Interleukin-18 levels correlate with severe ovarian hyperstimulation syndrome.
OBJECTIVE
To assess the involvement of interleukin-18 (IL-18) in the pathophysiology of severe ovarian hyperstimulation syndrome (OHSS), and study its use as a marker of disease and its correlation to capillary hyperpermeability.


METHODS
Prospective controlled study.


METHODS
An IVF unit in a tertiary medical center.


METHODS
Twenty-four patients with OHSS in an IVF program, two control groups: group 1, 40 healthy age-matched women without ovulation-induction treatment; group 2, 19 women who received the same ovulation-induction regimen without experiencing OHSS.


METHODS
Blood samples were obtained at three times: during acute OHSS, on significant clinical improvement, after complete resolution. Ascitic and pleural fluids were obtained by therapeutic paracentesis. Serum, peritoneal, and pleural fluids were analyzed for IL-18 and IL-6, and blood for hematocrit, white blood cell count, and E(2) levels.


METHODS
Hematocrit white blood cell count, serum, peritoneal, pleural fluid levels of IL-18, IL-6, E(2) in severe OHSS.


RESULTS
Significantly higher IL-18 levels were detected in serum, peritoneal, and pleural fluids of patients with severe OHSS as compared with both control groups. Serum IL-18 dropped significantly on transition to the diuretic phase and resolution. A statistically significant correlation between serum IL-18 and hyperpermeability characteristics (white blood cell count, hematocrit), serum E(2), and IL-6 levels was recorded.


CONCLUSIONS
This is the first study suggesting a role of IL-18 as a marker of OHSS, with correlation to capillary hyperpermeability parameters.
Barak
Vivian
V
Obstetrics and Gynecology Department, Hadassah Hebrew University Medical Center, Jerusalem, Israel. barak845@yahoo.com
Elchalal
Uriel
U
Edelstein
Michal
M
Kalickman
Inna
I
Lewin
Aby
A
Abramov
Yoram
Y
D015415:Biomarkers / Q000097:blood; D004958:Estradiol / Q000032:analysis; D005260:Female; D005307:Fertilization in Vitro; D006400:Hematocrit; D006801:Humans; D020382:Interleukin-18 / Q000032:analysis / Q000097:blood*; D015850:Interleukin-6 / Q000032:analysis; D007958:Leukocyte Count; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood* / Q000276:immunology; D010062:Ovulation Induction / Q000379:methods; D010996:Pleural Effusion / Q000737:chemistry / Q000276:immunology; D012016:Reference Values; D016896:Treatment Outcome
D015415:Biomarkers; D020382:Interleukin-18; D015850:Interleukin-6; D004958:Estradiol