Growth hormone can improve the response to ovarian stimulation in women undergoing IVF, but we use it hesitantly

I get it. You’re smart, savvy and you’ve done your research. And yet that IVF (in vitro fertilization) cycle did not work. So what do you do now?

Many of you spend a sleepless night (or two or three) scouring the internet for options that might improve the quality or quantity of your eggs. Some of you will be on chat rooms where other patients have told you their doctor’s recommendation after a failed IVF cycle. You keep seeing a recurring hormone, one that you only knew about from “Nightline” specials talking about men who were aging or who wanted to build more muscle mass for bodybuilding competitions: growth hormone.

So the big question is: What is growth hormone, and should I add it to my next IVF cycle?

Let’s start with the basics.

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How do growth hormones relate to IVF?

IVF is a complex and costly process that involves the use of medications to stimulate the ovaries to produce multiple eggs. One of the limitations of IVF is that not all women respond well to ovarian stimulation, leading to poor outcomes. Growth hormone (GH), also known as human growth hormone (HGH), has been proposed as a potential adjuvant therapy to improve the response to ovarian stimulation in women undergoing IVF.

In this blog, we will discuss the use of GH during IVF stimulation and the evidence supporting its efficacy.

What is growth hormone (human growth hormone)?

GH is a hormone produced by the pituitary gland that plays a critical role in regulating growth and metabolism. GH is involved in many biological processes, including cell growth and division, protein synthesis and fat metabolism. GH has been shown to have a positive effect on ovarian function and follicular development, making it a potential therapeutic option for women undergoing IVF.

GH enhances the sensitivity of the ovary to follicle-stimulating hormone (FSH), which is used to stimulate the ovaries during IVF. GH also promotes the growth of ovarian follicles, leading to the production of more eggs and higher quality embryos.

Clinical evidence for GH use in IVF stimulation

Several studies have evaluated the use of GH during IVF stimulation, producing mixed results. A meta-analysis of randomized controlled trials found that the use of GH was associated with a higher number of retrieved eggs, a higher number of mature eggs and a higher pregnancy rate compared with standard IVF protocols. However, another meta-analysis found no significant difference in clinical pregnancy rates between GH and non-GH groups.

GH dosing and administration

GH is typically administered daily via subcutaneous injection during the IVF stimulation cycle. The dose and duration of GH treatment vary depending on the individual patient and the specific IVF protocol being used. Some studies have used a high dose of GH (up to 20 IU/day), while others have used lower doses (1-4 IU/day).

Growth hormone side effects and safety

GH is generally considered safe when used for short-term treatment in IVF cycles. However, GH use may be associated with side effects such as headache, nausea and injection site reactions. Long-term use of GH has been associated with an increased risk of certain health problems, such as diabetes and cardiovascular disease. These risks are not relevant to the short-term use of GH during IVF stimulation.

Cost of growth hormone therapy

Growth hormone therapy is expensive, with the cost of a typical 10-day course ranging from $1,000 to $3,000. Insurance coverage for GH therapy varies by provider and region, and not all insurance plans cover the use of GH for IVF stimulation.

Who benefits from growth hormone therapy?

GH therapy may be beneficial for women who have a poor response to ovarian stimulation, as well as those with certain medical conditions that affect ovarian function, such as polycystic ovary syndrome (PCOS). Women who are older and have diminished ovarian reserve may also benefit from GH therapy.

At Reproductive Science Center, we typically do not add growth hormone for a woman’s first IVF cycle. Since the use of growth hormone in IVF is considered by the FDA as an off-label use of a medication without long-term studies of safety, RSC is hesitant to add this expensive injection without knowing there is a clear problem with egg quality.

However, if the initial IVF cycle was not successful and quantity or quality of eggs seemed to be an issue, there are two protocols that we may initiate in a subsequent cycle.

1. One protocol is the use of growth hormone the month prior to IVF. This can help increase the quantity.
2. The second protocol uses growth hormone during IVF stimulation in the week prior to egg retrieval. This can assist with quality.

We are continuing to follow our data at RSC in order to understand if there is a true benefit in terms of quality, quantity and the chromosomal euploidy of IVF embryos with preimplantation genetic testing for aneuploidy (PGT-A).

In summary, growth hormone is a potential adjuvant therapy used to improve the response to ovarian stimulation in women undergoing IVF. The evidence supporting its efficacy is mixed, but several studies have demonstrated a positive effect on ovarian function and follicular development.

GH therapy is generally considered safe when used for short-term treatment in IVF cycles, but it is expensive and not all insurance plans cover its use. This therapy may be beneficial for women who have a poor ovarian reserve, especially if demonstrated in their first IVF cycle.