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Clin Exp Reprod Med > Epub ahead of print
DOI: https://doi.org/10.5653/cerm.2019.00206    [Epub ahead of print]
Published online November 19, 2019.
Live birth outcomes of vitrified embryos generated under growth hormone stimulation are improved for women categorized as poor-prognosis
Kevin N Keane1,2  , Yun Ye1,3, Peter M Hinchliffe1, Sheena LP Regan1,2,4, Satvinder S Dhaliwal5  , John L Yovich1,2 
1PIVET Medical Center, Perth, Australia
2Faculty of Health Sciences, School of Pharmacy and Biomedical Science, Curtin University, Perth, Australia
3Zhongshan People’s Hospital, Zhongshan City, China
4Stem Cell and Cancer Biology Laboratory, School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, Australia
5School of Public Health, Curtin University, Perth, Australia
Correspondence:  Kevin N Keane, Tel: +61-8-9422-5400, Fax: +61-8-9382-4576, 
Email: kevin.keane@curtin.edu.au
John L Yovich, Tel: +61-8-9422-5400, Fax: +61-8-9382-4576, 
Email: jlyovich@pivet.com.au
Received: 11 April 2019   • Revised: 3 June 2019   • Accepted: 19 July 2019
*Kevin N Keane and Yun Ye contributed equally to this study as co-first authors.
Abstract
Objective
To determine the clinical pregnancy (CP) and live birth (LB) rates arising from frozen embryo transfers (FETs) that had been generated under the influence of in vitro fertilization (IVF) adjuvants given to women categorized as poor-prognosis.
Methods
A registered, single-center, retrospective study. A total of 1,119 patients with first FETs cycle include 310 patients with poor prognosis (109 treated with growth hormone [GH], (+)GH group vs. 201 treated with dehydroepiandrosterone, (–)GH group) and 809 patients with good prognosis (as control, (–)Adj (Good) group).
Results
The poor-prognosis women were significantly older, with a lower ovarian reserve than the (–)Adj (Good) group, and demonstrated lower chances of CP (p<0.005) and LB (p<0.005). After adjusting for confounders, the chances of both CP and LB in the (+)GH group were not significantly different from those in the (–)Adj (Good) group, indicating that the poor-prognosis patients given GH had similar outcomes to those with a good prognosis. Furthermore, the likelihood of LB was significantly higher for poor-prognosis women given GH than for those who did not receive GH (p<0.028). This was further confirmed in age-matched analyses.
Conclusion
The embryos cryopreserved from fresh IVF cycles in which adjuvant GH had been administered to women classified as poor-prognosis showed a significant 2.7-fold higher LB rate in subsequent FET cycles than a matched poor-prognosis group. The women with a poor prognosis who were treated with GH had LB outcomes equivalent to those with a good prognosis. We therefore postulate that GH improves some aspect of oocyte quality that confers improved competency for implantation.
Key Words: Adjuvants; Autologous; Dehydroepiandrosterone; Melatonin; Single embryo transfer; Vitrified embryos
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