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Hum. Reprod. Advance Access originally published online on April 28, 2005
Human Reproduction 2005 20(9):2536-2541; doi:10.1093/humrep/dei066
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions{at}oupjournals.org

Improvement of delivery and live birth rates after ICSI in women aged >40 years by ovarian co-stimulation with growth hormone

Jan Tesarik1,2,5, André Hazout3 and Carmen Mendoza1,4

1 MAR&Gen, Molecular Assisted Reproduction and Genetics, Gracia 36, 18002 Granada, Spain, 2 Laboratoire d'Eylau, 55 rue Saint-Didier, 75116 Paris, 3 ARCEFAR, 15 rue Faraday, 75017 Paris, France and 4 University of Granada, Campus Fuentenueva, 18004 Granada, Spain

5 To whom correspondence should be addressed. Email: cmendoza{at}ugr.es

BACKGROUND: Growth hormone (GH) is required for ovarian follicular development, and its administration during ovarian stimulation improves pregnancy rate in cow and sheep. Data on the use of exogenous GH in human assisted reproduction treatment are inconsistent. This prospective randomized study evaluates the usefulness of GH administration in women of >40 years undergoing ovarian stimulation for assisted reproduction treatment. METHODS: One hundred women of >40 years undergoing assisted reproduction treatment were randomized between a GH treatment group and a placebo group. Assisted reproduction treatment outcomes were evaluated. RESULTS: In patients of the GH treatment group, a similar number of oocytes, embryos and pregnancies was achieved as compared with the placebo group. However, the patients treated with GH suffered fewer pregnancy losses, resulting in higher delivery and live birth rates. These patients also showed higher peak serum estradiol concentration and higher concentrations of GH and estradiol in pre-ovulatory follicular fluid as compared with the placebo group. CONCLUSIONS: Administration of GH during ovarian stimulation alleviates age-related decrease in assisted reproduction treatment efficiency. This effect appears to be mainly due to an improvement of oocyte developmental potential, but GH action on the uterus cannot be excluded.

Key words: ovarian stimulation/growth hormone/ovarian ageing/delivery rate/birth rate


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