Är det någon härinne som har fått rekommenderat, eller diskuterat med sin läkare om, tillväxthormoner? Vid det här laget börjar det finnas så mycket studier som stöder användandet av tillväxthormoner för "poor responders". Det skall både ge ett extremt bättre resultat och vara "riskfritt" enligt studierna. Det vore intressant att veta om detta är något svenska (eller danska, tyska, grekiska, mm) läkare är öppna för.
Nedan följer sammanfattningar klippta ur några av studierna jag har läst (som vanligt är det bara att inboxa mig om ni vill att jag mailar studierna :).
Fertility & Sterility, October, 2012
CO-TREATMENT WITH GROWTH HORMONE (GH) MAY INCREASE PREGNANCY RATE IN POOR RESPONDERS UNDERGOING IVF/ET.
MATERIALS AND METHODS: 184 patients who matched the criteria for poor responders were included. The criteria was either advanced age (>40y/o), previous oocyte retrieval <3, or low AMH level(<1 ng/ml).94 couples were allocated to GH co-treatment group (group A), the other 90 served as the control (group B). Group A received a GnRHa ultra-long protocol with Leuprolide Acetate 1.88mg started in day3 of preceding cycle. Ovulation induction with gonadotropin since day 35-40. GH co-treatment was administrated daily with 4IU for three days and adjusted according by until hCG day. The patients in group B received the same treatment without GH.
RESULTS: The co-treatment with GH displayed a favorable COS and pregnancy rate. The E2 level (mean_ SE)on hCG day in Group A was significantly higher than Group B (679_47 vs 457_38 pg/ml; P<0.001). The oocyte retrieved in Group A and Group B was 5.5_0.3 and 2.1_0.1.(P<0.001). Number of embryo transfer was also higher in Group A (2.6_0.1vs1.7_0.1; P<0.001). Pregnancy rate in Group A was statistically higher than group B (31.9% vs16.7%; P<0.05). However, there was no difference in abortion rate between these two groups.
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Cochrane 2010
Growth hormone for in vitro fertilization (Review)
Main results
Ten studies (440 subfertile couples) were included. Results of the meta-analysis demonstrated no difference in outcome measures and adverse events in the routine use of adjuvant growth hormone in in-vitro fertilisation protocols. However, meta-analysis demonstrated a statistically significant difference in both live birth rates and pregnancy rates favouring the use of adjuvant growth hormone in invitro fertilisation protocols in women who are considered poor responders without increasing adverse events, OR 5.39, 95% CI 1.89 to 15.35 and OR 3.28, 95% CI 1.74 to 6.20 respectively.
P L A I N L A N G U A G E S U M M A R Y
Growth hormone in in-vitro fertilisation
Before starting an in-vitro fertilisation cycle, some women need help to ovulate and the use of growth hormone therapy may help these women. This aims to reduce the use of gonadotropin therapy to stimulate ovulation, a hormone that can cause multiple pregnancy. The review of trials found no evidence that growth hormone helps improve birth rates in women who are undergoing ovulation induction prior to in-vitro fertilisation. However there is some evidence of increased pregnancy and birth rates in women who are considered ’poor responders’ to in-vitro fertilisation. More research is needed.
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Fertility & Sterility, November, 2011
The value of growth hormone supplements in ART for poor ovarian responders
Recently, three meta-analyses have concluded that cotreatment with GH improves assisted reproduction outcome in poor controlled ovarian stimulation responders. Although generally GH supplements did not increase controlled ovarian stimulation response or number of oocytes, the supplements improved pregnancy and live-birth rates— thus speaking for an effect on oocyte quality.
