Impact of Human Growth Hormone on Ivf Outcomes in Patients With Diminished Ovarian Reserve

Objective: This study aimed to determine whether adjuvant hGH therapy improves live birth rates and blastocyst yield per cycle in patients with diminished ovarian reserve (DOR) undergoing IVF compared to untreated controls. Design: A single-center retrospective chart review of IVF cycles using a GnRH antagonist protocol at SpringCreek Fertility (2015–2024). Materials and Methods: 816 patients meeting DOR criteria based on AMH, FSH, and AFC thresholds, stratified into an hGH treatment group (n = 614) and a control group (n = 202). Continuous variables were compared using independent or Welch’s t-tests, categorical variables with chi-square tests, and multivariable regression models adjusted for age, AMH, FSH, and BMI. Results: Baseline characteristics differed between groups, with hGH-treated patients being older and having lower AMH levels, with a greater proportion meeting POSEIDON Group 4 criteria. No statistically significant differences were observed in live birth rates per retrieval (27.7% no-hGH vs. 27.9% hGH; p = 1.0) or mean blastocysts per cycle (2.0 ± 1.9 vs. 1.9 ± 1.9; p = 0.598). Exploratory POSEIDON subgroup analyses suggested age-dependent effects, whereby younger patients (Group 3, <35 years) experienced a clinically meaningful 10-point improvement in live birth rates with hGH, whereas no benefit was observed among older patients (Group 4, ≥35 years). Conclusions: Adjuvant hGH co-treatment was not associated with improved live birth rates or blastocyst yield among DOR patients undergoing IVF in this retrospective cohort. Exploratory subgroup analyses identified a possible clinically meaningful benefit in younger patients (POSEIDON Group 3), supporting the need for prospective, controlled trials to further evaluate age-stratified hGH response. Notably, the preferential use of hGH in patients with poorer prognostic features may have introduced selection bias, potentially obscuring a true treatment effect in the overall analysis.