| Purpose: 1.To evaluate the effect of growth hormone preconditioning on in vitro fertilization in patients with poor ovarian response;2.The effect of growth hormone on mitochondria and membrane potential of hyporeactive granulosa cells was studied in vitro.Methods: This study is divided into two parts.The first part retrospectively analyzed 136 patients who were admitted to our center from April 2017 to October 2018,and all of them were diagnosed with poor ovarian response.The study population was divided into intergroup control and self-control according to the treatment method of growth hormone and the timing of growth hormone administration.There were 107 people in the control group,which were divided into the growth hormone preconditioning group,in which group GH was continuously applied for about 4 weeks before Gn administration and the number of people is 58.and the non-preconditioning group,in which group GH was discontinuously applied after Gn administration the number of people is 49.In the self-control group,29 patients were treated with growth hormone preconditioning after failure of transplantation or ovulation collection and all of them continuously applied GH for about 4 weeks before Gn administration.In intergroup control group,the total amount and the number of days of Gn administration,the number of retrieved oocytes,the number of embryos,the number of high quality embryos,the implantation rate,the biochemical pregnancy rate and the clinical pregnancy rate were compared.In the self-control group,the total amount and number of days of Gn administration,the number of retrieved oocytes,the number of embryos,the number of high-quality embryos,the number of biochemical pregnancy,the number of clinical pregnancy and transplantation rate were compared.In the second part,we investigated the effect of GH on mitochondrial and membrane potential in hyporeactive granulosa cells in vitro.First,Low-reactive granule cell model was treated with 5mg/L cisplatin.Then,the object of study were divided into three groups: fresh group,poor reaction group and GH treatment group.The number and morphology of granulosa cells were observed by light microscopy and stained with JC-1/PI staining solution,and the mitochondrial morphological changes of granulosa cells were observed by confocal microscopy and the differences in mitochondrial membrane potential were compared between groups.Results: Part I: In the intergroup control,the total Gn(2031.03±945.55)and the number of days of Gn use(8.93±2.53)in the pretreatment group were significantly less than the total Gn(3578.24±1277.56)and the number of days of Gn use(11.63±3.04)in the non-pretreatment group,and the number of embryos(2.38 ± 1.75),number of high-quality embryos(1.79 ± 1.41),transplantation rate(36.14%),biochemical pregnancy rate(55.17%),and clinical pregnancy rate(48.28%)were significantly higher than the number of embryos(1.76±1.01),high-quality embryo number(1.14±1.14),transplantation rate(18.97%),biochemical pregnancy rate(24.49%),and clinical pregnancy rate(18.37%)in the non-pretreatment group,and the differences were statistically significant(P<0.05).However,there was no significant difference(P>0.05)in the number of retrieved oocytes between the pretreatment group(4.98±3.10)and the non-pretreatment group(4.67±1.95).In the self-control group,the total amount and number of days of Gn administration were significantly decreased,and number of retrieved oocytes,number of embryos,number of high-quality embryos,number of biochemical pregnancy,number of clinical pregnancy and transplantation rate were significantly increased after treating with GH preconditioning,and the differences were statistically significant(P<0.05).Part II: Firstly,it was observed by light microscopy that the number of granulosa cells treated with 5 mg/L cisplatin was significantly reduced with morphological changes,and then the number of granule cells increased significantly with morphological recovery after GH intervention..In addition,mitochondrial membrane potential of granulosa cells treated with 5mg/L cisplatin was significantly lower than that of untreated group,and the difference was statistically significant(P < 0.05).Mitochondrial membrane potential of granulosa cells in cisplatin +GH treatment group was significantly higher than that in cisplatin treatment group(P < 0.05),and the difference was not statistically significant(P > 0.05).Conclusions: 1)growth hormone pretreatment can significantly improve the clinical outcome of in vitro fertilization in POR patients,and significantly reduce the total amount and days of Gn use.2)GH can improve mitochondrial function of granulosa cells,and increase membrane potential of mitochondria of low-reactive granulosa cells. |
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