Serum insulin-like growth factor I (IGF-I) and IGF-binding protein 3 (IGFBP-3) in IVF patients with polycystic ovary syndrome: correlations with outcome.
OBJECTIVE
To evaluate serum insulin-like growth factor I (IGF-I) and IGF-binding protein 3 (IGFBP-3) levels during stimulation in polycystic ovary syndrome (PCOS) and control populations as factors predictive of IVF outcome.


METHODS
Observational study.


METHODS
Academic medical center-based IVF practice.


METHODS
Forty-three PCOS and 33 male-factor control patients undergoing IVF from 2002 to 2004.


METHODS
Treatment with a dual suppression protocol incorporating oral contraceptive pills (OCPs) and GnRH agonist suppression followed by low-dose gonadotropin therapy.


METHODS
The PCOS and control patients' serum IGF-I and IGFBP-3 levels were compared and correlated with IVF outcome.


RESULTS
PCOS and control patients were comparable in terms of demographics and IVF outcome. In both, mean serum IGF-I levels increased during stimulation. PCOS patients whose IGF-I levels decreased from day 3 to day of hCG had a significantly higher mean number of immature oocytes retrieved (4.8 +/- 1.1 vs. 2.4 +/- 0.4; P=.02). IGFBP-3 levels increased during stimulation in PCOS patients but tended to decrease in control patients. In PCOS patients, an increase in IGFBP-3 levels during stimulation was associated with a greater likelihood of becoming pregnant (P=.03) and of ongoing pregnancy (P=.02).


CONCLUSIONS
The bioavailability of IGF-I appears to play a key role in oocyte maturation in PCOS patients. Alterations in IGFBP-3 concentration during stimulation may be a critical mechanism in modulating IGF-I activity.
Schoyer
Katherine D
KD
Center for Reproductive Medicine and Infertility, Weill Cornell Medical College, New York, New York, USA. kgd2002@med.cornell.edu
Liu
Hung-Ching
HC
Witkin
Steven
S
Rosenwaks
Zev
Z
Spandorfer
Steven D
SD
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D010062:Ovulation Induction / Q000379:methods; D011085:Polycystic Ovary Syndrome / Q000097:blood*; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends; D011446:Prospective Studies
D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I