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.
Highlights
The incidence of severe Ovarian Hyperstimulation Syndrome (OHSS) in gonadotropin-treated cycles is 0.5% 3.0% [1]
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
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
Summary
The incidence of severe Ovarian Hyperstimulation Syndrome (OHSS) in gonadotropin-treated cycles is 0.5% 3.0% [1]. Rat ovaries hyperstimulated in vivo using gonadotropins plus human Chorionic Gonadotropin (hCG) demonstrated increased vascular permeability, which was reversed by administration of a specific Vascular Endothelial Growth Factor (VEGF) inhibitor [3] or by block-. VEGF was found to be the key factor in OHSS development during gonadotropin treatment for infertility [6,7]. VEGF, known as Vascular Permeability Factor, is a homodimeric glycoprotein acting as an endothelial cell mitogenic/angiogenic factor [8] and as a permeability factor [9]. It is able to induce proliferation of endothelial cells and their organization into a new vascular network, supplying blood rich in oxygen, nutrients, hormones, and various growth factors [10]. The balance of VEGF isoforms control follicle progression and luteogenesis [11]
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