Cycle day 2 serum levels of insulin-like growth factor-1 as a prognostic indicator for poor responders to controlled ovarian hyperstimulation

Objective: This study aimed to compare serum insulin-like growth factor (IGF)-1 levels on cycle day 2 among poor ovarian responders, age-matched normal responders, and high responders undergoing in vitro fertilization (IVF). The investigation sought to understand the potential correlation between IGF-1 levels and ovarian response, with a focus on advanced maternal age and poor ovarian response. Methods: Conducted at the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies in Baghdad, this clinical experiment involved 30 infertile individuals. The primary outcome measures included Cycle Day 2 IGF-1 serum levels, anti-Müllerian hormone (AMH) levels, antral follicle count (AFC), and retrieved oocytes. Secondary outcomes comprised intrauterine pregnancy, live birth, unfavorable pregnancy outcomes, oocyte maturation, and fertilization. Participants were categorized based on antral follicle count: Group 1 (≤3 AFC) and Group 2 (4 to 10 AFC). Results: In participants with usual responses, 72.5% had 4-10 AFC, while poor responders had ≤3 AFC in 27.5% of cases. Poor responders exhibited higher mean ages, lower mean AMH, and higher mean IGF-1 levels. However, poor responders and normal responders showed similar mean FSH levels. Female age positively correlated with FSH and IGF-1, while negatively correlating with AMH. The study also indicated negative correlations between female AMH, FSH, and IGF-1, along with a positive correlation between IGF-1 and FSH. Conclusion: The findings suggest that FSH, AMH, and IGF-1 readings in fertility-assessed women can serve as indicators of ovarian age and reserve. The observed correlations with age imply a diminishing ovarian function. This study contributes valuable insights into the relationship between serum IGF-1 levels, ovarian response, and aging, particularly in the context of poor ovarian responders undergoing IVF.