The levels of angiogenic factors and interleukin-8 in the serum and follicular fluid of patients at high risk for ovarian hyperstimulation syndrome when replacing an ovulation trigger


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Abstract

Objective. To study the concentrations of angiogenic factors (vascular endothelial growth factor (VEGF) and its receptors-1 and -2) and interleukin-8 (IL-8) in patients at high risk for ovarian hyperstimulation syndrome (OHSS) in the replacement of an ovulation trigger and in different variants of luteal phase support. Subjects and methods. The investigation included 51 patients at high risk for OHSS undergoing an IVF program within a gonadotropin-releasing hormone (GnRH) antagonist protocol. According to the chosen ovulation trigger, the patients were divided into three groups: 1) GnRH agonist (GnRH-a); 2) GnRH-a in combination with human chorionic gonadotropin (hCG); 3) hCG. Results. The serum level of VEGF-A on the day of transvaginal ovarian puncture (TOP) was determined to be significantly higher in Group 3 than in Group 1 and this tended to increase in Group 2 as compared to Group 1. There were no significant differences in the serum concentrations of VEGF receptor-1 in the women of the examined groups. Both on the day of TOP and on that of embryo transfer, the serum level of VEGF receptor-2 was statistically significantly higher in Group 3 than in Groups 1 and 2. Examining the follicular fluid concentrations of the angiogenic factors and IL-8 in Groups 1, 2, and 3 revealed significantly higher IL-8 levels in Group 1 than in Group 2. The conception rate was 44.44% in Group 1, 16.67% in Group 2, and 26.67% in Group 3 with less than 12-week pregnancy termination rates of 16.67%, 11.11%, and 6.67%, respectively. The incidence of mild OHSS was 11.11% in the GnRH-a group, 22.22% in the GnRH-a + hCG group, and 33.33% in the hCG group. Moderate OHSS developed only in Group 3 and amounted to 13.33%. No severe OHSS case was recorded in all the examined groups. Conclusion. The results of the investigation may lead to the conclusion that the patients who had used hCG as an ovulation trigger showed statistically significant higher serum concentrations of VEGA and its receptor-2 on the day of TOP than did those who had been given GnRH-a for final oocyte maturation. This is evidence in favor of the association between the concentration of VEGA and the development of OHSS and also the lower incidence of the latter when GnRH-a is used as an ovulation trigger.

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About the authors

B. A Martazanova

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: bellamart88@mail.ru
graduate student

Valentina V. Vtorushina

Academician V. I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: vtorushina@inbox.ru
Ph.D. in medical sciences, doctor of laboratory diagnostics in Laboratory of Clinical Immunology

S. E Ipen

I.M. Sechenov First Moscow State Medical university

Email: dr.snehaeapen@gmail.com
graduate student

N. G Mishieva

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: nondoc555@mail.ru
MD, Senior researcher of 1st gynecology department

Lyubov V. Krechetova

Academician V. I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: k_l_v_@mail.ru
Ph.D. in medical sciences, Head of Laboratory of Clinical Immunology

A. M Gracheva

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: Alusha.M.Petruk@yandex.ru
graduate student

M. V Martynova

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: Martinova_m@bk.ru
graduate student

S. M Mullabaeva

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: s_mullabaeva@oparina4.ru
Head of laboratory for the collection and storage of biomaterials

A. N Abubakirov

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: nondoc555@yahoo.ru
PhD, Head of 1st gynecology department

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