Measuring IGF-1 and IGFBP-3 profiles in women seeking assisted reproduction; response of women categorized as poor-prognosis to recombinant growth hormone adjuvant therapy (Study 4)

In this fourth study examining the relevance of measuring the IGF profile (IGF-1, IGFBP-3 and the ratio of IGFBP-3/ IGF-1) in women presenting for assisted reproductive technologies (ART), we have examined the influence of recombinant growth hormone (rGH) prescribed as an adjuvant on the profile. Of 1633 ART-naïve women who completed an assessment cycle (AC) workup, and which included an IGF profile, 941 women proceeded to an in-vitro fertilization ± intracytoplasmic sperm injection (IVF±ICSI) treatment cycle during the period January 2011 to December 2019. Among those women, 90 were prescribed rGH because they were classified as likely poor-prognosis cases on the basis of advanced age or evidence of severely reduced ovarian reserve parameters. These women had their IVF±ICSI treatment within 3-months of their AC and consented to a second IGF profile measurement 4-6 weeks during their rGH treatment phase. Of the 90 women prescribed rGH adjuvant, 71 used the adjuvant and 19 deferred the treatment, but still completed the second IGF-profile. The data showed that rGH caused a significant elevation in IGF-1 (p<0.0001) as well as its main binding protein, IGFBP-3 (p<0.001), albeit to a lesser degree. Consequently, the IGF ratio, considered a more reliable marker of IGF-1 activity, was shown to be significantly reduced towards the normal range (p<0.0001). The data of clinical outcomes from these 90 women as well as the entire 941 women entering the IVF±ICSI treatment are presented for comparison, noting these data are not suitable for statistical evaluation as the groupings are disparate and unmatched. Further studies are intended to show the clinical relevance of increasing the IGF-1 levels in the analytical investigation of rGH as an adjuvant in ART.