Intrafollicular melatonin concentration is elevated in patients with ovarian hyperstimulation syndrome (OHSS) and can serve as an important predictor of OHSS.

Abstract

Melatonin is an important factor in regulating numerous processes in human female reproduction. The aim of the present study was to compare melatonin levels in the follicular fluid (FF) of ovarian hyperstimulation syndrome (OHSS) women with those of non-OHSS women undergoing in vitro fertilization (IVF)-embryo transfer and to evaluate the relationship between FF melatonin levels and IVF outcomes in these women. We determined FF melatonin levels in 20 OHSS women and 23 non-OHSS women on oocyte retrieval day. OHSS patients had significantly higher melatonin levels as compared to the non-OHSS women (P<0.001). In addition, melatonin levels of the patients were significantly positively correlated with antral follicle count (AFC), serum anti-Müllerian hormone (AMH) levels, serum estradiol (E2) levels on human chorionic gonadotropin (HCG) administration day, number of retrieved oocytes, total fertilized oocytes, normally fertilized oocytes, cleaved zygotes, top quality embryos on day 3, blastocysts obtained and embryos suitable for transplantation (day 3 embryos+day 5/6 blastocysts) (P<0.05). While, the intrafollicular melatonin levels were significantly negatively correlated with age, basal serum follicle-stimulating hormone (FSH) levels, serum FSH levels on HCG administration day (P<0.01). Since younger women with more AFC, higher AMH levels, higher serum E2 levels and larger number of retrieved oocytes are much easier to encounter OHSS, while FF melatonin levels are significantly correlated with these five indices in our study, we propose that intrafollicular melatonin concentration can also be an important predictor of OHSS. This is the first demonstration that FF melatonin levels were significantly higher in OHSS patients than in non-OHSS group and FF melatonin levels may serve as an important predictor of OHSS.