title: Gonadotropin-releasing hormone antagonists increase follicular fluid insulin-like growth factor-I and vascular endothelial growth factor during ovarian stimulation cycles.
abstract: The aim of the present study was to investigate the effect of gonadotropin-releasing hormone (GnRH) antagonists (GnRH-ant) on follicular fluid (FF) insulin-like growth factor-I (IGF-I) and FF vascular endothelial growth factor (VEGF) levels. Sixty women undergoing assisted reproduction were randomized and assigned to two different GnRH analog regimens: GnRH agonist (GnRH-a) and GnRH-ant. FF VEGF and FF IGF-I concentrations were significantly increased in the patients treated with GnRH-ant (p < 0.001). In the same patients we observed a statistically significant reduction in serum luteinizing hormone (LH) and estradiol (E2) levels (p < 0.001 and p < 0.05, respectively), FF E2 and FF androstenedione levels (p < 0.05 and p < 0.001, respectively), as well as a reduction in the number of pregnancies although this was not statistically significant. In the GnRH-ant group, FF VEGF levels were positively correlated with FF IGF-I levels, and both were negatively correlated with serum LH levels. The increase in FF IGF-I and FF VEGF levels in women treated with GnRH-ant could be explained by a deleterious follicular environment in response to profound suppression of LH and E2 levels.
authors.affiliation: Centre for Reproductive Medicine, Department of Obstetrics, Gynaecology and Neonatology, University of Parma, Parma, Italy. bruno.ferrari@unipr.it
authors.forename: Bruno
authors.initials: B
authors.lastname: Ferrari
authors.forename: Antonio
authors.initials: A
authors.lastname: Pezzuto
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Barusi
authors.forename: Francesco
authors.initials: F
authors.lastname: Coppola
mesh_terms: D000328:Adult; D000735:Androstenedione / Q000097:blood; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D004958:Estradiol / Q000097:blood; D005260:Female; D015571:Follicular Fluid / Q000737:chemistry*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000819:agonists / Q000031:analogs & derivatives / Q000037:antagonists & inhibitors*; D006801:Humans; D007246:Infertility / Q000628:therapy; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D016729:Leuprolide / Q000008:administration & dosage; D007986:Luteinizing Hormone / Q000097:blood; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis*
chemical_list: D006063:Chorionic Gonadotropin; D042461:Vascular Endothelial Growth Factor A; D007987:Gonadotropin-Releasing Hormone; D000735:Androstenedione; D004958:Estradiol; D007334:Insulin-Like Growth Factor I; D007986:Luteinizing Hormone; D016729:Leuprolide; C062876:cetrorelix