Controlled ovarian hyperstimulation: A state of neutrophil activation

PROBLEM: To investigate if controlled ovarian hyperstimulation (COH) affect s the expression of neutrophil adhesion molecules and if a correlation exis ts between neutrophil activation and serum sex-steroid levels. METHOD OF STUDY: The pilot study was carried out in the in vitro fertilizat ion (IVF) unit of our department, and required no modification of our routi ne IVF protocol. Four patients arriving for baseline hormonal profile on da y 1 of the menstrual cycle before initiation of COH (control group) and 11 patients admitted for; oocyte recovery (study group) were included. Venous blood was obtained from all patients and examined for hormonal profile and neutrophil activation. The latter was performed by staining for the surface adhesion molecules beta 2 integrin and L-selectin. Positive cell count and mean fluorescence intensity were determined by flow cytometry. RESULTS: While neutrophil L-selectin was significantly lower in the study g roup than in the control group, neutrophil beta 2 integrin was nonsignifica ntly higher. Though no significant correlations were found between neutroph il adhesion molecules and patient age, serum estradiol level, and human cho rionic gonadotropin level; neutrophil L-selectin was negatively correlated with serum progesterone levels. CONCLUSIONS: COH leads to neutrophil activation, which correlates with the degree of luteinization. Further studies are required to elucidate the rela tionship between the immune system and COH. These may lead to new strategie s for promoting fertility and preventing complications of COH.