Clin Exp Reprod Med.  2019 Dec;46(4):178-188. 10.5653/cerm.2019.00206.

Live birth outcomes of vitrified embryos generated under growth hormone stimulation are improved for women categorized as poor-prognosis

Affiliations
  • 1PIVET Medical Center, Perth, Australia. kevin.keane@curtin.edu.au, jlyovich@pivet.com.au
  • 2Faculty of Health Sciences, School of Pharmacy and Biomedical Science, Curtin University, Perth, Australia.
  • 3Zhongshan People's Hospital, Zhongshan City, China.
  • 4Stem Cell and Cancer Biology Laboratory, School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, Australia.
  • 5School of Public Health, Curtin University, Perth, Australia.

Abstract


OBJECTIVE
To determine the clinical pregnancy (CP) and live birth (LB) rates arising from frozen embryo transfers (FETs) that had been generated under the influence of in vitro fertilization (IVF) adjuvants given to women categorized as poor-prognosis.
METHODS
A registered, single-center, retrospective study. A total of 1,119 patients with first FETs cycle include 310 patients with poor prognosis (109 treated with growth hormone [GH], (+)GH group vs. 201 treated with dehydroepiandrosterone, (-)GH group) and 809 patients with good prognosis (as control, (-)Adj (Good) group).
RESULTS
The poor-prognosis women were significantly older, with a lower ovarian reserve than the (-)Adj (Good) group, and demonstrated lower chances of CP (p<0.005) and LB (p<0.005). After adjusting for confounders, the chances of both CP and LB in the (+)GH group were not significantly different from those in the (-)Adj (Good) group, indicating that the poor-prognosis patients given GH had similar outcomes to those with a good prognosis. Furthermore, the likelihood of LB was significantly higher for poor-prognosis women given GH than for those who did not receive GH (p<0.028). This was further confirmed in age-matched analyses.
CONCLUSION
The embryos cryopreserved from fresh IVF cycles in which adjuvant GH had been administered to women classified as poor-prognosis showed a significant 2.7-fold higher LB rate in subsequent FET cycles than a matched poor-prognosis group. The women with a poor prognosis who were treated with GH had LB outcomes equivalent to those with a good prognosis. We therefore postulate that GH improves some aspect of oocyte quality that confers improved competency for implantation.

Keyword

Adjuvants; Autologous; Dehydroepiandrosterone; Melatonin; Single embryo transfer; Vitrified embryos

MeSH Terms

Dehydroepiandrosterone
Embryo Transfer
Embryonic Structures*
Female
Fertilization in Vitro
Growth Hormone*
Humans
Live Birth*
Melatonin
Oocytes
Ovarian Reserve
Pregnancy
Prognosis
Retrospective Studies
Single Embryo Transfer
Dehydroepiandrosterone
Growth Hormone
Melatonin
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