To Explore the Effect of GH Pretreatment on Clinical Outcomes in Patients With Low Ovarian Reserve

Study Overview
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Brief Summary
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Growth hormone (GH) has been used in the field of assisted reproduction technology for over 30 years. Studies for GH have been exploring in the applicable population, drug dosage, starting time and time limitation. In previous clinical applications, it worked as an adjuvant drug for improving ovarian reactivity. With the development of basic research and clinical applications, the improvement effect on egg quality is gradually recognized. However, which protocol of GH may work well and maximize the clinical effect remains mystery. The investigators' previous self-controlled retrospective research about 380 cases treated with GH found that the average daily injection of GH dose of 2IU for about 6 weeks can significantly improve embryo quality and clinical pregnancy outcomes of the patients with low ovarian response. The new POSEIDON standard clearly groups people with low prognosis and better classifies heterogeneous people, which may help classifying the specific subgroup that benefit most from GH of poor ovarian response (POR). The investigators design a prospective cohort study to explore whether GH low-dose long-term pretreatment can improve the outcome of assisted pregnancy and its possible mechanism in people with low ovarian reserve.

Official Title
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To Explore the Effect of Low-dose Long Term Growth Hormone Pretreatment on Clinical Pregnancy Outcomes in Patients With Low Ovarian Reserve

Conditions
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GH, Low Ovarian Reserve

Intervention / Treatment
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* Drug: growth hormone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: low ovarian reserve(AMH <1.2ng/ml, or AFC <5); patients who have not participated in any clinical trials within the three months; patients who voluntarily signed informed consent. Exclusion Criteria: patients with BMI ≥30kg/m2; patients with medical diseases such as endocrine and metabolic diseases, autoimmune disease, etc; ovarian neoplasm that ≥4 cm in diameter and has no clear pathological diagnosis by surgery; complicated with adenomyosis, endometriosis confirmed by surgery; patients with untreated abnormal intrauterine environment, such as uterine effusion, endometritis, etc; untreated hydrosalpinx.
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| GH group<br>GH group: Participants diagnosed POR according to POSEIDON criteria with low ovarian reserve undergo IVF in our center with long protocol or antagonist protocol and is adjuvant with GH 2IU/d from previous menstrual period for about six weeks. | Drug: growth hormone<br>* growth hormone was adjuvanted 2IU/d from previous menstrual period for about six weeks.<br>|
| NGH group<br>NGH (non-GH) group: Participants diagnosed POR according to POSEIDON criteria with low reserve undergo IVF in our center with long protocol or antagonist protocol without GH adjuvant. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| rate of good quality embryos | the number of good quality embryos divide by the number of transferrable embryos | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| number of oocytes retrieved | number of oocytes retrieved | 2 years | 
| fertilization rate | the fertilized oocytes divided by the number of oocytes retrieved | 2 years | 
| clinical pregnancy rate | the patients confirmed clinical pregnancy divided by the patients undergoing fresh embryo transferred. | 2 years | 
| live birth rate | the patients have a live birth divided by the patients undergoing fresh embryo transferred. | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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GH, low ovarian reserve, POSEIDON