Importance of IGF-I levels in IVF: potential relevance for growth hormone (GH) supplementation

Abstract

Purpose Growth hormone (GH) supplementation in association with in vitro fertilization (IVF) is worldwide again increasing, even though study outcomes have been discrepant. Since GH acts via insulin-like growth factor-1 (IGF-1), its utilization in IVF would only seem to make sense with low IGF-1. We, therefore, determined whether IGF-I levels affect IVF outcomes. Methods Retrospectively, 302 consecutive first fresh, non-donor IVF cycles were studied, excluding patients on GH supplementation. Patients were divided into 3 subgroups: IGF-1 in lower 25th percentile (group A, < 132 ng/mL, n = 64); 25th–75th percentile (B, 133–202 ng/mL, n = 164), and upper 25th percentile (C, > 202 ng/mL, n = 74). IGF-1 was tested immunochemiluminometric with normal range at 78–270 ng/mL. Because of the study patients’ adverse selection and low pregnancy chances, the main outcome measure for the study was cycle cancellation. Secondary outcomes were oocyte numbers, embryos transferred, pregnancies, and live births. Results Group A was significantly older than B and C (P = 0.019). IGF-1 decreased with increasing age per year by 2.2 ± 0.65 ng/mL (P = 0.0007). FSH was best in group B and worst in A (trend, P = 0.085); AMH was best in B and worst in A (N.S.). Cycle cancellations were lowest in C (11.6%) and highest in A (25.0%; P = 0.042). This significance further improved with age adjustment (P = 0.021). Oocytes, embryo numbers, pregnancies, and live birth rates did not differ, though oocyte numbers trended highest in B. Conclusions Here presented results support the hypothesis that IGF-1 levels affect IVF outcomes. GH treatments, therefore, may be effective only with low IGF-1.

Büyüme hormonu seviyeleri ile over rezervleri arasındaki ilişki

“…The median age was 35.5 (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) in Group-I, 29.5 (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) in Group-II, and 33.0 in Group-III, and the difference between the groups was statistically significant (p<0.001). The mean BMI was 23.55 in Group-I, 23.1 in Group-II, and 24.0 in Group-III (p=0.751).…”

“…A recent study about GH and infertility, investigated the pregnancy results depending on the serum IGF-1 levels (Groups; <25 th percentile, 25 th -75 th percentile, >75 th percentile) 37 . The cycle cancellation rates were highest in the IGF-1 <25 th percentile group.…”

Molecular crosstalk between insulin‐like growth factors and follicle‐stimulating hormone in the regulation of granulosa cell function

“… 242 In addition, serum IGF1 levels decline with age, which correlates with the well‐known decrease in fertility due to aging. 243 These findings underscore the close interaction between FSH and IGFs in regulating human follicle development.…”

Comparative efficacy of different growth hormone supplementation protocols in improving clinical outcomes in women with poor ovarian response undergoing assisted reproductive therapy: a network meta-analysis

“…Therefore, to enhance oocyte yield, it seems more appropriate to initiate GH co-treatment before commencing ovarian stimulation, which is consistent with the regularity of follicle growth and maturation. Gleicher and colleagues endorsed this hypothesis and suggested that the administration of GH should at least 6 weeks prior to COH 64 . In this NMA, we have found that compared to the control group, using GH at a dosage > 8 IU/day for at least 2 weeks before oocyte retrieval could improve the number of obtained oocytes in POR patients but did not show significant advantages compared to the medium dose, follicular phase protocol (protocol D).…”