Variations in serum vascular endothelial growth factor binding profiles and the development of ovarian hyperstimulation syndrome

Abstract

Objective: To compare the ability of serum to sequester vascular endothelial growth factor (VEGF) among patients who did and did not develop ovarian hyperstimulation syndrome (OHSS). Design: Prospective, observational study. Setting: A regional fertility centre with a commitment to research. Patient(s): Five patients undergoing controlled ovarian hyperstimulation as part of an in vitro fertilization cycle who developed severe OHSS, and five controls. Intervention(s): Serum, collected at the time of oocyte retrieval, was incubated with radioactive VEGF ( 125I-VEGF 165) for 2 hours before being passed down a sephadex G-150 gel filtration column. The fractional radioactive profile was then determined. Main Outcome Measure(s): The distribution of radioactive VEGF across the various fractions was measured in serum samples obtained from the two groups. Result(s): The 125I-VEGF 165 applied to the column eluted in two peaks centered on fractions 18 ± 2 and 39 ± 2. The molecular weight in the first peak was >300,000 kDa and represented “bound” VEGF; the second peak represented “unbound” VEGF. In the OHSS group, there was statistically significantly less radioactivity in the first peak than in the no-OHSS group. Conclusion(s): Patients who do not develop OHSS appear to have a high-molecular-weight protein that binds VEGF to a greater degree than occurs in patients who develop OHSS.