Cd. Chen et al., Prognostic importance of serial cytokine changes in ascites and pleural effusion in women with severe ovarian hyperstimulation syndrome, FERT STERIL, 72(2), 1999, pp. 286-292
Objective: To determine the prognostic value of various cytokine levels in
ascites and pleural effusion during the evolution of severe ovarian hyperst
imulation syndrome (OHSS).
Design: A longitudinal study.
Setting: University teaching hospital.
Patient(s): Twenty patients with severe OHSS who required either paracentes
is or thoracentesis or both from whom ascites (n = 56) or pleural effusion
(n = 12) samples were obtained. Control peritoneal fluid was obtained from
20 patients undergoing ovarian stimulation for IVF.
Intervention(s): Abdominal paracentesis for tense ascites and thoracentesis
for massive pleural effusion. Control peritoneal fluid was obtained before
oocyte retrieval.
Main Outcome Measure(s): Levels of interleukin-1 beta (IL-1 beta), interleu
kin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-alpha)
, vascular endothelial growth factor (VEGF), E-2, and progesterone concentr
ations in ascites and pleural effusion.
Result(s): Levels of VEGF and IL-6 in ascites dropped significantly during
the course of OHSS and were not correlated with E-2 concentrations. Levels
of VEGF were significantly correlated with levels of IL-1 beta, IL-8, and T
NF-alpha, as well as progesterone concentrations, hematocrit, and white blo
od cell counts. None of the cytokine levels measured in pleural effusion we
re correlated with the course of OHSS.
Conclusion(s): These results suggest that local cytokines might be involved
in the evolution of severe OHSS and possibly serve as prognostic markers f
or this syndrome. (C) 1999 by American Society for Reproductive Medicine.