Follicular fluid levels of vascular endothelial growth factor - Are they predictive markers for ovarian hyperstimulation syndrome

OBJECTIVE: To determine the possible predictive role of vascular endothelia l growth factor (VEGF) levels in the follicular fluid (FF) at the time of o ocyte retrieval in the development of ovarian hyperstimulation syndrome (OH SS) and its possible origin. STUDY DESIGN: FF was obtained from 174 high-responder patients at the time of oocyte retrieval. The study group comprised 16 high-responder patients w ho developed early, severe OHSS and from whom serum and peritoneal fluid (P F) were obtained during the active phase of the syndrome. These women were compared to 16 high-responder patients who did not develop OHSS. An additio nal control group comprised 16 low-responder patients who also did not deve lop OHSS. The FF, serum and PF samples were tested for VEGF by enzyme-lined immunosorbent assay. RESULTS: No differences in the FF VEGF levels were found among the OHSS gro up (1,742.3 +/- 522.4 pg/mL), the high-responder group that did not develop OHSS (1,802.0 +/- 584.3 pg/mL) and the low-responder group (1,686.7 +/- 37 4.2 pg/mL). In the OHSS group, no differences were found between the serum and PF VEGF levels (247.3 +/- 31.4 and 642.9 +/- 328.3 pg/mL, respectively) . No correlation runs found between the FF concentrations of VEGF and the m ean serum 17-beta estradiol levels or number of oocytes retrieved. CONCLUSION: We conclude that preovulatory FF levels should nor serve as a p ossible predictive factor development of OHSS. The increased capillary perm eability found in OHSS may be due to ifs systemic effect.