Growth Hormone in IVF Over 40: Unlocking Potential or Opening Pandora's Box?

Background: Women over 40 undergoing IVF often face challenges due to diminished ovarian reserve and declining oocyte quality, leading to lower IVF success rates. Growth Hormone has been investigated as an adjuvant therapy to potentially improve outcomes in this population. Objective: This review presents a SWOT analysis to evaluate the Strengths, Weaknesses, Opportunities, and Threats associated with the use of GH as an adjunct in IVF treatment specifically for women over 40. Methods: A comprehensive review of existing literature, including clinical trials, meta-analyses, and relevant studies, was conducted to identify key factors influencing the efficacy and safety of GH in this context. These factors were then categorized into Strengths, Weaknesses, Opportunities, and Threats. We also ended this narrative review with a debate to clarify the entailed arguments and controversies.Results: Strengths of GH supplementation may include enhanced ovarian response, improved oocyte quality, and increased implantation rates in some patients. Weaknesses comprise inconsistent evidence, potential side effects, and higher costs. Opportunities lie in identifying specific patient subgroups that benefit most, optimizing treatment protocols, and exploring combination therapies. Threats include the risk of publication bias, ethical concerns regarding unproven therapies, and the potential for widespread, ineffective use of adjuvants. Conclusion: GH use in IVF for women over 40 presents a complex risk-benefit profile. While it may offer advantages for women over 40, further research is crucial to define its role, optimize its application, and ensure informed clinical decision-making. A balanced consideration of the SWOT factors is essential for both clinicians and patients.