Low peripheral blood levels of the immunosuppressive cytokine interleukin 10 (IL-10) at the start of gonadotrophin stimulation indicates increased risk for development of ovarian hyperstimulation syndrome (OHSS).
Our hypothesis was that patients developing ovarian hyperstimulation syndrome (OHSS) might have a disturbed responsiveness or delayed activation of the immunosuppresive cytokine system. In a prospective cohort study, women (n=428) undergoing in vitro fertilisation (IVF) treatment were subjected to repeated blood sampling and collection of clinical data. Fifteen patients, who developed severe OHSS, were compared with matched (age, follicle numbers, pregnancy) control patients. Samples of serum and plasma were collected throughout the stimulation and up to 7 days after embryo transfer as well as during hospitalisation for OHSS. Levels of IL-4, IL-10, IL-13, oestradiol and progesterone were measured. Significantly lower levels of IL-10 were seen at the start of gonadotrophin stimulation in OHSS patients, with an increase seen after the development of OHSS. In these OHSS patients, a negative correlation between IL-10 levels and number of follicles at time of aspiration existed, but there were no correlations between steroid and IL-10 levels. Levels of IL-13 and IL-4 were low in both groups and did not change during stimulation. The lower levels of IL-10 at start of stimulation in OHSS patients, as compared with controls, may be of pathophysiological importance by allowing for an enhanced Th-1 type immune response during gonadotrophin stimulation and thereby increased and generalised inflammation. The increase in IL-10 after development of OHSS indicates that IL-10 at that time is induced in a systemic attempt to suppress the inflammation of OHSS.
Enskog
A
A
Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Göteborg University, S-413 45 Göteborg, Sweden.
Nilsson
L
L
Brännström
M
M
D015331:Cohort Studies; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000276:immunology*; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000276:immunology*; D006801:Humans; D007165:Immunosuppression Therapy; D016753:Interleukin-10 / Q000097:blood* / Q000276:immunology; D018793:Interleukin-13 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood* / Q000209:etiology / Q000276:immunology; D011247:Pregnancy; D011374:Progesterone / Q000097:blood; D012307:Risk Factors
D018793:Interleukin-13; D019382:Human Growth Hormone; D016753:Interleukin-10; D015847:Interleukin-4; D011374:Progesterone; D004958:Estradiol; D005640:Follicle Stimulating Hormone