Prognostic importance of serial cytokine changes in ascites and pleural effusion in women with severe ovarian hyperstimulation syndrome.
OBJECTIVE
To determine the prognostic value of various cytokine levels in ascites and pleural effusion during the evolution of severe ovarian hyperstimulation syndrome (OHSS).


METHODS
A longitudinal study.


METHODS
University teaching hospital.


METHODS
Twenty patients with severe OHSS who required either paracentesis or thoracentesis or both from whom ascites (n = 56) or pleural effusion (n = 12) samples were obtained. Control peritoneal fluid was obtained from 20 patients undergoing ovarian stimulation for IVF.


METHODS
Abdominal paracentesis for tense ascites and thoracentesis for massive pleural effusion. Control peritoneal fluid was obtained before oocyte retrieval.


METHODS
Levels of interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-alpha), vascular endothelial growth factor (VEGF), E2, and progesterone concentrations in ascites and pleural effusion.


RESULTS
Levels of VEGF and IL-6 in ascites dropped significantly during the course of OHSS and were not correlated with E2 concentrations. Levels of VEGF were significantly correlated with levels of IL-1 beta, IL-8, and TNF-alpha, as well as progesterone concentrations, hematocrit, and white blood cell counts. None of the cytokine levels measured in pleural effusion were correlated with the course of OHSS.


CONCLUSIONS
These results suggest that local cytokines might be involved in the evolution of severe OHSS and possibly serve as prognostic markers for this syndrome.
Chen
C D
CD
Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei.
Wu
M Y
MY
Chen
H F
HF
Chen
S U
SU
Ho
H N
HN
Yang
Y S
YS
D000328:Adult; D001201:Ascites / Q000276:immunology*; D016207:Cytokines / Q000032:analysis*; D004322:Drainage; D016228:Endothelial Growth Factors / Q000032:analysis; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D007315:Insemination, Artificial; D007375:Interleukin-1 / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D008222:Lymphokines / Q000032:analysis; D016471:Ovarian Hyperstimulation Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D019152:Paracentesis; D010996:Pleural Effusion / Q000276:immunology*; D011379:Prognosis; D011677:Punctures; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D016207:Cytokines; D016228:Endothelial Growth Factors; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D008222:Lymphokines; D014409:Tumor Necrosis Factor-alpha; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors