In vitro fertilization (IVF) is a boon for women suffering from infertility all over the world. However, one of the main problems with IVF is the poor ovarian response. To overcome this, the human growth hormone has been used as an add-on therapy to IVF for many years. But the role of growth hormone is still controversial among many scientists. In a 2016 randomized trial, which was conducted as an Australian/New Zealand collaboration, researchers demonstrated that human growth hormone was no better than a placebo.
What is the human growth hormone?
Human growth hormone is a peptide hormone produced by the somatotroph cells of the anterior part of the pituitary gland. It is believed to promote oocyte (egg) development by stimulating IGF-1 and acting on the growth hormone receptors present in the egg cells. Thus, it is a strong activator of follicular proliferation and differentiation. In other words, it increases follicular size and ovarian weight.
Many scientists consider the growth hormone to be crucial for follicle formation, which is essential for egg retrieval during the transfer stage. Due to this reason, HGH was used for decades as a key supplement in IVF done for infertile women who were undergoing artificial induction of ovulation.
A recent study about the significance of growth hormone’s role in IVF
In a placebo-controlled study done in Helsinki, 136 women from infertility centers in Australia and New Zealand were recruited. Those participants all met the criteria for poor ovarian response and were called poor responders. Poor responders are the candidates with a prior IVF cycle with less than or equal to five eggs collected after maximal ovarian stimulation with gonadotropins. The endpoint of the study was set as the live birth of a healthy infant. One group of participants was given growth hormone as an adjunct therapy, and another group was only given the placebo.
The study revealed a clinical pregnancy rate of 14% per cycle in the group who used growth hormone as an add-on therapy and 11% in the group who used the placebo. The participants of both groups were equally compared in the number of eggs collected, the quality of the embryos, and the total duration of the therapy. Hence, it was concluded that there was no statistically significant benefit of using HGH as an adjunct therapy in IVF.
According to Professor Robert Norman from the Robinson Research Institute at the University of Adelaide, who was one of the members leading the study, “growth hormone still offered no strong evidence of a real benefit for poor responders in IVF”. He further added that more substantial evidence could only be achieved by a very large randomized trial. Also, the previous studies that found a benefit of adding growth hormone were not placebo-controlled and had pregnancy as an endpoint instead of the live birth of a healthy infant. He also pointed out that growth hormone was not a cheap therapy (USD 1000 for normal doses) to consider in the first place.
FAQ: Growth Hormone in IVF Treatment
1. What is the role of growth hormone in IVF?
Growth hormone (HGH) is believed to support oocyte (egg) development and follicular growth, making it a potential adjunct therapy for women with poor ovarian response in IVF.
2. Does growth hormone improve IVF success rates?
Recent studies, including a placebo-controlled trial, suggest that growth hormone does not significantly improve live birth rates in IVF treatments.
3. How does growth hormone work in ovarian stimulation?
HGH stimulates IGF-1 and acts on growth hormone receptors in egg cells, promoting follicular proliferation and ovarian function.
4. What did the 2016 randomized trial conclude?
The study found no statistically significant difference in pregnancy rates between women who received growth hormone and those who received a placebo.
5. Is growth hormone widely recommended for IVF?
Many fertility experts remain skeptical due to the lack of strong evidence supporting its benefits in improving live birth rates.
6. What are the costs of using growth hormone in IVF?
Growth hormone therapy can cost around $1,000 per cycle, making it an expensive add-on with uncertain benefits.
7. Are there any risks associated with growth hormone use in IVF?
While generally considered safe, growth hormone can have side effects and may not provide meaningful improvements in fertility outcomes.
8. Why do some doctors still use growth hormone in IVF?
Some clinics continue to use it based on smaller studies that suggested benefits, though larger placebo-controlled trials have questioned its effectiveness.
9. What are alternative strategies for poor ovarian responders in IVF?
Other approaches include modified ovarian stimulation protocols, DHEA supplementation, and PRP (platelet-rich plasma) therapy.
10. Will future studies clarify the role of HGH in IVF?
Larger randomized trials are needed to determine if growth hormone has any real benefit in improving IVF success rates.
Conclusions
Poor response is a great clinical challenge in the field of reproductive medicine. The use of growth hormones was one of the many substances tried in the past to overcome this problem in women who had a hard time conceiving. However, a recent study suggests that although growth hormone improves pregnancy outcomes, it has no substantial role in IVF to help deliver a healthy infant. Hereby, bigger trials on alternative supplement therapies are needed at the moment.
References
Hart, R. J. (2019). Use of growth hormone in the IVF treatment of women with poor ovarian reserve. Frontiers in Endocrinology, 10, 500. https://doi.org/10.3389/fendo.2019.00500
