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Human Reproduction, Vol. 11, No. 7, pp. 1381-1386, 1996
© 1996 European Society of Human Reproduction and Embryology


research-article

Endocrinology: Plasma inflammatory cytokines correlate to the ovarian hyperstimulation syndrome

Y. Abramov1, J.G. Schenker, A. Lewin, S. Friedler, B. Nisman and V. Barak

Department of Obstetrics and Gynecology, and the Immunology Laboratory for Tumour Diagnosis, Oncology Department, The Hebrew University Hadassah Medical Center Em-Kerem, Jerusalem, Israel

Correspondence: 1To whom correspondence should be addressed at Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Em Kerem, PO Box 12000, Jerusalem il-91120, Israel

The objective of this study was to follow the kinetics of four inflammatory cytokines in the plasma and aseitic fluid of seven patients who developed severe ovarian hyperstimulation syndrome (OHSS) after induction of ovulation for in-vitro fertilization. Blood samples were obtained from these patients at three different times: upon hospitalization; when significant clinical improvement was evident; and after complete resolution. Samples were analysed for interleukin-1 (IL-i), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor {alpha} (TNF-{alpha}). Ascitic fluid was obtained by therapeutic paracentesis from all study patients during the active phase and analysed for these cytokines. Two control groups were available: the first Included 15 women undergoing controlled ovarian stimulation for in-vitro fertilization without developing OHSS, while the second consisted of 25 healthy women not undergoing ovulation induction or any other medical treatment. High concentrations of IL-1, IL-6, and TNF-{alpha} were detected in all individuals upon admission for severe OHSS. Concentrations dropped significantly along with clinical improvement, reaching normal values after complete resolution. A statistically significant correlation was found between plasma cytokine concentrations and certain biological char acteristics of the syndrome such as leukocytosis, increased haematocrit, and elevated plasma 17-{beta}-oestradiol concentrations. Ascitic fluid obtained from the study patients contained high IL-6 and IL concentrations, while other cytokines were unaltered. These results suggest close association between inflammatory cytokines and the pathophysiology of the ovarian hyperstimulation syndrome.

Key words: interleukin-1/interleukin-6/interleukin-8/ovarian hyperstimulation syndrome/tumour necrosis factor


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