Recently a study was published in May 2022. in the journal of Human Reproduction. The article, “Administration of growth hormone improves endometrial function in women undergoing in vitro fertilization,” suggests that treatment with growth hormone in IVF is associated with improved reproductive outcomes. They are mediated mainly by an effect on endometrial function, especially in poor responders.
Growth hormone modulates endometrium function through endometrial growth factors. The mechanism improves cell proliferation, tissue vascularisation, and endometrial receptivity. The meta-analysis recommendations for increasing the CPR were in line with those for increasing endometrial thickness (EMT )rather than improving the quality of oocytes and embryos. Therefore, GH may promote fertility by improving endometrial quality.
GH mediates IGF-1 or upregulates the expression of related receptor molecules through the Janus. Kinase/signal transduction activator of transcription pathway. Growth hormone increases receptivity-related genes, such as vascular endothelial growth factor and integrin b3 (Hannan et al., 2011; Kaneko et al., 2011), which leads to modified cell proliferation.
GH administration combined with the GnRH agonist long protocol increased the cumulative pregnancy rate, endometrial thickness, and the number of transferred embryos among poor responders.
There might be a dose- and time-dependent relationship between different GH protocols and IVF outcomes in poor responders. Therefore, Cotreatment with the GnRH agonist long protocol might provide even more benefits. The Dose is daily <5 IU during the cycle’s follicular phase for endometrial improvement. Poor responders for oocyte number improvement is 5-10 IU per day.