Immunoreactive endothelin plasma levels in severe ovarian hyperstimulation syndrome.
OBJECTIVE
To determine the plasma levels of immunoreactive endothelin in patients with severe ovarian hyperstimulation syndrome (OHSS).


METHODS
Prospective longitudinal study.


METHODS
Assisted Reproduction Unit of the Hospital Clínic i Provincial in Barcelona, a tertiary care setting.


METHODS
Sixteen IVF patients with severe OHSS.


METHODS
Measurement during the syndrome and 4 to 5 weeks after recovery of the following: mean arterial pressure, hematocrit, plasma renin activity, plasma aldosterone, norepinephrine, antidiuretic hormone, atrial natriuretic peptide, and immunoreactive endothelin concentrations.


RESULTS
During the syndrome patients showed decreased mean arterial pressure (70.0 +/- 1.1 versus 85.2 +/- 1.6 mm Hg), increased mean hematocrit values (45.5% +/- 1.1% versus 38.1% +/- 0.4%), oliguria (630.6 +/- 40.7 versus 1,306.2 +/- 43.9 mL/d), and very high plasma levels of renin (36.0 +/- 9.1 versus 1.2 +/- 0.08 ng/mL per hour), aldosterone (190.6 +/- 28.4 versus 14.8 +/- 1.5 ng/dL), norepinephrine (602.1 +/- 91.0 versus 220.5 +/- 12.1 pg/mL), antidiuretic hormone (4.1 +/- 0.7 versus 1.0 +/- 0.1 pg/mL), and atrial natriuretic peptide (10.9 +/- 1.6 versus 4.7 +/- 0.2 fmol/mL). Immunoreactive endothelin plasma levels were increased significantly during OHSS (8.9 +/- 0.9 versus 3.9 +/- 0.2 pg/mL) and all patients had elevated values during the syndrome.


CONCLUSIONS
Circulating plasma levels of immunoreactive endothelin are elevated in patients with severe OHSS in parallel with other neurohormonal vasoconstrictor systems. It may represent a homeostatic response to maintain blood pressure.
Balasch
J
J
Faculty of Medicine, University of Barcelona, Hospital Clínic i Provincial, Spain.
Arroyo
V
V
Fábregues
F
F
Jiménez
W
W
Saló
J
J
Vanrell
J A
JA
D000328:Adult; D001794:Blood Pressure; D016232:Endothelins / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D006400:Hematocrit; D006728:Hormones / Q000097:blood; D006801:Humans; D007158:Immunologic Techniques; D008137:Longitudinal Studies; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood* / Q000503:physiopathology; D011446:Prospective Studies
D016232:Endothelins; D006728:Hormones