Impact of Growth Hormone Administration on Intracytoplasmic Sperm Injection (ICSI) Outcomes in Patients with Diminished Ovarian Reserve

Abstract

Background: Poor ovarian reserve (POR) affects IVF/ICSI outcomes, according to the Bologna criteria, factors like older age, a low number of oocytes retrieved, decreased antral follicle count (AFC) and Low levels of anti-Müllerian hormone (AMH) suggest a poor ovarian response (POR). Growth hormone (GH) might enhance follicle development through IGF-1, potentially boosting the ovarian response in individuals with POR. Aim: The objective is to examine how growth hormone adjuvant therapy affects outcomes of ICSI procedures for women with diminished ovarian reserve. Patients and methods: Prospective study focused on patients diagnosed as POR and underwent ICSI, and it was conducted at BeniSuef University from February 2022 through January 2024. Participants were allocated into 2 groups: (A) a control group without adjuvant therapy and (B) a group that received GH adjuvant therapy. Results: There were no initial differences in age, BMI, hormones, or AFC between the groups. The GH group experienced fewer days of stimulation (11.67±1.5 compared to 12.87±1.2, P<0.001), required a lower dose of gonadotropins (4828±1005 versus 5207±1018 IU, P=0.008), and had more number of metaphase II oocytes (2.99 ± 1.8 compared to 2.2±1.1, P=0.002). No variations in peak E2 levels, endometrial thickness, embryo transfer rates, or rates of chemical/clinical pregnancy (19.4% versus 14.8%, P=0.437), ongoing pregnancy, or miscarriage. Conclusion: Growth hormone (GH) adjuvant therapy is effective in reducing the duration and dosage of stimulation while increasing mature oocytes count in patients of poor ovarian response (POR). However, it does not improve pregnancy rates. To determine the optimal dosing and timing, large-scale randomized controlled trials (RCTs) are required.