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Background: Oxidative stress (OS), defined as an imbalance between excessive reactive oxygen species (ROS) and/or reactive nitrogen species (RNS) production and antioxidant insufficiency, has been suggested to be involved in the pathogenesis of poor ovarian response (POR). Growth hormone (GH) can reduce OS in some cell types. This study investigated whether GH can improve OS and the in vitro fertilization and embryo transfer (IVF-ET) outcomes of poor ovarian responders.
Methods: This study enrolled 105 patients with POR and 58 patients without POR (controls) who were diagnosed according to the Bologna criteria and underwent conventional IVF-ET. Poor ovarian responders were randomly assigned to two groups: the POR-GH group, which received pretreatment with GH 4 IU/d on day 2 of the previous menstrual cycle before IVF until the trigger day, and the POR-C group, which received no pretreatment. OS markers in follicular fluid (FF), ROS levels in granulosa cells (GCs), and the IVF outcomes of the groups were compared.
Result(s): Endometrial thickness on trigger day, the number of cleaved embryos, the number of higher-quality embryos, and the rates of embryo formation, higher-quality embryo formation, implantation and clinical pregnancy were significantly increased in the POR-GH group compared with the POR-C group (P < 0.05). Moreover, compared to those in the non-POR group, FF malondialdehyde (MDA), total oxidant status (TOS), oxidative stress index (OSI) and ROS levels in GCs were significantly higher, whereas superoxide dismutase (SOD) and the total antioxidant capacity (TAC) were significantly lower in the POR-C group (P < 0.05). Furthermore, compared with those in the POR-C group, the FF TAC was significantly increased in the POR-GH group, and TOS, OSI and intracellular ROS levels were significantly reduced (P < 0.05).
Conclusion(s): Pretreatment with GH alleviates OS and improves oocyte quality and IVF outcomes of poor ovarian responders.
Clinical Trial Registration: Chinese Clinical Trial Registry. ChiCTR1900021269. Registered 8 February 2019, http://www.chictr.org.cn/edit.aspx?pid=35837&htm=4.
Keywords
Poor ovarian response, in vitro fertilization, growth hormone, oxidative stress, reactive oxygen species
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CURRENT STATUS: Published
View the published article at Reproductive Biology and Endocrinology.
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Editorial decision: Accept
On 23 Aug, 2020
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On 16 Aug, 2020
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On 15 Aug, 2020
Editor invited
On 15 Aug, 2020
Version 3
Posted 15 Jul, 2020
No comments provided
Editorial decision: Accept but Needs Editing
On 12 Aug, 2020
Review #1 received
Received 03 Aug, 2020
Reviewer #1 agreed
On 29 Jul, 2020
Reviewers invited
Invitations sent on 26 Jul, 2020
Editor assigned
On 08 Jul, 2020
Submission checks complete
On 07 Jul, 2020
Editor invited
On 07 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 21 Jun, 2020
Review #1 received
Received 19 Jun, 2020
Reviewer #1 agreed
On 15 Jun, 2020
Reviewers invited
Invitations sent on 14 Jun, 2020
Editor assigned
On 24 May, 2020
Submission checks complete
On 23 May, 2020
Editor invited
On 23 May, 2020
No comments provided
Editorial decision: Major revision
On 03 May, 2020
Review #1 received
Received 21 Apr, 2020
Reviewer #1 agreed
On 16 Apr, 2020
Reviewers invited
Invitations sent on 06 Apr, 2020
Editor assigned
On 13 Mar, 2020
First submitted
On 12 Mar, 2020
Submission checks complete
On 12 Mar, 2020
Editor invited
On 12 Mar, 2020
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Subject Areas
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See the published version of this preprint at Reproductive Biology and Endocrinology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Reproductive Biology and Endocrinology.
No community comments so far
Editorial decision: Accept
On 23 Aug, 2020
Editor assigned
On 16 Aug, 2020
Submission checks complete
On 15 Aug, 2020
Editor invited
On 15 Aug, 2020
Version 3
Posted 15 Jul, 2020
No comments provided
Editorial decision: Accept but Needs Editing
On 12 Aug, 2020
Review #1 received
Received 03 Aug, 2020
Reviewer #1 agreed
On 29 Jul, 2020
Reviewers invited
Invitations sent on 26 Jul, 2020
Editor assigned
On 08 Jul, 2020
Submission checks complete
On 07 Jul, 2020
Editor invited
On 07 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 21 Jun, 2020
Review #1 received
Received 19 Jun, 2020
Reviewer #1 agreed
On 15 Jun, 2020
Reviewers invited
Invitations sent on 14 Jun, 2020
Editor assigned
On 24 May, 2020
Submission checks complete
On 23 May, 2020
Editor invited
On 23 May, 2020
No comments provided
Editorial decision: Major revision
On 03 May, 2020
Review #1 received
Received 21 Apr, 2020
Reviewer #1 agreed
On 16 Apr, 2020
Reviewers invited
Invitations sent on 06 Apr, 2020
Editor assigned
On 13 Mar, 2020
First submitted
On 12 Mar, 2020
Submission checks complete
On 12 Mar, 2020
Editor invited
On 12 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Endocrinology & Metabolism
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Reproductive Biology and Endocrinology.
Background: Oxidative stress (OS), defined as an imbalance between excessive reactive oxygen species (ROS) and/or reactive nitrogen species (RNS) production and antioxidant insufficiency, has been suggested to be involved in the pathogenesis of poor ovarian response (POR). Growth hormone (GH) can reduce OS in some cell types. This study investigated whether GH can improve OS and the in vitro fertilization and embryo transfer (IVF-ET) outcomes of poor ovarian responders.
Methods: This study enrolled 105 patients with POR and 58 patients without POR (controls) who were diagnosed according to the Bologna criteria and underwent conventional IVF-ET. Poor ovarian responders were randomly assigned to two groups: the POR-GH group, which received pretreatment with GH 4 IU/d on day 2 of the previous menstrual cycle before IVF until the trigger day, and the POR-C group, which received no pretreatment. OS markers in follicular fluid (FF), ROS levels in granulosa cells (GCs), and the IVF outcomes of the groups were compared.
Result(s): Endometrial thickness on trigger day, the number of cleaved embryos, the number of higher-quality embryos, and the rates of embryo formation, higher-quality embryo formation, implantation and clinical pregnancy were significantly increased in the POR-GH group compared with the POR-C group (P < 0.05). Moreover, compared to those in the non-POR group, FF malondialdehyde (MDA), total oxidant status (TOS), oxidative stress index (OSI) and ROS levels in GCs were significantly higher, whereas superoxide dismutase (SOD) and the total antioxidant capacity (TAC) were significantly lower in the POR-C group (P < 0.05). Furthermore, compared with those in the POR-C group, the FF TAC was significantly increased in the POR-GH group, and TOS, OSI and intracellular ROS levels were significantly reduced (P < 0.05).
Conclusion(s): Pretreatment with GH alleviates OS and improves oocyte quality and IVF outcomes of poor ovarian responders.
Clinical Trial Registration: Chinese Clinical Trial Registry. ChiCTR1900021269. Registered 8 February 2019, http://www.chictr.org.cn/edit.aspx?pid=35837&htm=4.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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