Oocyte Retrieval For IVF Research Articles

Pain relief during oocyte retrieval — exploring the role of different frequencies of electro-acupuncture

Electro-acupuncture has previously proven its analgesic effect in oocyte retrieval for IVF. The aim of the present prospective randomized study was to explore the optimal frequency for analgesia when electro-acupuncture was applied a few minutes prior to oocyte retrieval. A total of 152 patients were prospectively randomized to receive either a combination of high (80 Hz) and low frequency (2 Hz), 3 s each, a so-called mixed frequency, or a fixed frequency of 20 Hz during oocyte retrieval. In addition to electro-acupuncture, both groups had a paracervical block and manual acupuncture. No differences in pain before, during or after oocyte retrieval between the two groups were seen. In the fixed frequency group, however, a higher level of anxiety ( P < 0.05) before oocyte retrieval was seen, and a higher level of nausea after aspiration of one ovary ( P < 0.01) was seen in the mixed frequency group. No differences were seen regarding clinical outcome parameters. Contrary to previous reports on acute and chronic pain, the analgesic effect of the mixed frequency and the fixed frequency was similar when used for short duration electro-acupuncture.

A pelvic pseudoaneurysm (a rare complication of oocyte retrieval for IVF) treated by arterial embolization

This is a case report of the diagnosis and treatment of a pelvic pseudoaneurysm in a patient. Her history leads to the conclusion that this developed following egg retrieval during in vitro fertilization six years earlier.

Cardiopulmonary Comparisons in Healthy Normotensive Patients Undergoing Uncomplicated Transvaginal Oocyte Retrieval for IVF: Impact of Age and BMI

Cardiopulmonary Comparisons in Healthy Normotensive Patients Undergoing Uncomplicated Transvaginal Oocyte Retrieval for IVF: Impact of Age and BMI

Non-genomic action of estradiol and progesterone on cytosolic calcium concentrations in primary cultures of human granulosa-lutein cells

The present study examined whether the sex steroids, estradiol and progesterone, could alter cytoplasmic calcium concentrations ([Ca(2+)](cyt)) in human granulosa-lutein cells. Human granulosa cells were obtained at the time of oocyte retrieval for IVF and cultured for 3-7 days. Cells were loaded with Fura-2 AM and changes in [Ca(2+)](cyt) of single cells were studied using a dynamic digital Ca(2+) imaging system. Both estradiol and progesterone stimulated elevations of [Ca(2+)](cyt) in Ca(2+)-containing medium within seconds of exposure of the granulosa-lutein cells to the steroid, but only estradiol caused an increase in [Ca(2+)](cyt) in Ca(2+)-free medium. Both ICI-182780 and RU 486 stimulated [Ca(2+)](cyt) increases and inhibited the effects of estradiol and progesterone, respectively. Tamoxifen also induced transient increases in [Ca(2+)](cyt) concentrations but inhibited the effects of both estradiol and progesterone. The inhibitory effects of tamoxifen, ICI-182780 and RU 4486 on [Ca(2+)](cyt) responses to estradiol and progesterone could be reversed with higher concentrations of estradiol and progesterone, respectively. The [Ca(2+)](cyt) effects induced with tamoxifen could not be eliminated by prior treatment with RU 486 or ICI-182780. These results provide strong evidence that both estradiol and progesterone as well as the steroid antagonists, tamoxifen, RU 486 and ICI-182780, can act on human granulosa-lutein cells through a non-genomic mechanism.

