Comparisons of follicular levels of sex steroids, gonadotropins and insulin like growth factor-1 (IGF-1) and epidermal growth factor (EGF) in poor responder and normoresponder patients undergoing ovarian stimulation with GnRH antagonist.
OBJECTIVE
To determine the serum and intrafollicular concentrations of sex steroids, epidermal growth factor (EGF) and insulin like growth factor-1 (IGF-1) in women demonstrating poor response to ovarian stimulation with gonadotropins and GnRH antagonists, and to compare the results with age-matched women displaying normal ovarian response.


METHODS
This is a prospective cross-sectional study conducted in a private IVF center. Forty-eight age-matched women producing 5 or fewer oocytes (poor responders) or 10 or more oocytes (normoresponders) at the end of controlled ovarian stimulation for assisted conception participated in the experiment. Gonadotropins and GnRH antagonists were used for ovarian stimulation, while ICSI was employed for assisted fertilization. Serum and follicular concentrations of FSH, LH and sex steroids (estradiol, progesterone and testosterone), and follicular concentrations of EGF and IGF-1 were assayed in both groups.


RESULTS
Serum and follicular levels of E(2) and progesterone were significantly lower in the poor responder group compared to the normoresponder group. Follicular level of testosterone was also lower in poor responders, but not to a level of statistical significance. The serum FSH level was higher in the poor responder group, but follicular levels of gonadotropins did not differ between the two groups. The follicular level of IGF-1 was significantly lower in poor responders. In contrast, the EGF concentration did not differ between the two groups.


CONCLUSIONS
Decreased levels of sex steroids in poor responder patients undergoing COH with GnRH antagonist, suggests that reduced IGF-1 expression acts as a modulator of impaired ovarian steroidogenesis.
Bahceci
Mustafa
M
Bahceci Women Health Care Center and German Hospital in Istanbul, Turkey. mbahceci@superonline.com
Ulug
Ulun
U
Turan
Ersadik
E
Akman
Mehmet Ali
MA
D000328:Adult; D015415:Biomarkers; D003430:Cross-Sectional Studies; D004815:Epidermal Growth Factor / Q000378:metabolism; D004958:Estradiol / Q000097:blood / Q000378:metabolism; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000494:pharmacology; D006065:Gonadotropins, Pituitary / Q000097:blood / Q000378:metabolism; D006727:Hormone Antagonists / Q000494:pharmacology*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D006080:Ovarian Follicle / Q000187:drug effects* / Q000378:metabolism; D010062:Ovulation Induction; D011374:Progesterone / Q000097:blood / Q000378:metabolism; D011446:Prospective Studies; D020554:Sperm Injections, Intracytoplasmic; D013739:Testosterone / Q000097:blood / Q000378:metabolism; D016896:Treatment Outcome
D015415:Biomarkers; D006065:Gonadotropins, Pituitary; D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D004815:Epidermal Growth Factor; D007334:Insulin-Like Growth Factor I; C062876:cetrorelix