Changes in vascular endothelial growth factor levels and the risk of ovarian hyperstimulation syndrome in women enrolled in an in vitro fertilization program.

Objective: To evaluate plasma and follicular fluid levels of vascular endothelial growth factor (VEGF) in women undergoing controlled ovarian hyperstimulation to establish the possible role of this growth factor as a predictive marker of ovarian hyperstimulation syndrome (OHSS).

Design: Prospective observational study.

Setting: University hospital infertility unit.

Patient(s): Fifteen women at risk of OHSS and 15 controls.

Intervention(s): An IM injection of hCG was administered; plasma and follicular fluid samples were collected 34-38 hours after administration of hCG.

Main Outcome Measure(s): VEGF levels in plasma and in follicular fluid.

Result(s): VEGF levels increased after hCG administration in the patients at risk of developing OHSS and in those who developed OHSS. Further, on the day of the oocyte retrieval the increase in the VEGF levels in the plasma of the patients who developed OHSS was statistically significant compared with the increase in the levels in the women who did not. On the same day, the levels of VEGF in follicular fluid were 10 times greater than those in plasma.

Conclusion(s): Plasma levels of VEGF peak after hCG administration and are related to the risk of developing OHSS.