The influence of urinary versus recombinant gonadotropin on serum P-selectin levels in vivo.
OBJECTIVE
To determine the levels of serum P-selectin in patients undergoing controlled ovarian hyperstimulation (COH) cycles with urinary (uGn) versus recombinant gonadotropins (rGn) and their possible correlation with COH variables.


METHODS
This study was carried out in a large university-based infertility and in vitro fertilization unit. A total of 14 consecutive patients underwent our routine COH protocol for unexplained infertility with either uGn or rGn. Blood was drawn three times during the COH cycle: on day 2 or 3 of the menstrual cycle and before gonadotropin treatment (day-0); on the day of or prior to human chorionic gonadotropin (hCG) administration (day-hCG); and on the day of ovulation (day-OVU). Levels of sex steroids and serum P-selectin were compared among the three time points between the uGn and rGn subgroups. P-selectin was measured with a commercial quantitative sandwich immunoassay technique.


RESULTS
In both Gn subgroups, there was a non-significant increase in P-selectin level between day-hCG and day-0. In the rGN subgroup, no significant difference was observed in P-selectin levels between day-OVU and day-hCG. In the uGn subgroup, P-selectin levels were significantly lower in day-OVU as compared to day-hCG (p < 0.04) and day-0 (p < 0.04). No differences were noted between the uGn and rGn subgroups in patient age, number of gonadotropin ampules used or estradiol and progesterone levels during the COH cycle or P-selectin on day-0 or day-hCG. However, on day-OVU, P-selectin levels were significantly lower in the uGn than the rGn subroups (p < 0.01).


CONCLUSIONS
The increase in serum P-selectin level during COH until the peak of estradiol level was significantly attenuated after hCG administration in patients pretreated with uGn, but not rGN. It would therefore be prudent in patients at risk of developing thromboembolism undergoing COH to use uGN rather than rGN in order to attenuate platelet activation.
Orvieto
Raoul
R
Department of Obstetrics and Gynecology, Rabin Medical Center, Petah Tiqva and Sackler Faculty of Medicine, Tel Aviv University, Israel. orvieto@clalit.org.il
La Marca
Antonio
A
Badir
Walid
W
Golan
Oren
O
Bar
Jacob
J
Fisch
Benjamin
B
D000328:Adult; D006063:Chorionic Gonadotropin / Q000494:pharmacology*; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D010062:Ovulation Induction / Q000379:methods*; D019007:P-Selectin / Q000097:blood*; D011374:Progesterone / Q000097:blood; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000494:pharmacology; D018709:Statistics, Nonparametric
D006063:Chorionic Gonadotropin; D019007:P-Selectin; D011994:Recombinant Proteins; D011374:Progesterone; D004958:Estradiol