Effect of different frequency of growth hormone on the clinical outcome of IVF/ICSI in elderly patients
Objective To investigate the effect of two different pretreatment frequencies of recombinant human growth hormone(GH)on the clinical outcomes of in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)in elderly patients.Methods Review of 242 cycles of IVF/ICSI assisted reproduction in women aged 35～43 from January 2020 to June 2023 at the Reproductive Medical Center of Maternal and Child Health Care of Guangxi Zhuang Autonomous Region,in which short-acting GnRH-a long protocol with GH pretreatment was used.The patients were divided into two groups based on different GH dosing frequencies:group A received 2 U qd for 38 cycles,and group B received 2 U qod for 204 cycles.Propensity score matching(PSM)was used to match patients in terms of age,body mass index(BMI),anti-Miillerian hormone(AMH),and antral follicle count(AFC)in 1∶1 ratio with a matching ratio of 0.02.After matching,each group consisted of 38 cycles,and clinical indicators such as the average number of retrieved oocytes,usable embryos,high-quality embryos,and clinical pregnancy rate were compared between the two groups.Results There were no statistically significant differences in the duration and total dose of gonadotropin(Gn)treatment between the two matched groups(P＞0.05).However,there were statistically significant differences in the levels of estradiol(E2)on the day of human chorionic gonadotropin(hCG)injection(9 089.56±5 778.61 vs.5 949.34±3 939.86),the average number of retrieved oocytes(9.00±6.05 vs.5.58±3.57)and number of usable embryos(3.68±2.62 vs.2.21±1.40)and number of good-quality embryos(2.58±2.62 vs.1.50±1.37)(P＜0.05).There were no statistically significant differences in fresh cycle implantation rate and embryo implantation rate between the two groups(P＞0.05).December 31,2023,there was a statistically significant difference in the cumulative pregnancy rate(44.74％vs.18.42％)during the oocyte retrieval cycles between the two groups(P＜0.05).Conclusion For elderly patients undergoing short acting GnRH-a long protocol in IVF/ICSI assisted pregnancy,the frequency of using GH 2 U qd as dosing frequencies can increase the number of available embryos.
advanced agegrowth hormonein vitro fertilizationnumber of usable embryos
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