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Controlled ovarian hyperstimulation in assisted reproduction: effect on the immune system
A Giuliani1, W Schoell, J Auner
1Department of Obstetrics and Gynecology, University of Graz, Austria. giuliani@balu.kfunigraz.ac.at
Objective:
To determine how controlled ovarian hyperstimulation (COH) in assisted reproduction affects the immune system.
Design:
A prospective, nonrandomized, case-control study.
Setting:
Academic research setting.
Patient(S):
Women with regular menstrual cycles undergoing COH in an assisted reproduction program.
Intervention(S):
Blood samples were collected in the early and late follicular phase, at the time of ovulation, and in the luteal phase during a natural cycle, and at four times during the next cycle, which included COH and IVF.
Main Outcome Measure(S):
Lymphocyte subpopulations and the differential blood count.
Result(S):
In the natural cycles, a significant increase in the total numbers of lymphocytes, B cells, natural killer cells, and CD3+HLADR+ cells was observed in the late follicular phase, whereas the T helper/T suppressor cell ratio declined. In the hyperstimulated cycles, increases were seen in the total numbers of leukocytes and neutrophils on the day of hCG administration; the number of lymphocytes, monocytes, and neutrophils was increased on the day of oocyte retrieval, and the total number of leukocytes and neutrophils increased during the luteal phase.
Conclusion(S):
Controlled ovarian hyperstimulation with hMG and simultaneous administration of a GnRH antagonist did not affect the immune system.