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Collection of Human Follicular Fluid, Follicle Somatic Cells, and Immature Oocytes from Individuals Undergoing In Vitro Fertilization
Published on: October 24, 2025
Microparticles reveal cell activation during IVF - a possible early marker of a prothrombotic state during the first
Nina Olausson1, Fariborz Mobarrez, Håkan Wallen
1Nina Olausson, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, SE 18288 Stockholm, Sweden, Tel.: +46 7 052 302 20, Fax: +46 8 123 571 17,
Abstract:
Cell-derived microparticles (MPs) are known to be elevated in a number of diseases related to arterial and venous thromboembolism (VTE), such as acute myocardial infarction, VTE (deep-vein thrombosis and pulmonary embolism) and peripheral arterial disease. IVF-associated pregnancies have previously been shown to be associated with an increased incidence of VTE, mechanisms behind being unknown and sparsely studied. Our objective was to assess cell activation during IVF through analysis of MP levels and phenotype following ovarian stimulation. Thirty-one women undergoing IVF were included and blood samples were collected at down regulation of oestrogen and at high level stimulation with 10- to 100-fold increased endogenous oestrogen levels. MPs were analysed by flow cytometry and phenotyped according to size and protein expression. We found that overall phosphatidylserine positive platelet-, endothelial- and monocyte-derived MPs significantly increased following ovarian stimulation with increased levels of platelet activation markers CD40 ligand and P-selectin. Furthermore, there was an increase in endothelial-derived MPs exposing activation marker E-selectin and monocyte-derived MPs, while neutrophil-derived MPs decreased slightly. In conclusion we found a major increase in MPs and markers indicating cell activation in parallel with the profound oestrogen boost during IVF. To assess whether these changes in MPs are associated with thromboembolic events requires extended longitudinal studies.
Insights
In vitro fertilization (IVF) ovarian stimulation significantly increases cell-derived microparticles (MPs) and activation markers. These changes, linked to elevated estrogen, may contribute to the increased risk of venous thromboembolism (VTE) in IVF pregnancies.
Area of Science:
- Reproductive Medicine
- Hematology
- Cell Biology
Background:
- Cell-derived microparticles (MPs) are implicated in arterial and venous thromboembolism (VTE).
- IVF-associated pregnancies carry an increased risk of VTE, with underlying mechanisms poorly understood.
- Ovarian stimulation during IVF involves significant hormonal fluctuations, particularly estrogen.
Purpose of the Study:
- To investigate cell activation during IVF by analyzing microparticle (MP) levels and phenotypes.
- To assess the impact of ovarian stimulation on circulating MPs and cell activation markers.
Main Methods:
- Flow cytometry was used to analyze and phenotype MPs from 31 women undergoing IVF.
- Blood samples were collected during estrogen downregulation and high-level stimulation phases.
- Analysis focused on phosphatidylserine-positive MPs, platelet activation markers (CD40 ligand, P-selectin), and endothelial activation markers (E-selectin).
Main Results:
- A significant increase in platelet-, endothelial-, and monocyte-derived MPs was observed post-ovarian stimulation.
- Elevated levels of platelet activation markers (CD40 ligand, P-selectin) and endothelial activation marker E-selectin were noted.
- Neutrophil-derived MPs showed a slight decrease, while monocyte-derived MPs increased.
Conclusions:
- IVF ovarian stimulation leads to a substantial increase in MPs and cell activation markers, correlating with high estrogen levels.
- These findings suggest a potential link between IVF-induced hormonal changes and prothrombotic states.
- Further longitudinal studies are required to determine if these MP changes are associated with actual thromboembolic events.
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