HUMAN CHORIONIC GONADOTROPIN-DEPENDENT EXPRESSION OF VASCULAR ENDOTHELIAL GROWTH-FACTOR VASCULAR-PERMEABILITY FACTOR IN HUMAN GRANULOSA-CELLS - IMPORTANCE IN OVARIAN HYPERSTIMULATION SYNDROME

Ovarian hyperstimulation syndrome (OHSS) is a severe complication aris ing from controlled ovarian stimulation treatment. This iatrogenic con dition is potentially lethal and occurs in 0.3-5% of stimulated ovaria n cycles. hCG exacerbates OHSS. The pathophysiology of OHSS is still u nknown; therefore, treatment regimens are aimed at ameliorating sympto ms. Prominent features of OHSS are an elevated risk of thromboembolism due to enhanced production of von Willebrand factor by endothelial ce lls and ascites, or pulmonary edema due to increased vascular permeabi lity followed by third space fluid accumulation. Both of these sequela e can be evoked by vascular endothelial growth factor (VEGF), also kno wn as vascular permeability factor (VPF). High concentrations of VEGF/ VPF have been demonstrated in ascitic fluid from patients with OHSS, b ut the source of VEGF/VPF in these patients remained unidentified. Her e we report that the messenger ribonucleic acid expression of VEGF/VPF in human luteinized granulosa cells (GCs) is dose and time dependentl y enhanced by hCG in vitro. Furthermore, VEGF/VPF proteins are produce d by GCs. Our results suggest that the effects of hCG on the developme nt and course of OHSS may be mediated by the production of VEGF/VPF by GCs.