Insulin-like growth factors: clinical experience in ovarian function.

Insulin, insulin-like growth factor, and insulin-like growth factor binding proteins have been shown to play major roles in the modulation of both normal and disturbed ovarian physiology. Identification of many of the actions of these peptides was initially characterized using animal models. However, an increasing body of evidence has emerged to clarify their contributions in human reproductive function. It is clear that at various stages of folliculogenesis, local steroid production acts in concert with intraovarian peptides to promote dominant follicle development. This review will discuss the physiologic role(s) of the insulin-insulin-like growth factor-insulin-like growth factor binding protein family in reproductive function and disorders of androgen excess.