Lack of insulin-like growth factor binding protein-3 variation after follicle-stimulating hormone stimulation in women with polycystic ovary syndrome undergoing in vitro fertilization.
OBJECTIVE
To investigate serum and follicular fluid (FF) insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) behavior in superstimulated cycles in patients with polycystic ovary syndrome (PCOS).


METHODS
Controlled clinical study.


METHODS
Department of Obstetrics and Gynecology, University of Naples.


METHODS
Thirty-two patients with regular menses and tubal and/or male factor infertility and 21 patients with PCOS undergoing IVF.


METHODS
The IVF program used leuprolide acetate suppression followed by sequential hMG in the subsequent cycle. After follicular development, hCG administration was followed 34-36 hours later by oocyte retrieval.


METHODS
E2, GH, IGF-I, and IGFBP-3 assayed by RIA and immunoradiometric assay.


RESULTS
The controls and patients with PCOS showed similar increases in E2 and GH titers in response to FSH stimulation. Serum IGF-I did not change in either group and was equivalent in the FF. Patients with PCOS had a higher FF IGFBP-3 titer and did not show the decrease in serum IGFBP-3 levels of the control group after FSH stimulation.


CONCLUSIONS
The apparent failure of IGFBP-3 reduction in patients with PCOS alters IGF-I bioavailability. Increased sequestration of IGF-I affects ovarian steroidogenesis and may explain the poor response to gonadotropin stimulation.
Amato
G
G
Department of Endocrinology, Second University of Naples, Italy.
Izzo
A
A
Tucker
A T
AT
Bellastella
A
A
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000209:etiology / Q000628:therapy*; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D016729:Leuprolide / Q000627:therapeutic use; D008297:Male; D008596:Menotropins / Q000627:therapeutic use; D011085:Polycystic Ovary Syndrome / Q000150:complications*
D006063:Chorionic Gonadotropin; D018972:Insulin-Like Growth Factor Binding Protein 3; D019382:Human Growth Hormone; D004958:Estradiol; D008596:Menotropins; D007334:Insulin-Like Growth Factor I; D005640:Follicle Stimulating Hormone; D016729:Leuprolide