Growth hormone for in vitro fertilization

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Harper K, Proctor M, Hughes E

Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD000099. DOI: 10.1002/14651858.CD000099


The purpose of this review was to assess the effectiveness of GH or growth hormone releasing (GRF) adjuvant therapy, primarily in terms of improving live birth rate, for women undergoing ovulation induction prior to in vitro fertilization (IVF), in both patients with a history of poor response and those with no previous history of poor response. Growth hormone (GH) therapy is sometimes used in women who do not produce enough follicles in their ovaries. This aims to reduce the use of gonadotropin therapy to stimulate ovulation, a hormone that can cause multiple pregnancy.


This review analyzed randomized controlled clinical trials which were identified from a search of the Cochrane Menstrual Disorders and Subfertility Group's trials register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Biological Abstracts and reference lists of articles. The reviewers assessed studies for methodological quality and extracted data from nine studies that addressed the research question and provided outcome data for intervention and control subjects.


The studies included 401 couples. Six of the trials investigated a total of 302 women, who had been previous poor responders to in vitro fertilization. In this group there were no significant differences in live birth when combining trials of GH and GRF. When trials using GH alone were analyzed separately there was an increase in live births. The other three trials investigated 91 women, with no history of poor response to IVF and there was no evidence that routine use of GH affected the outcome of live birth. There were no significant differences in any adverse events, but these were poorly and inconsistently reported.


The review of trials found no evidence that growth hormone helps improve birth rates in women who are undergoing ovulation induction prior to IVF. However, there is some evidence of increased pregnancy and birth rates in women who have a history of poor response to IVF. Due to the limited data available GH should only be considered in the context of a clinical trial.



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