Measuring IGF-1 and IGFBP-3 profiles in women seeking assisted reproduction; relevance to clinical outcomes from in vitro fertilization (Study 5).

John L Yovich; Syeda Zaidi; Minh DK Nguyen; Peter M Hinchliffe

doi:10.30574/gscbps.2020.13.3.0355

Authors

John L Yovich Department of Pharmacy and Biomedical Sciences Curtin University Perth, Western Australia, Australia 6845.
Syeda Zaidi Current address Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Malaya Lembah Pantai, Kuala Lumpur Malaysia 59100.
Minh DK Nguyen PIVET Medical Centre Perth, Western Australia, Australia 6007.
Peter M Hinchliffe PIVET Medical Centre Perth, Western Australia, Australia 6007.

DOI:

https://doi.org/10.30574/gscbps.2020.13.3.0355

Keywords:

Growth Hormone (GH), Insulin-Like Growth Factor (IGF). IGF-1 Profile, IGFBP-3/ IGF-1 Ratio (IGF Ratio), Assisted Reproductive Technology (ART), In Vitro Fertilization (IVF), Growth Hormone (GH)Poor Prognosis Female, Pregnancy Productivity Rate, Live Birth Productivity Rate.

Abstract

In this fifth study examining the relevance of the insulin-like growth factor (IGF) profiles, namely serum IGF-1 levels, its main binding protein, serum IGFBP-3 levels and the IGF ratio (IGFBP-3/IGF-1), we have examined clinical outcomes with respect to the quartile ranges of each parameter measured in 1633 IVF-naïve women. The outcomes were derived from 1035 of these women who initiated 1747 IVF cycles. Of the three parameters, only IGF-1 levels proved relevant to the clinical outcomes. In particular, this study confirmed our earlier report that IGF-1 levels decline across the quartiles with the woman’s advancing age and the proportion of women with IGF-1 levels in the highest quartile comprised the younger, whilst those women ≥40 years were mostly in the lowest quartile (p<0.0001). IVF cycle cancellations were not different across the quartiles but at oocyte pick-up (OPU) there were significantly more oocytes from the highest IGF-1 quartile (10.4 oocytes) compared to the lowest (8.9 oocytes; p<0.01). Furthermore, the proportion of oocytes shown to be at the mature MII stage were also significantly higher (p=0.01). Consequently, the oocyte utilization rate was significantly greater from those women with the highest IGF-1 levels generating 5.3 embryos vs 4.3 embryos for the lowest quartile. However, the utilization rate of those embryos generated were similar across the IGF-1 quartiles and there were similar rates of “freeze-all embryos”, albeit more women had increased monitoring for ovarian hyperstimulation risk, related to the higher egg numbers in the highest IGF-1 quartile. The most striking clinical outcomes were that of the pregnancy productivity rate (including fresh and frozen embryo transfers from a single OPU) which was greatest in the highest IGF-1 quartile (61.5% vs 48.2% per OPU across all ages p<0.0002). Miscarriage rates were not different but live birth productivity rates were significantly greatest for the highest IGF-1 quartile (49% vs 33% per OPU across all ages; p<0.0002). We conclude that a preliminary measurement of the IGF-1 level can help to define the poor-prognosis female prior to IVF treatment and on whom adjuvant studies can be focused.

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