VASCULAR ENDOTHELIAL GROWTH-FACTOR LEVELS IN SERUM AND FOLLICULAR-FLUID OF PATIENTS UNDERGOING IN-VITRO FERTILIZATION

Objective: To define the relationship between serum and follicular flu id (FF) levels of vascular endothelial growth factor (VEGF), E-2, and P in patients undergoing IVF; to quantify the effects of hCG on serum levels of VEGF during early pregnancy; and to report serial measuremen ts of serum and ascites fluid levels of VEGF in a patient with severe ovarian hyperstimulation syndrome (OHSS). Design: Prospective observat ional study. Setting: University IVF program. Patient(s): Women underg oing conventional IVF, receiving donated oocytes or spontaneously conc eiving. One patient hospitalized with severe OHSS. Main Outcome Measur e(s): Concentrations of VEGF, E-2, and P in serum, FF, or peritoneal f luid. Result(s): At the time of egg retrieval, FF VEGF concentrations were positively correlated with serum and FF P concentrations and with patient age. At 11 to 14 days after ET, pregnant recipients of autolo gous fresh embryos had higher serum VEGF levels than both nonpregnant recipients of autologous fresh embryos and pregnant recipients of dono r eggs. Elevated serum VEGF levels in a patient with severe OHSS coinc ided with the clinical onset and recurrence of symptoms. Conclusion(s) : In patients undergoing IVF, FF VEGF levels at the time of egg retrie val correlated with the degree of follicular luteinization. There is a significant ovarian contribution to circulating VEGF levels during ea rly gestation. Elevated serum VEGF levels may be a factor in the etiol ogy of OHSS symptoms. (C) 1997 by American Society for Reproductive Me dicine.