The Metabolic-Endocrine Axis: Interplay Between Follicular Adiponectin and Igf-1 In Determining Oocyte Competence and ICSI Outcomes

Abstract

Background: Ovarian response and follicular development are regulated through complex interactions between metabolic and endocrine pathways. adiponectin and insulin-like growth factor-1 (igf-1) are key mediators involved in metabolic homeostasis, follicular growth, and oocyte maturation. their role within the follicular microenvironment may influence ovarian response and assisted reproductive outcomes in women undergoing intracytoplasmic sperm injection (icsi).Aim of the Study: evaluate the associations of serum and follicular fluid adiponectin and IGF-1 levels with ovarian response, hormonal profiles, oocyte characteristics, embryo quality, and pregnancy outcomes in women undergoing icsi.
Subjects and Methods: This prospective comparative study enrolled 120 infertile women scheduled for ICSI at the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Iraq. According to ovarian response, the women were allocated into three equal groups of 40 each: poor responders, normal responders, and hyper responders. Serum samples were drawn on two occasions—at the day of oocyte retrieval and again on the day of embryo transfer—whereas follicular fluid was aspirated during the retrieval procedure itself. Adiponectin and IGF-1 levels in the collected specimens were quantified by enzyme-linked immunosorbent assay (ELISA). The relationship of these two markers with ovarian response, hormonal indices, oocyte characteristics, embryo grade, and pregnancy outcome was then examined statistically.
Results: Serum and follicular fluid adiponectin and IGF-1 levels differed significantly among ovarian response groups, with the highest values observed in hyper responders (p<0.001). both biomarkers showed significant positive correlations with anti-müllerian hormone, estradiol, and luteinizing hormone levels. adiponectin and igf-1 were also positively associated with total oocyte count and mature metaphase ii oocytes. furthermore, elevated levels of both biomarkers were significantly associated with high-quality grade 1 embryos. however, neither adiponectin nor igf-1 demonstrated a significant association with pregnancy outcomes.
Conclusion: Adiponectin and IGF-1 are closely associated with ovarian responsiveness, endocrine regulation, oocyte maturation, and embryo quality in women undergoing icsi. these biomarkers may serve as useful indicators of ovarian activity and follicular competence; however, their value in predicting pregnancy outcomes remains limited.