Growth Hormone’s Impact on Oxidative Stress, Ovarian Response, and <i>In Vitro</i> Fertilization in Polycystic Ovary Syndrome Across Different Ages

<b>Aims/Background</b> Growth hormone (GH) supplementation contributes to improved reproductive and pregnancy outcomes in <i>in vitro</i> fertilization (IVF)-embryo transfer (ET) in polycystic ovary syndrome (PCOS) women. This study aimed to explore the effects of GH on the oxidative stress, ovarian reactivity, and pregnancy outcomes of IVF-ET in PCOS patients of different ages. <b>Methods</b> The clinical data of 342 women with PCOS undergoing <i>in vitro</i> fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) were collected for retrospective analysis. Based on age, patients were divided into three groups: <35 years (n = 118), 35-40 years (n = 120), and >40 years (n = 104). Each age group was further subdivided into a GH subgroup and a control subgroup, according to whether GH was supplemented during ovarian stimulation. Ovarian stimulation parameters and IVF/ICSI-ET outcomes were recorded. Levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in both follicular fluid and serum were measured using commercial assay kits. <b>Results</b> In the 35-40 years group, the total number of oocytes retrieved, metaphase II (MII) oocytes, and ovarian sensitivity index (OSI) were significantly higher in the GH group compared to the control group (<i>p</i> = 0.012, 0.049, 0.006, respectively). In the >40 years group, the total number of oocytes retrieved and OSI were also significantly increased in the GH group compared to the control group (<i>p</i> = 0.001, 0.002, respectively). In the <35, 35-40, and >40 years groups, the serum SOD level on the trigger day was significantly higher in the GH groups than in the control groups (<i>p</i> = 0.004, 0.001, 0.012, respectively), while the serum MDA level was significantly lower (<i>p</i> = 0.032, 0.015, 0.004, respectively). In the 35-40 and >40 years groups, the fertilization rate was significantly higher in the GH subgroups compared to the control subgroups (<i>p</i> = 0.040, 0.001, respectively). A total of 43 ET cycles were cancelled, and 299 ET cycles were analyzed. In the 35-40 years group, the GH subgroup showed a significantly higher pregnancy rate compared to the control subgroup (<i>p</i> = 0.043); although the live birth rate was slightly higher, the difference was not statistically significant (<i>p</i> = 0.064). In the <35 years and >40 years groups, no significant differences were observed in pregnancy rate, miscarriage rate, or live birth rate between the GH and control subgroups (<i>p</i> > 0.05). <b>Conclusion</b> GH improves serum oxidative stress and ovarian reactivity in women with PCOS, and increases both the number of oocytes retrieved and the fertilization rate in those aged ≥35 years. Additionally, GH increases the pregnancy rate in PCOS patients aged 35-40 years, although it does not show a significant benefit in live birth rate.