Serum and follicular fluid insulin like growth factors I and II during growth hormone co‐treatment for in‐vitro fertilization and embryo transfer

Abstract

Summary. objective We wished to assess the changes in serum IGF‐I and IGF‐ll concentrations during gonadotrophin treatment alone or with additional GH treatment and to compare follicular fluid IGF‐I and IGF‐II concentrations in the two treatment groups. design We performed an open study of co‐treatment with GH and subsequently a randomized double blind comparison of addition of placebo or GH to clomiphene citrate and gonadotrophins. patients We studied previously poor responders to superovulation regimens for in‐vitro fertilization and embryo transfer, six women in an open study, four of whom had ultrasound diagnosed polycystic ovaries, and 17 women in a double blind study, 12 of whom had polycystic ovaries. measurements We measured serum IGF‐I and IGF‐II concentrations throughout treatment cycles. Follicular fluid concentrations were measured at the time of oocyte recovery. results Neither serum IGF‐I nor IGF‐ll concentrations were altered by gonadotrophin treatment alone. However, co‐treatment with GH led to a significant rise In serum IGFI concentrations In women with ultrasound diagnosed polycystic ovaries. Concentrations of IGF‐I and IGF‐ll In follicular fluid were lower than in serum, although follicular fluid IGF‐I concentrations were higher in women receiving GH than in those receiving placebo. conclusions Poor responders to superovulation regimens may have an abnormality of growth factor response. GH co‐treatment leads to an increase in circulating IGF‐I concentrations in women with polycystic ovaries but our results do not support the hypothesis that GH stimulates IGF‐I production in the human ovary.