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Insulin-like growth factor binding protein 1, also known as IGFBP1, is a member of the insulin-like growth factor binding protein (IGFBP) family that are cysteine-rich proteins that act as a carrier protein. The protein binds both insulin-like growth factors (IGFs) I and II and circulates in the plasma. Binding of this protein prolongs the half-life of the IGFs and alters their interaction with cell surface receptors. IGFBP-1 is particularly important in female reproductive physiology, where it is involved with other factors in a complex system which regulates menstrual cycles, puberty, ovulation, decidualization, implantation and fetal growth. There is evidence for a pathophysiological role for IGFBP-1 in pre-eclampsia, intrauterine growth restriction, polycystic ovarian syndrome and trophoblast and endometrial neoplasms.1