Soluble ICAM-1 and E-selectin levels correlate with clinical and biological aspects of severe ovarian hyperstimulation syndrome

Objective: To assess the potential involvement of the soluble endothelial c ell-leukocyte adhesion molecules E-selectin and intercellular adhesion mole cule-1 (ICAM-1) in the pathophysiology of capillary hyperpermeability in th e ovarian hyperstimulation syndrome (OHSS). Design: Controlled clinical study. Setting: Women hospitalized for severe OHSS after ovulation induction for I VF at two tertiary medical centers. Patient(s): Eleven patients with severe OHSS undergoing IVF and 20 controls who had received a similar ovulation induction regimen and did not develop OHSS. Intervention(s): Serial serum samples were obtained from all patients with OHSS from admission until discharge. Ascitic fluid was obtained from all pa tients by therapeutic paracentesis. Serum was obtained from all controls 4- 8 days after ET. Main Outcome Measure(s): Samples were assayed for soluble E-selectin and so luble ICAM-1 by using enzyme-linked immunosorbent assay and results were co rrelated with clinical and biological aspects of OHSS. Result(s): Compared with controls, patients with severe OHSS had higher lev els of soluble ICAM-1 and lower levels of soluble E-selectin detected in se rum and ascites. Serum levels of soluble ICAM-1 decreased, while soluble E- selectin levels increased along with clinical and biological improvement. S erum soluble ICAM-1 showed significant positive correlation and serum solub le E-selectin showed significant negative correlation with clinical and bio logical aspects of severe OHSS. Conclusion(s): Soluble ICAM-1 and soluble E-selectin seem to be involved in the pathophysiology of capillary hyperpermeability in severe OHSS. (C) 200 1 by American Society for Reproductive Medicine.