Comparison of follicular fluid and serum levels of Inhibin A and Inhibin B with calculated indices used as predictive markers of Ovarian Hyperstimulation Syndrome in IVF patients.
BACKGROUND
Ovarian Hyperstimulation Syndrome (OHSS) is a severe health complication observed in some patients undergoing hormonal stimulation during IVF. Presence of OHSS is often associated with a high count of growing follicles responding to FSH hyperstimulation. However, the number of responding follicles may not be sufficient enough to predict the onset and severity of OHSS. The aim of this study was to find whether follicular fluid (FF) and serum concentrations of Inhibin A and Inhibin B in patients undergoing IVF treatment may serve as a predictor of OHSS status independent of the growing follicles count.


METHODS
Serum and follicular fluid of fifty-three women undertaking the IVF program were separated into four groups according to their OHSS status and growing follicles count and analyzed for serum and FF concentrations of Inhibin A and Inhibin B. The resulting data were combined with clinical and demographic data to calculate indices independent of the growing follicles count.


RESULTS
Serum Inhibin A and Inhibin B concentrations showed no significant difference between the severe OHSS group and the control group without OHSS. Moreover, the serum concentrations of Inhibin A and Inhibin B were strongly correlated with the growing follicles count. Their concentrations in the high responders group (>18 follicles) were significantly higher (p < 0.00001, p < 0.0001) when compared with normal and low responders (<18 follicles). To suppress the dependence on the growing follicle count, three indices were constructed and calculated. The best association with OHSS status and independence of the growing follicle count was achieved by using the Inhibin B TFF/SBM index calculated as follows: [concentration in FF] x [growing follicle count]/[concentration in serum] x [body mass]. The Inhibin B TFF/SBM index showed a clear difference (p = 0,00433) between the group with severe OHSS and the control group, while showing no apparent correlation with the growing follicle count.


CONCLUSIONS
These observations demonstrated that while neither serum nor FF concentrations of Inhibin A nor Inhibin B can be used as an OHSS predictor independent of the growing follicle count, calculated indices may meet the criteria.
Moos
Jiri
J
Assisted Reproduction Centre, Department of Obstetrics and Gynecology, General Teaching Hospital in Prague, Czech Republic. jmoos@seznam.cz
Rezabek
Karel
K
Filova
Vanda
V
Moosova
Martina
M
Pavelkova
Jana
J
Peknicova
Jana
J
D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D002452:Cell Count; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000737:chemistry* / Q000378:metabolism; D006305:Health Status Indicators; D006801:Humans; D007265:Inhibins / Q000032:analysis / Q000097:blood / Q000378:metabolism; D006080:Ovarian Follicle / Q000473:pathology; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers; C422362:inhibin A; C422364:inhibin B; D007265:Inhibins
Endocrine. 2005 Apr;26(3):285-90
16034183
Hum Reprod. 2008 Jan;23(1):160-7
18000172
Hum Reprod. 2000 Mar;15(3):532-8
10686192
Hum Reprod. 2003 Feb;18(2):323-7
12571168
Hum Reprod. 2000 Nov;15(11):2341-6
11056129
Hum Reprod. 1995 Jun;10(6):1355-8
7593495
Reprod Biol Endocrinol. 2007 Mar 15;5:9
17362511
Fertil Steril. 1999 May;71(5):808-14
10231037
Hum Reprod. 2006 May;21(5):1260-5
16439507
BJOG. 2005 Oct;112(10):1384-90
16167941
Hum Reprod. 1993 Sep;8(9):1353-60
8253917
Hum Reprod. 2002 Jun;17(6):1535-43
12042274
Hum Reprod. 1991 Nov;6(10):1395-9
1770133
Hum Reprod Update. 2003 May-Jun;9(3):275-89
12859048
Fertil Steril. 2006 May;85(5):1541-3
16566934
Clin Endocrinol (Oxf). 1996 Dec;45(6):741-8
9039341
Fertil Steril. 2001 Dec;76(6):1185-90
11730748
Hum Reprod. 2006 Jun;21(6):1453-60
16488907
Recent Prog Horm Res. 1988;44:1-34
3064204
Hum Reprod. 2006 Aug;21(8):2126-30
16682403
J Clin Endocrinol Metab. 1996 Apr;81(4):1401-5
8636341
Annu Rev Physiol. 1995;57:219-44
7778866
Hum Reprod. 2001 Dec;16(12):2491-5
11726564
Obstet Gynecol Surv. 1989 Jun;44(6):430-40
2660037
Fertil Steril. 2009 May;91(5):1739-44
18384778
Endocrinology. 1978 Nov;103(5):1960-3
371953
Recent Prog Horm Res. 2001;56:417-50
11237224
Fertil Steril. 2006 Jun;85(6):1723-9
16650414
Fertil Steril. 1997 Jan;67(1):110-4
8986693
Proc Natl Acad Sci U S A. 1988 Jan;85(1):247-51
2829170
Am J Obstet Gynecol. 1988 Jul;159(1):210-5
3134814
Fertil Steril. 1992 Aug;58(2):249-61
1633889