title: 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.
abstract: 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.
authors.affiliation: Center for Reproductive Medicine and Infertility, Weill Cornell Medical College, New York, New York, USA. kgd2002@med.cornell.edu
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Schoyer
authors.forename: Hung-Ching
authors.initials: HC
authors.lastname: Liu
authors.forename: Steven
authors.initials: S
authors.lastname: Witkin
authors.forename: Zev
authors.initials: Z
authors.lastname: Rosenwaks
authors.forename: Steven D
authors.initials: SD
authors.lastname: Spandorfer
mesh_terms: 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
chemical_list: D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I