Abstract
Research question
Does the addition of human growth hormone (HGH) to an IVF cycle improve the live birth
rate in previously documented poor responders to FSH?
Design
Double-blind, placebo-controlled, randomized clinical trial comparing HGH to placebo
in maximal stimulation in an IVF cycle. The study was stopped after 4 years. Women
receiving ovarian stimulation in one IVF cycle, having failed to produce more than
5 eggs in a previous cycle with more than 250 IU/day of FSH were included. Basal FSH
was ≤15 IU/l, body mass index <33 kg/m2, age <41 years. HGH or placebo were added from the start of the cycle in a double-blinded
manner. The primary outcome was live birth rate.
Main results
The live birth rates following an IVF cycle were 9/62 (14.5%) for growth hormone and
7/51 (13.7%) for the placebo group (risk difference 0.8%, 95% confidence interval
[CI] –12.1 to 13.7%; odds ratio [OR] 1.07, 95% CI 0.37–3.10). There was a greater
odds of oocyte retrieval with growth hormone (OR 5.67, 95% CI 1.54–20.80) but no better
chance of embryo transfer (OR 1.42, 95% CI 0.50–4.00). Birth weights were comparable.
Conclusions
Planned participant numbers were not reached. It was not possible to demonstrate an
increase in live birth rate from the addition of growth hormone in women with a previous
poor ovarian response to IVF.
Keywords
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Biography
Robert Norman is a Professor of Reproduction and Periconceptual Medicine at the University of Adelaide. He is a subspecialist in reproductive medicine and is former President of Aspire – the Asia Pacific Initiative on Reproduction.Article info
Publication history
Published online: February 26, 2019
Accepted:
February 5,
2019
Received in revised form:
January 18,
2019
Received:
November 5,
2018
Declaration: RJN is a unitholder in a fertility company, Fertility SA, and has received travel and grant funding from Ferring and Merck; HA is a shareholder in a fertility company, Monash IVF; LH has nothing to declare; BWM reports consultancy for ObsEva, Merck and Guerbet, and research grants from Guerbet and Merck; RH is a shareholder in a fertility company, Fertility Specialists of Western Australia, has grant support from MSD, Merck Serono, Ferring Pharmaceuticals; TLK has nothing to declare; LR is a shareholder in Monash IVF Group and has received unrestricted educational and research sponsorship from MSD, Merck and Ferring Pharmaceuticals.Identification
Copyright
© 2019 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
