Effect of long-acting growth hormone pretreatment on the clinical outcome and safety of IVF/ICSI in women of advanced age
10.3760/cma.j.cn101441-20200930-00541
- VernacularTitle:探讨长效生长激素预处理对高龄助孕患者IVF/ICSI临床结局及安全性的影响
- Author:
Yiwen XIONG
1
;
Junwei ZHANG
1
;
Lulu WANG
1
;
Mingze DU
1
;
Yichun GUAN
1
;
Lijun SUN
1
Author Information
1. 郑州大学第三附属医院生殖医学科 450052
- Publication Type:Journal Article
- Keywords:
Growth hormone;
Advanced age;
Reproductive technology, assisted;
Cumulative live birth rate
- From:
Chinese Journal of Reproduction and Contraception
2021;41(9):783-789
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of long-acting growth hormone (GH) pretreatment on the clinical outcome and safety of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in women of advanced age. Methods:It was a prospective, self-controlled study. The patients who underwent IVF/ICSI-embryo transfer (ET) in the Department of Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from May 2018 to November 2019 were included. The patients with age between 35 and 39 years, number of unilateral basal antral follicles ≥5, the basic follicle-stimulating hormone (FSH) <10 IU/L, and ≥50% of the embryos in the previous IVF/ICSI-ET cycle belong to Ⅳ grade embryos were collected in group A1, and in the next IVF/ICSI cycle, GH was added for more than 6 weeks of pretreatment (group A2). The parallel control group was selected for IVF/ICSI during the same period, the criteria for inclusion in the group are the same as above, group B1: the first cycle of routine IVF/ICSI without GH treatment; group B2: adopt the same controlled ovarian hyperstimulation (COH) protocol as the first cycle, without GH treatment. The main outcome measure was the cumulative live birth rate (CLBR).Results:The duration of gonadotropin (Gn) used, the thickness of the endometrium on human chorionic gonadotropin (hCG) injection day, the levels of estrogen and progesterone on hCG injection day, and IVF ratio were not statistically significantly different between before and after self-control groups ( P>0.05). The dosage of Gn used in group A2 was higher than that in group A1 [(3 880.4±902.0) IU vs. (3 485.6±1 054.0) IU, P=0.012], and the dosage of Gn used in group B2 was higher than that in group B1 [(3 377.7±899.2) IU vs. (3 117.8±891.3) IU, P=0.025]. Available embryo rate[55.17% (160/290)], high-quality embryo rate [21.38% (62/290)], clinical pregnancy rate of frozen-thawed embryo transfer [60.87% (14/23)], cumulative pregnancy rate [61.11% (22/36)] and CLBR [50.00% (18/36)] of group A2 were significantly higher than those of group A1 [45.98% (120/261), P=0.031; 12.64% (33/261), P=0.007; 17.39% (4/23), P=0.003; 17.50% (7/40), P<0.001; 2.50% (1/40), P<0.001], the difference was statistically significant. Comparing group B2 with group B1, there were no statistical differences in available embryo rate, high-quality embryo rate, clinical pregnancy rate of fresh cycle, and clinical pregnancy rate of frozen-thawed embryo transfer (all P>0.05). The cumulative pregnancy rate [34.21% (13/38) vs. 12.50% (5/40), P=0.023] and CLBR [26.32% (10/38) vs. 2.50% (1/40), P=0.003] were significantly different. Compared with group B2, available embryo rate [55.17% (160/290) vs. 45.56% (113/248), P=0.026], high-quality embryo rate [21.38% (62/290) vs. 13.31% (33/248), P=0.014], cumulative pregnancy rate [61.11% (22/36) vs. 34.21% (13/38), P=0.021] and CLBR [50.00% (18/36) vs. 26.32% (10/38), P=0.036] in group A2 were significantly higher, and the differences were statistically significant. The group A2 had no significant difference in the incidence of ovarian hyperstimulation syndrome (OHSS), the rate of multiple pregnancy, and the rate of ectopic pregnancy compared with group A1, but the abortion rate of group A2 was significantly lower than that of group A1 [18.18% (4/22) vs. 71.43% (5/7), P=0.016]. There were no significant differences in fasting blood glucose before the use of GH on Gn start day and oocyte retrieval day in group A2 ( P>0.05). Conclusion:GH may improve the outcome of assisted pregnancy in advanced age patients. The clinical application of GH is relatively safe.
