In vitro fertilization (IVF) is a boon for women suffering from infertility all over the world. But one of the main problems with IVF is the poor ovarian response. In order 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 the 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 the 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 from 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 live birth of a healthy infant. One group of participants were given growth hormone as an adjunct therapy and another group was only given the placebo.
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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 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, more substantial evidence could only be achieved by only a very large randomized trial. Also, the previous studies which found a benefit of adding growth hormone were not placebo-controlled and had pregnancy as endpoints instead of the live birth of a healthy infant. He also pointed out that growth hormone was also not a cheap therapy (USD 1000 for normal doses) to consider in the first place.
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. But the 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 alternate supplement therapies are needed at the moment.