生殖医学杂志

目的 探讨重组人生长激素(GH)注射液能否改善早发性卵巢功能不全(POI)的不孕症患者辅助生殖技术助孕的妊娠结局。方法 选取2022年5月至2024年8月广西壮族自治区生殖医院收治的不孕症中诊断为POI的648例患者作为研究对象，根据在控制性卵巢刺激(COS)过程中是否添加GH,将患者分为A组(添加GH,n=78)和B组(未添加GH,n=570)。比较两组患者的基本资料、COS相关资料、受精情况以及妊娠结局。结果 两组患者间年龄、体质量指数(BMI)、不孕年限、基础卵泡数、基础性激素[FSH、 LH、雌二醇(E₂)]水平、受精方式等一般资料比较均无显著性差异(P>0.05)。两组患者的COS方案中占比最大者均为拮抗剂方案；A组启动日LH水平显著低于B组，而促性腺激素(Gn)启动剂量及总量显著高于B组，获卵数亦显著高于B组(P<0.05)。A组受精卵数显著高于B组，而D3优胚率显著低于B组(P<0.05)。两组患者间临床妊娠率比较无显著性差异(P>0.05)。结论 在POI不孕患者COS过程中添加GH可增加获卵数和受精卵数，但对临床妊娠结局无显著改善，GH对POI患者临床结局的影响仍需进一步探讨。

Objective:To investigate the potential of recombinant human growth hormone(GH) in improving the pregnancy outcomes of infertile patients with premature ovarian insufficiency(POI) undergoing assisted reproductive technology(ART).Methods:A total of 648 patients diagnosed with POI at the Reproductive Hospital of Guangxi Zhuang Autonomous Regionl from May 2022 to August 2024 were selected as study subjects. Patients were divided into two groups based on whether GH was added during the controlled ovarian stimulation(COS) process: group A(GH added, n=78) and group B(no GH added, n=570). The study compared the data of the two groups, including baseline characteristics, the COS strategy, the fertilization status and pregnancy outcomes.Results:There were no significant differences between the two groups in terms of age, body mass index(BMI),the duration of infertility, baseline number of follicles, and baseline levels of hormonal indicators [FSH,LH,estradiol(E₂)](P>0.05),fertilization methods. In terms of the COS strategy, the antagonist protocol was the most common in both groups. Group A had significantly lower LH levels on the initiating day, higher initiating doses, higher total gonadotropin(Gn) usage and higher numbers of oocytes retrieved when compared with group B(P<0.05). In terms of fertilization, group A had a significantly higher number of fertilized oocytes and a significantly lower rate of high-quality embryos on Day 3 when compared with group B(P<0.05). There was no significant difference in clinical pregnancy rates between the two groups(23.53% vs. 17.02%,P>0.05).Conclusions:In the ART process for patients with POI,GH can increase the number of both oocytes retrieved and fertilized oocytes, but it does not significantly improve clinical pregnancy outcomes. The impact of GH on clinical outcomes in POI patients requires further exploration.