OVARIAN HYPERSTIMULATION SYNDROME - PREOVULATORY SERUM CONCENTRATIONSOF INTERLEUKIN-6, INTERLEUKIN-1 RECEPTOR ANTAGONIST AND TUMOR-NECROSIS-FACTOR-ALPHA CANNOT PREDICT ITS OCCURRENCE

The pathogenesis of the ovarian hyperstimulation syndrome (OHSS) is po orly understood, Since significant elevations in cytokines are found i n OHSS, our objective was to conduct a prospective case-controlled stu dy to assess if preovulatory cytokine serum concentrations can predict its occurrence. The study group was selected from in-vitro fertilizat ion patients who subsequently developed severe OHSS, along with a matc hed group who did not develop this complication (n = 20), and a health y normal control group (n = 10), Interleukin-6 (IL-6), interleukin-1 r eceptor antagonist (IL-1RA) and tumour necrosis factor-alpha (TNF alph a) measurements were performed with sensitive immunoassays and confirm ed with bioassays, Serum IL-6 (mean concentration +/- SEM: 4.38 +/- 0. 36 pg/ml), IL-1RA (829 +/- 292 pg/ml) and TNF alpha (15.5 +/- 1.32 pg/ ml) concentrations did not show differences throughout the normal mens trual cycle group, Cytokine variability and pre-ovulatory values were similar in OHSS compared to controlled ovarian hyperstimulation (COH) patients, However, average follicular phase serum IL-6 concentrations were higher in OHSS (8.71 +/- 0.41 pg/ml) and COH (7.66 +/- 0.38 pg/ml ) patients than in normally menstruating women (4.34 +/- 0.99 pg/ml) ( P < 0.0001), Pre-ovulatory serum IL-6 concentrations were also higher in OHSS (9 +/- 0.94 pg/ml) and COH (7.3 +/- 0.97 pg/ml) patients than in controls (4.57 +/- 1.1 pg/ml) (P < 0.01 and P < 0.04 respectively), IL-1RA and TNF alpha concentrations were comparable in all the groups . This study suggests that cytokine measurements cannot be used to pre dict the occurrence of OHSS prior to the administration of human chori onic gonadotropin.