ABSTRACT
Over the past 20 years, the expression, signaling mechanisms, and roles of members
of the insulin-like growth factor (IGF) family (ligands, receptors, binding proteins,
and binding protein proteases and their inhibitors) have been elucidated in ovarian
follicle function in humans and other species. In vitro studies with human, nonhuman
primate, and farm animal granulosa and thecal cells and genetic approaches using mouse
knockout models for IGF family members have revealed that IGFs are key intraovarian
regulators of follicle growth, selection, atresia, cellular differentiation, and steroidogenesis,
oocyte maturation, and cumulus expansion. Some of these actions are synergistic with
gonadotropins, although most are not sustainable with IGFs alone and require gonadotropin
actions, thereby designating IGFs as “co-gonadotropins.” In the human disorder of
polycystic ovarian syndrome, characterized by small antral follicle arrest, the IGF
system appears to contribute to the observed resistance to follicle-stimulating hormone
action at the level of the granulosa compartment and the persistence of an androgen-dominant
milieu in the arrested follicles. Interestingly, recent studies demonstrate that endocrine-disrupting
chemicals can compromise IGF activity and signaling in the ovarian follicle, affecting
follicle development, steroidogenesis, and oocyte quality. The successful development
of a healthy oocyte and appropriate granulosa and theca cell steroidogenesis on a
cyclic basis are contingent on multiple factors, including a properly functioning
intraovarian IGF system. Disruption of even one component of this system can lead
to abnormal follicular development and function and compromised reproductive capacity.
KEYWORDS
Insulin-like growth factors (IGFs) - steroidogenesis - signaling pathways - endocrine
disruptors
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Linda C GiudiceM.D.
Professor and Chair, Department of Obstetrics, Gynecology and Reproductive Sciences,
University of California, San Francisco
505 Parnassus, M1495, Box 0132, San Francisco, CA 94143-0132
Email: giudice@obgyn.ucsf.edu