OJOG  Vol.3 No.2 , March 2013
Variations in vascular endothelial growth factor levels during ovarian superovulation and reduction of ovarian hyperstimulation incidence in young women: A prospective study
ABSTRACT

Variations in Vascular Endothelial Growth Factor (VEGF) levels were prospectively evaluated in 18 young women undergoing in vitro fertilization treatments according to the “Long Protocol” and a typical pattern of VEGF levels was recorded. A significant increase in VEGF concentrations was observed only when the follicles reached a mean diameter of 15.3 mm in concurrence with mature oocyte retrieval. Since an increase in VEGF levels is related to follicular vascularity and oocyte developpment, our study supports the approach that oocyte retrieval may be performed when follicles > 15 mm in diameter appear. Anticipating egg retrieval in young patients with an optimal ovarian reserve may decrease the incidence of severe ovarian hyperstimulation, without compromising the treatment results.


Cite this paper
Levitas, E. , Huleihal, M. , Lunenfeld, E. , Gakman, R. , Friger, M. and Potashnik, G. (2013) Variations in vascular endothelial growth factor levels during ovarian superovulation and reduction of ovarian hyperstimulation incidence in young women: A prospective study. Open Journal of Obstetrics and Gynecology, 3, 296-300. doi: 10.4236/ojog.2013.32055.
References
[1]   Vlahos, N.F. and Gregoriou, O. (2006) Prevention and management of Ovarian Hyperstimulation Syndrome. Annals of the New York Academy of Science, 1092, 247-264. doi:10.1196/ annals.1365.021

[2]   Gera, P.S., Tatpati, L.L., Allemand, M.C., Wentworth, M.A. and Coddington, C.C. (2010) Ovarian hyperstimulation syndrome: Steps to maximize success and minimize effect for assisted reproductive outcome. Fertility and Sterility, 94, 173-178. doi:10.1016/j.fertnstert.2009.02.049

[3]   Gomez, R., Simon, C., Remohi, J. and Pellicer, A. (2002) Vascular endothelial growth factor receptor-2 activation induces vascular permeability in hyperstimulated rats, and this effect is prevented by receptor blockade. Endocrinology, 143, 4339-4348. doi:10.1210/en.2002-220204

[4]   Soares, S.R. (2012) Etiology of OHSS and use of dopamine agonists. Fertility and Sterility, 97, 517-522. doi:10.1016/j.fertnstert.2011.12.046

[5]   Fraser, H.M. and Duncan, W.C. (2009) SEB reproduction, fertility and development award lecture 2008: Regulation and manipulation of angiogenesis in the ovary and endometrium. Reproduction, Fertility and Development, 21, 377-392. doi:10.1071/RD08272

[6]   McClure, N., Healy D.L., Rogers, P.A., Sullivan, J., Beaton, L., Haning, R.V. Jr., Connolly, D.T. and Robertson, D.M. (1994) Vascular Endothelial Growth Factor as capillary permeability agent in ovarian hyperstimulation syndrome. Lancet, 344, 235-236. doi:10.1016/S0140-6736(94)93001-5

[7]   Wang, T.H., Horng, S.G., Chang, C.L., Wu, H.M., Tsai, Y.J., Wang, H.S. and Soong, Y.K. (2002) Human chorionic gonadotropin-induced ovarian hyperstimulation syndrome is associated with up-regulation of vascular endothelial growth factor. Journal of Clinical Endocrinology and Metabolism, 87, 3300-3308. doi:10.1210/jc.87.7.3300

[8]   Ferrara, N., Houck, K., Jakeman, L. and Leung, D. (1992) Molecular and biological properties of vascular endothelial growth factor family of proteins. Endocrine Reviews, 13, 18-32.

[9]   Senger, D.R., Gali, S.J., Dvorak, A.M., Perruzzi, C.A., Harvey, V.S. and Dvorak, H.F. (1983) Tumor cells secrete a vascular permeability factor that promotes accumulation of ascites fluid. Science, 219, 983-985. doi:10.1126/science.6823562

[10]   Risau, W. (1997) Mechanism of angiogenesis. Nature, 386, 671-674. doi:10.1038/386671a0

[11]   Qiu, Y., Seager, M., Osman, A., Castle-Miller, J., Bevan, T., Tortonese, D.J., Murphy, D., Harper, S.J., Fraser, H.M., Donaldson, L.F. and Bates, D.O. (2012) Ovarian VEGF165b expression regulates follicular development, corpus luteum function and fertility. Reproduction, 143, 501-511. doi:10.1530/ REP-11-0091

