The effect of using Growth Hormone in Invitro Fertilisation on livebirth rates

It is well known that the chance of live birth in assisted reproduction treatment decreases with increasing female age, and drops markedly after 40 years of age, however, some woman younger than this is an ‘unexpected poor responder’ during their IVF cycle. Tesarik reported in 2005 that the ability of human oocytes to form normal embryos is related to the concentration of different hormones in follicular fluid (Mendoza et al., 1999, 2002). Among the hormones studied, growth hormone (GH) showed the most consistent relationship with different parameters of embryo quality, and higher concentrations of GH in follicular fluid were associated with rapid embryo cell division, good embryo morphology and a high embryo implantation potential (Mendoza et al., 1999, 2002).He also reports a decrease in follicular fluid GH concentration in women aged 40 years as compared with young women. Studies evaluating the benefits of co-treatment with recombinant human Growth Hormone (r-hGH) during controlled ovarian stimulation for human assisted reproduction treatment have reported controversial findings. A Cochrane review (Harper et al. 2008) and updated as part of a review of the management of poor responders (Kyrou et al. 2008), suggest that there exists some evidence for the use of GH in the management of IVF cycles of poor responders. The aim of this study is to determine the influence of GH treatment as an adjunct to stimulation with the maximal dose of Follicle Stimulating Hormone(FSH) stimulation in the unexpected poor responding IVF patient, ie patients requiring maximal dose of stimulation despite being under 41 years of age.