Follicular fluid levels of vascular endothelial growth factor. Are they predictive markers for ovarian hyperstimulation syndrome?
OBJECTIVE
To determine the possible predictive role of vascular endothelial growth factor (VEGF) levels in the follicular fluid (FF) at the time of oocyte retrieval in the development of ovarian hyperstimulation syndrome (OHSS) and its possible origin.


METHODS
FF was obtained from 174 high-responder patients at the time of oocyte retrieval. The study group comprised 16 high-responder patients who developed early, severe OHSS and from whom serum and peritoneal fluid (PF) were obtained during the active phase of the syndrome. These women were compared to 16 high-responder patients who did not develop OHSS. An additional control group comprised 16 low-responder patients who also did not develop OHSS. The FF, serum and PF samples were tested for VEGF by enzymelined immunosorbent assay.


RESULTS
No differences in the FF VEGF levels were found among the OHSS group (1,742.3 +/- 522.4 pg/mL), the high-responder group that did not develop OHSS (1,802.0 +/- 584.3 pg/mL) and the low-responder group (1,686.7 +/- 374.2 pg/mL). In the OHSS group, no differences were found between the serum and PF VEGF levels (247.3 +/- 31.4 and 642.9 +/- 328.3 pg/mL, respectively). No correlation was found between the FF concentrations of VEGF and the mean serum 17-beta estradiol levels or number of oocytes retrieved.


CONCLUSIONS
We conclude that preovulatory FF levels should not serve as a possible predictive factor for development of OHSS. The increased capillary permeability found in OHSS may be due to its systemic effect.
Geva
E
E
Sara Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Israel.
Amit
A
A
Lessing
J B
JB
Lerner-Geva
L
L
Daniel
Y
Y
Yovel
I
I
Azem
F
F
Barak
V
V
D016022:Case-Control Studies; D016228:Endothelial Growth Factors / Q000032:analysis* / Q000097:blood; D005260:Female; D015571:Follicular Fluid / Q000737:chemistry*; D006801:Humans; D008222:Lymphokines / Q000032:analysis* / Q000097:blood; D016471:Ovarian Hyperstimulation Syndrome / Q000175:diagnosis* / Q000209:etiology; D010062:Ovulation Induction / Q000009:adverse effects; D011237:Predictive Value of Tests; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D016228:Endothelial Growth Factors; D008222:Lymphokines; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors