Lack of insulin-like growth factor binding protein-3 variation after follicle-stimulating hormone stimulation in women with polycystic ovary syndromeundergoing in vitro fertilization

Objective: To investigate serum and follicular fluid (FF) insulin-like grow th factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP -3) behavior in superstimulated cycles in patients with polycystic ovary sy ndrome (PCOS). Design: Controlled clinical study. Setting: Department of Obstetrics and Gynecology, University of Naples. Patient(s): Thirty-two patients with regular menses and tubal and/or male f actor infertility and 21 patients with PCOS undergoing IVF. Intervention(s): The IVF pro,sram used leuprolide acetate suppression follo wed by sequential hMG in the subsequent cycle, After follicular development , hCG administration was followed 34-36 hours later by oocyte retrieval. Main Outcome Measure(s): E-2, GH, IGF-I, and IGFBP-3 assayed by RIA and imm unoradiometric assay. Result(s): The controls and patients with PCOS showed similar increases in E-2 and GH titers in response to FSH stimulation. Serum IGF-I did not chang e in either group and was equivalent in the FF. Patients with PCOS had a hi gher FF IGFBP-3 titer and did not show the decrease in serum IGFBP-3 levels of the control group after FSH stimulation. Conclusion(s): The apparent failure of IGFBP-3 reduction in patients with P COS alters IGF-I bioavailability. Increased sequestration of IGF-I affects ovarian steroidogenesis and may explain the poor response to gonadotropin s timulation. (Fertil Steril(R) 1999;72:454-7. (C) 1999 by American Society f or Reproductive Medicine.)