At ACFS, we have found one additional option that has proven successful in patients attempting IVF- that is the addition of human growth hormone or hGH to the treatment protocol. It is a known fact that hGH is a cogonadotrophin and, like FSH and LH, is absolutely needed for the full and final maturation of an egg. Although, if measured, a patient will have a normal level of hGH in the blood, some patients do not have enough hGH for all the extra eggs that they make. These patients are impossible to identify “up front” but young patients that make a lot of eggs and have poor fertilization rates or do not get pregnant as expected; or women over the age of 38-39, in ACFS experience, and backed up by the scientific literature, seem to have better success rates when adding hGH to their treatment protocol. At ACFS, it is now our policy that all women 38 or older are offered the option of using hGH, as part of their starting protocol for IVF.