Transforming growth factor-β1, 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-beta(1) (TGF-beta(1)), 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 E-2 with the use of ELISA and RIA. Main Outcome Measure(s): Levels of TGF-beta(1), IGF-I, IGF-II, IGFBP-1, and IGFBP-3 in follicular fluid and levels of E-2 in serum were measured. Result(s): Compared with highly purified FSH, ovarian hyperstimulation with hMG produced lower levels of TGF-beta(1) 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-beta(1), 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. (Fertil Steril(R) 1998;70:129-34 (C) 1998 by American Society for Reproductive Medicine.).