title: Serum vascular endothelial growth factor levels following luteal gonadotrophin-releasing hormone antagonist administration in women with severe early ovarian hyperstimulation syndrome.
abstract: OBJECTIVE
  To investigate the kinetics of serum vascular endothelial growth factor (VEGF) following gonadotrophin-releasing hormone (GnRH) antagonist administration in the luteal phase in women with established severe early ovarian hyperstimulation syndrome (OHSS).
  
  
  METHODS
  Pilot observational cohort study.
  
  
  METHODS
  Private in vitro fertilisation (IVF) Unit.
  
  
  METHODS
  Twelve IVF women diagnosed with established severe early OHSS 5 days post oocyte retrieval (POR).
  
  
  METHODS
  Women undergoing IVF diagnosed with severe early OHSS 5 days POR were given 0.25 mg GnRH antagonist for 4 days, from day 5 until and including day 8 POR, combined with elective blastocyst cryopreservation. Serum VEGF was measured from the day of oocyte retrieval until day 11 POR. Ovarian volume, ascites, serum estradiol and progesterone, haematocrit and white blood cells were monitored during the same period.
  
  
  METHODS
  Kinetics of VEGF following luteal GnRH antagonist administration in women with established severe early OHSS.
  
  
  RESULTS
  The concentration of VEGF was highest (390.9 ± 137.4 pg/ml) 5 days POR, coinciding with the day of diagnosis of severe OHSS. There was a significant decline of VEGF on day 7 (302.8 ± 104.9 pg/ml; P = 0.026), day 9 (303.3 ± 148.3 pg/ml; P = 0.007), and day 11 (252.6 ± 182.7 pg/ml; P = 0.010) compared with day 5 POR. This decline was associated with an improvement of ultrasound and laboratory parameters, indicating regression of severe OHSS. All women were managed at an outpatient level.
  
  
  CONCLUSIONS
  GnRH antagonist administration in the luteal phase is associated with a significant decline of VEGF and with regression of established severe early OHSS.
authors.affiliation: Eugonia Unit of Assisted Reproduction, Athens, Greece.
authors.forename: G T
authors.initials: GT
authors.lastname: Lainas
authors.forename: E M
authors.initials: EM
authors.lastname: Kolibianakis
authors.forename: I A
authors.initials: IA
authors.lastname: Sfontouris
authors.forename: I Z
authors.initials: IZ
authors.lastname: Zorzovilis
authors.forename: G K
authors.initials: GK
authors.lastname: Petsas
authors.forename: T G
authors.initials: TG
authors.lastname: Lainas
authors.forename: B C
authors.initials: BC
authors.lastname: Tarlatzis
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors* / Q000627:therapeutic use; D006801:Humans; D008183:Luteal Phase; D016471:Ovarian Hyperstimulation Syndrome / Q000188:drug therapy*; D010865:Pilot Projects; D012720:Severity of Illness Index; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D042461:Vascular Endothelial Growth Factor A; D007987:Gonadotropin-Releasing Hormone; C062876:cetrorelix
keywords: Gonadotrophin-releasing hormone antagonist; OHSS-free clinic; ovarian hyperstimulation syndrome; tertiary OHSS prevention; vascular endothelial growth factor