The Impact of Growth Hormone Supplementation on Ovarian Response and IVF Outcomes in Poor Responders: A Prospective Observational Study

Abstract

Background: Poor ovarian response (POR) is a significant challenge in in-vitro fertilization (IVF) treatment, characterized by a limited number of oocytes retrieved, poor embryo quality, and reduced pregnancy rates. Growth hormone (GH) supplementation has been proposed as a potential adjunct therapy to improve ovarian response and reproductive outcomes in poor responders. This study aimed to evaluate the effectiveness of GH supplementation in enhancing ovarian response and IVF outcomes in poor responders. Methods: This single-centre prospective observational study was conducted at the Department of Reproductive Medicine, SAIMS, Indore. A total of 40 women diagnosed as poor responders according to the Bologna criteria were enrolled in the study. Participants were divided into two groups: the intervention group (n=10), which received GH supplementation alongside standard ovarian stimulation, and the control group (n=30), which underwent standard IVF treatment without GH. The primary outcome was the number of mature oocytes retrieved, while secondary outcomes included fertilization rate, embryo quality, blastocyst formation, implantation rate, and clinical pregnancy rate. Data were analyzed using Stata 17.0. Results: The intervention group showed a significant improvement in the number of mature oocytes retrieved (5.0 ± 1.2 vs. 3.4 ± 1.1, p < 0.05). The fertilization rate was higher in the GH group (71.2% ± 9.3%) compared to the control group (63.8% ± 8.7%, p < 0.05). Embryo quality on Day 3 and blastocyst formation on Day 5 were significantly improved in the GH group (p < 0.05). While the implantation rate was higher in the GH group (38.0% ± 7.5% vs. 29.2% ± 6.8%, p < 0.05), the clinical pregnancy rate showed a trend toward improvement but was not statistically significant (30% vs. 20%, p = 0.08). No significant adverse events were reported. Conclusion: GH supplementation significantly improves ovarian response, oocyte quality, and early reproductive outcomes in poor responders undergoing IVF. Although the clinical pregnancy rate did not reach statistical significance, the overall trend suggests that GH may offer a beneficial adjunctive treatment for improving IVF success rates in this challenging patient population. Keywords: Poor ovarian response, growth hormone, IVF, oocyte quality, fertilization rate, clinical pregnancy