Application of recombinant human growth hormone in patients with previous in vitro fertilization failure

Objective To investigate the effect of recombinant human growth hormone (rhGH) on embryo quality and clinical outcome of patients used an early follicular phase prolonged protocol with previous in vitro fertilization (IVF) failure. Methods From April 2017 to April 2018, 54 patients who had pregnancy failure due to no available embryo or poor quality of embryo in the previous cycle with early follicular phase prolonged protocol were selected for the study. Patients used an early follicular phase prolonged protocol both before and after in the two cycles. In the second cycle, rhGH pretreatment was added for 4 weeks (GH group), and rhGH was maintained until human chorionic gonadotropin (hCG) injection day during ovulation induction. The improvement of embryo quality and the pregnancy outcome after rhGH addition was observed by self-control method. Results There were no significant differences in the duration of gonadotropin (Gn) used, total dosage of Gn used, the endometrial thickness and estrogen levels on hCG injection day, the number of oocytes retrieved, two pronucleus (2PN) cleavage rate, embryo transfer number per cycle between the two groups (P>0.05). In GH group, the progesterone levels on hCG injection day [(0.55±0.29) mg/L], the early abortion rate (7.69%) and the cancellation cycle rate due to poor embryo quality (0%) were significantly lower than those in control group [(0.80±0.31) mg/L, P<0.001; 66.67%, P=0.042; 24.07%, P<0.001]. The 2PN fertilization rate (64.36%), the available embryo rate (56.08%), the clinical pregnancy rate (50.98%) and the implantation rate (42.39%) in GH group were significantly higher than those in control group (53.90%, 31.75%, 7.50%, 4.84%) (all P<0.001). Conclusion Low dose rhGH pretreatment can significantly improve embryo quality and pregnancy outcome in patients who had previous pregnancy failure due to poor embryo quality, and received an early follicular phase prolonged protocol in IVF cycles. Key words: Growth hormone; Clinical pregnancy rate; Fertilization in vitro; Embryo transfer; Embryo quality; Early follicular phase prolonged protocol