Transforming growth factor-beta1, insulin-like growth factors, and insulin-like growth factor binding proteins in ovarian follicular fluid are differentially regulated by the type of ovarian hyperstimulation used for in vitro fertilization.

OBJECTIVE

To determine the effects of hMG and highly purified FSH on follicular production of the ovarian growth factors transforming growth factor-beta1 (TGF-beta1), insulin-like growth factors I and II (IGF-I and IGF-II), and insulin-like growth factor binding proteins-1 and -3 (IGFBP-1 and IGFBP-3).

DESIGN

Controlled clinical study.

SETTING

University IVF program.

PATIENT(S): One hundred twenty women who were <38 years old and had a >3-year duration of infertility in their present relationship participated in the study.

INTERVENTION(S): Follicular fluid and matched serum were collected at oocyte pick-up and analyzed for growth factors and E2 with the use of ELISA and RIA.

MAIN OUTCOME MEASURE(S): Levels of TGF-beta1, IGF-I. IGF-II, IGFBP-1 and IGFBP-3 in follicular fluid and levels of E2 in serum were measured.

RESULT(S): Compared with highly purified FSH, ovarian hyperstimulation with hMG produced lower levels of TGF-beta1 and IGF-I and higher levels of IGFBP-1. Levels of IGF-II and IGFBP-3 were similar with the 2 treatments.

CONCLUSION(S): In patients undergoing IVF, the follicular expression of TGF-beta1, IGF-I, and IGFBP-1 was regulated differently by highly purified FSH compared with a preparation containing FSH and LH in a 1:1 ratio (hMG). The results indicate that FSH and LH control ovarian production of these growth factors differentially.