Does growth hormone-releasing factor assist follicular development in poorresponder patients undergoing ovarian stimulation for in-vitro fertilization?

Treatment with growth hormone-releasing factor (GRF) has been reported to i mprove the ovarian response to gonadotrophins in women who respond poorly t o ovarian stimulation during in-vitro fertilization (IVF), The efficacy and tolerability of GRF were studied in a randomized, double-blind, placebo-co ntrolled trial involving 196 patients. Following down-regulation with a gon adotrophin-releasing hormone agonist (GnRHa), patients were randomized to r eceive GRF (500 mu g twice daily; n = 96) or placebo (n = 100) in addition to follicle stimulating hormone (FSH); treatment was continued until human chorionic gonadotrophin was given, or for a maximum of 14 days. GRF had no significant effect on the mean number of follicles with a diameter of great er than or equal to 16 mm (GRF: 3.26 +/- 2.29; placebo: 3.27 +/- 2.30; P = 0.95), the number of FSH ampoules required to achieve ovarian stimulation ( GRF: 55.2 +/- 16.4; placebo: 54.9 +/- 17.2; P = 0.50), or on secondary meas ures of ovarian response and treatment outcome. There were, however, signif icant increases in circulating growth hormone (GH) and insulinlike growth f actor (IGF)-1 concentrations. GRF was well tolerated, It is concluded that, despite producing significant increases in GH and IGF-1, concomitant treat ment with GRF does not improve the ovarian response to FSH in poorly respon sive women undergoing IVF.