Prolonged growth hormone pretreatment is associated with improved embryo quality in women with poor quality embryos in previous IVF cycles

Abstract

Abstract Background Approximately 10–15% of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles have most embryos of poor quality, often characterized by extensive anuclear cytoplasmic fragments. These cycles are usually associated with poor reproductive outcomes, including diminished implantation, clinical pregnancy, and live birth chance. Growth hormone (GH) has emerged as a potential adjuvant therapy to improve oocyte and embryo quality in these IVF cycles. However, the optimal duration of GH treatment in women with poor quality embryos remains unclear. Objective To evaluate whether prolonged GH pretreatment is associated with better IVF outcomes in women with poor quality embryos in previous cycles. Methods A retrospective cohort study was conducted at the Reproductive Center of the First Affiliated Hospital of Wenzhou Medical University, including women with poor embryo quality in previous IVF cycles. Patients were divided into three groups based on GH pretreatment duration: non-GH (Group A), 2–4 weeks GH (Group B), and 12 weeks GH (Group C). IVF outcomes, including D3 good-quality embryo rate, blastocyst formation rate, and fresh and cumulative live birth rates, were compared. Statistical analyses were performed using Kruskal–Wallis rank-sum tests and multivariate linear regression. Results Group C had significantly higher D3 good-quality embryo rate (46.17% ± 33.57%) compared with Group A (25.66% ± 25.41%, P < 0.001) and Group B (30.93% ± 25.45%, P = 0.02). Multivariate regression analysis confirmed that GH pretreatment for 12 weeks had significantly increased D3 embryo quality when compared with GH pretreatment for 2–4 weeks and no GH pretreatment. Additionally, Group B and C exhibited significantly higher blastocyst formation rates compared with Group A. Regarding the clinical outcomes, Group C achieved a significantly higher live birth rate following fresh embryo transfer (57.14%) than Group A (25.64%) ( P = 0.04), but had non significant higher cumulative live birth rate than group A and B. Conclusion Prolonged GH pretreatment for 12 weeks was associated with improved embryo quality in women with poor embryo quality in previous IVF cycles. Although a higher live birth rate was observed in fresh embryo transfer cycles, no significant improvement was found in cumulative live birth rate.