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Controlled ovarian hyperstimulation--a state of endothelial activation
R Orvieto1, A Schwartz, I Bar-Hava
1Department of Obstetrics and Gynecology, Rabin Medical Center, Petah Tiqva, Israel.
American Journal of Reproductive Immunology (New York, N.Y. : 1989)
|December 28, 2000
Summary
Controlled ovarian hyperstimulation (COH) activates the endothelium, particularly after human chorionic gonadotropin (hCG) administration. This endothelial activation during IVF cycles may inform strategies for preventing hyperstimulation syndrome.
Area of Science:
- Reproductive endocrinology
- Vascular biology
- In vitro fertilization (IVF)
Background:
- Controlled ovarian hyperstimulation (COH) is a key component of assisted reproductive technologies like IVF.
- Endothelial activation, a marker of vascular inflammation, is a potential concern during COH.
- The relationship between COH, sex hormones, and endothelial activation requires further investigation.
Purpose of the Study:
- To determine if COH induces endothelial activation in patients undergoing IVF.
- To investigate the correlation between endothelial activation markers and serum sex-steroid levels during COH.
Main Methods:
- Prospective study of 14 patients undergoing a standard IVF long protocol.
- Blood samples collected at three key time points: post-suppression (Day-S), pre-hCG (Day-hCG), and ovum pick-up (Day-OPU).
- Plasma soluble endothelial (E)-selectin levels measured via ELISA; sex steroids analyzed.
Main Results:
- Soluble E-selectin levels were significantly elevated on Day-OPU compared to Day-S and Day-hCG.
- No significant difference in soluble E-selectin was observed between Day-S and Day-hCG.
- No significant correlations found between soluble E-selectin and patient age, gonadotropin dose, oocyte yield, or serum estradiol, progesterone, or hCG levels.
Conclusions:
- Human chorionic gonadotropin (hCG) administration appears to trigger endothelial activation during COH, irrespective of ovarian response.
- Further research is needed to fully understand the COH-endothelial activation link.
- These findings may contribute to developing novel strategies for managing and preventing COH-related complications like severe ovarian hyperstimulation syndrome (OHSS).