IGF-1 and IGFBP-1 in peripheral blood and decidua of early miscarriages with euploid embryos: comparison between women with and without PCOS

Abstract

This study aims to demonstrate the possible relationship between the insulin-like growth factor (IGF) system and early miscarriage in polycystic ovarian syndrome (PCOS) patients with euploid embryos. 40 pregnant women included. 9 had PCOS and miscarried; 20 had PCOS and a successful ongoing pregnancy; the remaining 11 women did not have PCOS and miscarried. An ultrasound scan was performed to prove clinical pregnancy and a blood sample was taken on day 55 ± 4 of gestation. Serum samples of IGF-1, insulin-like growth factor binding protein-1 (IGFBP-1), total testosterone, serum hormone binding protein (SHBG), leptin and soluble leptin receptor (sOb-R) were obtained. In miscarriages, samples of decidua were obtained during vaccum curettage. Embryonic chromosomes in all miscarriages were proven to be normal. The expression of IGF-1, IGFBP-1, leptin, long-form leptin receptor and androge sOb-R n receptor (AR) were examined in the decidua. We found that miscarried PCOS patients showed significantly increased free androgen index and free IGF index, as well as decreased SHBG and IGFBP-1 than other two groups in peripheral blood. In the decidua, miscarried PCOS patients showed significantly increased expression of IGF-1 and decreased IGFBP-1 when compared with non-PCOS. AR was not expressed in the decidua of either group. Our results suggest that early miscarriage is associated with increased IGF-1 and decreased IGFBP-1 in PCOS patients.

Chinese abstract

本研究旨在证明胰岛素样生长因子（IGF）系统和多囊性卵巢综合征（PCOS）患者整倍体胚胎的早期流产的可能关系。共纳入40例孕妇。其中，9 例PCOS孕妇出现了流产；20例 PCOS孕妇怀孕过程正常，其余的11例为非PCOS患者出现了流产。在怀孕55±4天的时候通过超声扫描证明临床妊娠，并抽取血液样本。获取血清样本中的IGF- 1、胰岛素样生长因子结合蛋白1（IGFBP-1）、总睾酮、血清激素结合蛋白（SHBG）、瘦素和可溶性瘦素受体（sOb-R）水平。在宫腔刮除术中留取流产孕妇的蜕膜样本。所有流产胚胎的染色体均正常。检测蜕膜中IGF-1、IGFBP-1、瘦素、长型瘦素受体和雄激素sOb-R受体(AR)的表达。我们发现流产的PCOS患者外周血中游离雄激素指数和游离IGF指数明显升高，而SHBG 和IGFBP-1水平比其他两组明显降低。相比于非PCOS流产患者，PCOS流产患者蜕膜中的IGF-1表达明显升高，而IGFBP-1的表达降低。AR在各组中均未表达。我们的结果表明PCOS患者的早期流产与IGF-1水平增加和IGFBP-1水平降低有关。

• Early miscarriage
• IGF-1
• IGFBP-1
• polycystic ovary syndrome

Acknowledgement

We thank T. C. Li, Yana Wang and Xiaoxiong Ni for language supports.

Declaration of interest

None of the authors have any direct or indirect commercial, proprietary, or financial interests in the products or companies mentioned in this article. The authors alone are responsible for the content and writing of the paper.