FEATURES OF THE RENIN-ANGIOTENSIN SYSTEM IN ASCITES AND PLEURAL EFFUSION DURING SEVERE OVARIAN HYPERSTIMULATION SYNDROME

Purpose: The purpose of this work was to investigate the ovarian renin -angiotensin system (RAS) during severe ovarian hyperstimulation syndr ome (OHSS) with ascites and pleural effusion. Methods: Two patients wh o developed severe OHSS after ovarian stimulation for in vitro fertili zation were investigated, Both patients presented ascites and pleural effusion. Blood, ascites, and pleural fluid were simultaneously sample d during therapeutic paracentesis and thoracocentesis. Renin activity, active renin, prorenin, and angiotensin II immunoreactivity (Ang II-i r) were measured simultaneously in plasma, ascites, and pleural fluid. Results: Prorenin, renin activity, active renin, and Ang II-ir levels were much higher than normal plasmatic laboratory norms in the three compartments. Prorenin and Ang II-ir levels were the highest in the as cites, while they were in the same range in the pleural fluid and in t he plasma. Conclusions: The present findings provide additional eviden ce for the ovarian origin of the prorenin and Ang II-ir in the ascites of severe OHSS.