IGFBP1 is a multifunctional protein that regulates insulin-like growth factor (IGF) availability and signaling, controlling cell migration, proliferation, differentiation, and apoptosis 12. Beyond IGF sequestration, IGFBP1 promotes cell migration through RGD-motif interactions with integrin ITGA5:ITGB1, activating focal adhesion kinase and MAPK pathways 1. In reproductive physiology, IGFBP1 is a critical decidualization marker in endometrial stromal cells, where its expression is regulated by progesterone signaling through HBP1-mediated transcriptional control 3. IGFBP1 expression is essential for successful embryo implantation and pregnancy maintenance 43. Circulating IGFBP1 levels positively correlate with insulin sensitivity during pregnancy; low early-pregnancy IGFBP1 predicts gestational diabetes mellitus development 5. The IGFBP1 rs1065780 A>G polymorphism reduces preeclampsia risk through elevated protein levels 6. In cancer biology, IGFBP1 induction through Stat3 inactivation and FOXO3a/SP1 crosstalk suppresses lung cancer cell growth 78. Impaired IGFBP1 expression contributes to reproductive pathologies including recurrent implantation failure, spontaneous abortion, and gestational complications 4910.