Growth hormone administration to improve reproductive outcomes in women with Recurrent Implantation Failure (RIF): a systematic review

Abstract

Recurrent implantation failure (RIF) has been used to describe embryos' failure to implant following IVF, arising concerns to the importance of its treatment. Growth hormone (GH) has been studied as one of the possible co-interventions. Our updated review evaluated GH intervention vs. No intervention from randomized controlled trials (RCTs) in RIF patients. Electronic searches on The Menstrual Disorders and Subfertility Group (MDSG), The Cochrane Central Register for Clinical Trials, PubMed MEDLINE, Ovid EMBASE, PsycINFO, CINAHL, LILACS. and Google Scholar up to June 2020 identified 2 RCTs, compiled with the above inclusion criteria. The Risk of Bias (RoB) and the quality of evidence was assessed according to the Cochrane Collaboration tool and GRADE group guidelines. Metanalysis found higher rates of clinical pregnancy (OR: 4.97 CI 95% 2.05 to 12.05 I^2:0%), live birth (OR: 5.13 CI 95% 2.03 to 12.91 I^2:0%), when compared GH to No intervention. However, this review cannot provide a strong recommendation due to the quality of evidence rated as "very low quality of evidence" in all the outcomes we selected, therefore we recommend all physicians to individualize each patient in their need or possible benefit with this co-intervention. We emphasize the importance of upcoming research in RIF patients, which may be a minority; it is still one of the highest impacts on life quality.