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Human Reproduction, Vol. 11, No. 7, pp. 1377-1380, 1996
© 1996 European Society of Human Reproduction and Embryology

research-article

Endocrinology: Ovarian hyperstimulation syndrome: pre-ovulatory serum concentrations of interleukin-6, interleukin-1 receptor antagonist and tumour necrosis factor-{alpha} cannot predict its occurrence

J. Ricardo Loret de Mola1,3,5, Gavin P. Baumgardner2,4, James M. Goldfarb1,3 and Miriam A. Friedlander2,4

1Departments of Reproductive Biology Case Western Reserve University Division of Nephrology, University Hospitals of Cleveland, Cleveland, OH, USA 2Departments of Reproductive Medicine Case Western Reserve University Division of Nephrology, University Hospitals of Cleveland, Cleveland, OH, USA 3Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, University MacDonald Womenls Hospital Division of Nephrology, University Hospitals of Cleveland, Cleveland, OH, USA 4Department of Methcine Division of Nephrology, University Hospitals of Cleveland, Cleveland, OH, USA

Correspondence: 5To whom correspondence should be addressed at University of Pennsylvania, Department of Obstetrics and Gynecology, 3400 Spruce Street, Dulles 106, Philadelphia, PA 19104-4283, USA

The pathogenesis of the ovarian hyperstimulation syndrome (OHSS) is poorly understood. Since significant elevations in cytokines are found in 01155, our objective was to conduct a prospective case-controlled study to assess if preovulatory cytokine serum concentrations can predict its occurrence. The study group was selected from in-vitro fertilization patients who subsequently developed severe OHSS, along with a matched group who did not develop this complication (n = 20), and a healthy normal control group (n = 10). Interleukin-6 (IL-6), interleukin-1 receptor antagonist (IL-1RA) and tumour necrosis factor-{alpha} (TNF{alpha}) measurements were performed with sensitive immune-assays and confirmed with bioassays. Serum IL-6 (mean concentration ± SEM: 4.38 ± 0.36 pg/ml), IL-1RA (829 ± 292 pg/ml) and TNF{alpha} (15.5 ± 132 pg/ml) concentrations did not show differences throughout the normal menstrual cycle group. Cytokine variability and pre-ovulatory values were similar in OHSS compared to controlled ovarian hyperstiinulation (COH) patients. However, average follicular phase serum 1L-6 concentrations were higher in OHSS (8.71 ± 0.41 pg/ml) and COH (7.66 ± 0.38 pg/ml) patients than in normally menstruating women (4.34 ± 0.99 pg/ml) (P < 0.0001). Pre-ovulatory serum 1L-6 concentrations were also higher in OHSS (9 ± 0.94 pg/ml) and COH (73 ± 0.97 pg/ml) patients than in controls (4.57 ± 1.1 pg/ml) (P < 0.01 and P < 0.04 respectively). IL-1RA and TNF{alpha} concentrations were comparable in all the groups. This study suggests that cytokine measurements cannot be used to predict the occurrence of OHSS prior to the administration of human chorionic gonadotrophin.

Key words: interleukin-6/interleukin-1 receptor antagonist/ovarian hyperstimulation syndrome/ovulation induction/tumour necrosis factor-{alpha}


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