[12]   Phillips, H.S., Hains, J., Leung, D.W. and Ferrara, N. (1990) Vascular endothelial growth factor is expressed in rat corpus luteum. Endocrinology, 127, 965-967. doi:10.1210/endo-127-2-965

[13]   Wulff, C., Wilson, H., Wiegand, S.J., Rudge, J.S. and Fraser, H.M. (2002) Prevention of thecal angiogenesis, antral follicular growth, and ovulation in the primate by treatment with vascular endothelial growth factor trap RIR2. Endocrinology, 143, 2797-2807. doi:10.1210/en.143.7.2797

[14]   Otani, N., Sawako, M., Yamoto, M., Shikone, T., Otani, H., Nishiyama, R., Otani, T. and Nakano, R. (1999) The vascular endothelial growth factor/fms-like tyrosine kinase system in human ovary during the menstrual cycle in early pregnancy. Journal of Clinical Endocrinology and Metabolism, 84, 3845-3851. doi:10.1210/jc.84.10.3845

[15]   Levitas, E., Chamoun, D., Udoff, L.C., Ando, M., Resnick, B.S. and Adashi, E.Y. (2000) Periovulatory and interleukin-1β-dependent up-regulation of intraovarian vascular endothelial growth factor in the rat: Potential role for VEGF in the promotion of periovulatory angiogenesis and vascular permeability. Journal of the Society for Gynecologic Investigation, 7, 51-60. doi:10.1016/S1071-5576(99)00066-0

[16]   Lee, A., Christenson, L.K., Stouffer, R.L., Burry, K.A. and Patton, P.E. (1997) Vascular endothelial growth factor levels in serum and follicular fluid of patients undergoing in vitro fertilization. Fertility and Sterility, 68, 305-311. doi:10.1016/S0015-0282(97)81520-8

[17]   Humaidan, P., Quartarolo, J., Evangelos, G. and Papanikolaou, E.G. (2010) Preventing ovarian hyperstimulation syndrome: Guidance for the clinician. Fertility and Sterility, 94, 389-340. doi:10.1016/j.fertnstert.2010.03.028

[18]   Christenson, L.K. and Stouffer, R.L. (1997) Follicle-stimulating hormone and luteinizing hormone/ chorionic gonadotropin stimulation of vascular endothelial growth factor production by macaque granulose cells from preand periovulatory follicles. Journal of Clinical Endocrinology and Metabolism, 82, 2135-2142. doi:10.1210/jc.82.7.2135

[19]   Shrestha, S.M., Costello, M.F., Sjoblom, P., McNally, G., Bennet, M., Steigrad, S.J. and Hughes, G.J. (2006) Power doppler ultrasound assessment of follicular vascularity in the early follicular phase and its relationship with outcome of in vitro fertilization. Journal of Assisted Reproduction and Genetics, 23, 161-169. doi:10.1007/s10815-006-9029-1

[20]   Merce, L.T., Bau, S., Barco, M.J., Troyano, J., Gay, R., Sotos, F. and Villa, A. (2006) Assessment of the ovarian volume, number and volume of follicles and ovarian vascularity by three-dimensional ultrasonography and power Doppler angiography on the hCG day to predict the outcome of IVF/ICSI cycles. Human Reproduction, 21, 1218-1226.

[21]   Kim, K.H., Oh, D.S., Jeong, J.H., Shin, B.S., Joo, B.S. and Lee, K.S. (2004) Follicular blood flow is a better predictor of the outcome of in vitro fertilization-embryo transfer than follicular fluid vascular endothelial growth factor and nitric oxide concentrations. Fertility and Sterility, 82, 586-592. doi:10.1016/j.fertnstert.2004.02.120

[22]   Salha, O., Nugent, D., Dada, T., Kaufmann, S., Levett, S., Jenner, L., Luyi, S. and Sharma, V. (1998) The relationship between follicular fluid aspirate volume and oocyte maturity in in-vitro fertilization cycles. Human Reproduction, 13, 1901-1906. doi:10.1093/humrep/13.7.1901

[23]   Rosen, M.P., Shen, S.H., Dobson, A.T., Rinaudo, P.F., McCulloch, C.E. and Cedars, M.I. (2008) A quantitative assessment of follicle size on oocyte developmental competence. Fertility and Sterility, 90, 684-690. doi:10.1016/j.fertnstert.2007.02.011

[24]   Ectors, F.J., Vanderzwalmen, P., Van Hoeck, J., Nigs, M., Verhaegen, G., Delvigne, A., Schoysman, R. and Leroy, F. (1997) Relationship of human follicular diameter with oocyte fertilization and development after in-vitro fertilization or intracytoplasmic sperm injection. Human Reproduction, 12, 2002-2005. doi:10.1093/humrep/12.9.2002

 
 
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