Anti‐müllerian hormone as a marker of ovarian reserve*

To analyse the usefulness of plasma anti-mullerian hormone (AMH) measurement as a tool for assessing ovarian reserve in a general infertility population. Plasma AMH levels were analysed in 238 women aged 18-46 years during day 3-5 of their menstrual cycle. All 238 patients had follicle stimulating hormone (FSH) levels less than 10 i.u./L, suggesting normal ovarian reserve on traditional FSH criteria. Eighty-seven patients gave their consent to correlate their AMH levels with IVF oocyte retrieval outcome. Patients producing > or = 8 oocytes were classified as having normal ovarian reserve, while those producing < or = 4 oocytes were classified as having poor ovarian reserve. Plasma AMH levels remained relatively static (20-25 pmol/L) from 18 to 29 years of age. By 30 years of age, plasma AMH levels start to drop rapidly, reaching only 10 pmol/L by 37 years. Despite this 50% fall in AMH levels between 29 and 37 years of age, minimal changes in FSH levels were observed. Using a cut off value of 8.1 pmol/L, plasma AMH assessment could predict poor ovarian reserve on a subsequent IVF cycle with a sensitivity of 80% and a specificity of 85%. Plasma AMH assessments are superior to FSH in identifying women with reduced ovarian reserve. Anti-mullerian hormone assessment should be considered as a useful adjunct to FSH/oestradiol levels and antral follicle count when estimating ovarian reserve.

The Efficacy of Test Tube Warming Devices Used During Oocyte Retrieval for IVF

To investigate whether commonly used test tube warming devices maintain a constant temperature in follicular fluid aspirates. By using a digital thermocouple, temperature was measured and comparisons were made between an analog dry block heater, a digital dry block heater, and a thermostatic test tube heater. For small fluid volumes, temperature in the block heaters increased above 37 degrees C after being in the block for over 2 min. The thermostatic heater maintained a constant temperature, but this was below the factory setting of 36.9 degrees C. Temperature maintenance was influenced by fluid volume in each tube. One of the key factors in the handling of gametes and embryos is the maintenance of constant temperature. Test tube warming devices require verification of their ability to maintain fluid at the desired temperature. Temperature may vary with fluid volume and the type of test tube warming device used.

The relationship between the expression of the apoptosis-related genes (caspase-3, 8, PARP) in granulosa cells and the outcome of IVF patients

Although the precise mechanism of granulosa cell (GC) apoptosis has not yet been clarified, GC died during follicular atresia and luteolysis results from apoptosis have suggested a potential role in human reproduction. Besides, that apoptotic episode may be involved in the outcome of IVF. The objective of this study was to investigate the effects of apoptosis-related genes in the GC of IVF patients regarding fertilization, cleavage, and pregnancy rate. A prospective clinical study Human GCs were obtained from pooled collections of follicular fluid from 56 women with normal FSH levels (aged <40 years) that were undergoing oocyte retrieval for IVF under the indications of tubal factor, male factor, and unexplained cases. The GCs were lysed in a sample buffer. Western blot were performed with the ECL detection system. We designated the active form of apoptosis-related genes as group1(g1), while group2 (g2) showing no active form. The active form of cysteine protease caspase-8 was detected in 39 women (g1) but not in 17 (g2). The percentage of fertilization, cleavage, and pregnancy rate in g1/g2 was 97.6/98.5, 72.0/72.0 and 25.6/52.9 (p=0.0473), respectively. There was a statistically significant difference in the pregnancy rate between the two groups (p<0.05). On the other hand, the active form of caspase-3 was observed in 34 women (g1) but not in 22 (g2). Fertilization, cleavage, and pregnancy rates between g1 and g2 were 97.5/97.9, 75.1/69.7, and 29.4/40.9, respectively. The cleavage fragment of PARP was observed in 33 women (g1), but not in 23 (g2). The fertilization, cleavage, and pregnancy rates in g1/g2 were 96.7/95.6, 73.0/70.0 and 33.3/34.8. Data were analyzed using X2-test and Fisher’s exact test (p<0.05). Our study demonstrated higher pregnancy rate revealed group2 than group1. On the other hand, there were no differences in the fertilization, cleavage, and pregnancy rates between group1 and group2 of caspase-3, PARP. Although some authors have not confirmed the existence of a relationship between apoptosis and the outcome of IVF patients, several reports have been published showing relationship. However, it was noted that women with lower percentage of GC apoptosis had higher pregnancy rates. Caspases’ activation did not occur until after oocyte activation. The ligation of Fas ligand to Fas in the cellular membrane triggers the activation of caspase 8. Once activated, caspase 8 transduces signal to effector caspases including caspase 3 known to be a major executioner protease. This leads to the degradation of those caspases, cellular substrates, including cytoplasmic structural proteins such as actin and nuclear proteins such as PARP. Interestingly, in Xenopus, the activation of embryonic gene transcription leads to a decrease in embryo susceptibility to apoptosis after the previous increase due to oocyte activation. Although caution must be shown when comparing results obtained with caspase 8, which was associated with pregnancy rate, it has been well demonstrated that caspase 8 and 3 are directly associated with the Fas-mediated apoptosis pathway, as already reported. In all circumstances, further studies are progressed to demonstrate a prognostic role for apoptosis of GC, such as confirming the results in vivo according to the women stimulation protocol.

