improve ovulation induction in poor ovarian responders. Ten patie nts aged 28-43 years and requiring > 25 ampoules of HMG for ovulation were admitted to the study. Pituitary growth hormone reserve was evalu ated by clonidine stimulation and insulin tolerance tests before comme ncement of treatment. The patients underwent one treatment cycle with D-tryptophan-6-luteinizing hormone-releasing hormone (D-Trp6-LHRH) and HMG and another cycle with D-Trp6-LHRH, HMG and HGH. Serum HGH, insul in-like growth factor (IGF)-I and oestradiol were measured throughout the two treatment cycles and follicular maturation was assessed by ult rasonographic studies. All patients tested showed no elevation of thei r serum HGH concentration during a clonidine test, but showed an adequ ate response during insulin tolerance tests. No significant difference was found in the number of HMG ampoules, duration of treatment, numbe r of leading follicles, and serum oestradiol concentration between the two treatment cycles. Co-treatment with HGH and HMG did not improve o varian performance in poor ovarian responders. No correlation was foun d between the results of HGH pituitary function tests and the ovarian response to gonadotrophins.