Thrombocythemia and hemoperitoneum after transvaginal oocyte retrieval for in vitro fertilization

To present the first report of massive hemoperitoneum in a case of essential thrombocythemia after transvaginal oocyte retrieval for IVF and review the relevant literature related to the management of patients with this condition. Case report. Assisted conception unit of a tertiary care university hospital in the United Kingdom. A 37-year-old woman with essential thrombocythemia who developed massive intra-abdominal bleeding after transvaginal oocyte retrieval for IVF. Emergency laparotomy and right salpingoophorectomy. Resuscitation of the patient. Overall management of the patient is discussed. The management of patients with essential thrombocythemia at the childbearing period poses a difficult problem. Fertility may be reduced, and an adverse outcome of pregnancy due to thrombotic or bleeding complications is a matter of concern. A multidisciplinary approach with close and early cooperation with the hematologists before initiation of IVF therapy for patients with essential thrombocythemia is essential. Efforts should be made to reduce the platelet count and assess the platelet function before embarking on IVF, keeping in mind the double jeopardy from bleeding and thrombosis in these cases.

Relationship of follicular fluid growth factors with IVF outcome

Objective: The role of cytokines and growth factors in the ovulatory process is increasingly evident. The objective of this study was to evaluate the levels of TGF- B1, TGF- B2, and VEGF in the periovulatory FF during IVF cycles.Design: A prospective study.Materials and Methods: Follicular fluid from 23 women was obtained while they underwent oocyte retrieval for IVF. We measured the concentrations of TGF- B1, TGF- B2, and VEGF in FF using quantative ELISA kits and compared the levels among women who became pregnant and those who did not.Results: We were not able to detect TGF- B1 and TGF- B2 in the FF of all cycles. The patients were grouped according to FF VEGF vlaues into group A <1000 pg/mL and group B >1000 pg/mL. Pregnancy rate was 27% in group A as compared to 50% in group B. Both pregnant and non-pregnant patients were comparable regarding age, parity, ovarian stimulation parameters, fertilization rates, and embryo freezing rates (table). Good quality embryos were significantly higher in group A as compared to group B (p = 0.02).Conclusion: High levels of VEGF in the periovulatory FF may be associated with low quality of the developing embryos derived from this cycle. Further studies involving high number of cycles are needed to verify these data. Tabled 1∗P value <0.05 considered significant between the 2 groups. Objective: The role of cytokines and growth factors in the ovulatory process is increasingly evident. The objective of this study was to evaluate the levels of TGF- B1, TGF- B2, and VEGF in the periovulatory FF during IVF cycles. Design: A prospective study. Materials and Methods: Follicular fluid from 23 women was obtained while they underwent oocyte retrieval for IVF. We measured the concentrations of TGF- B1, TGF- B2, and VEGF in FF using quantative ELISA kits and compared the levels among women who became pregnant and those who did not. Results: We were not able to detect TGF- B1 and TGF- B2 in the FF of all cycles. The patients were grouped according to FF VEGF vlaues into group A <1000 pg/mL and group B >1000 pg/mL. Pregnancy rate was 27% in group A as compared to 50% in group B. Both pregnant and non-pregnant patients were comparable regarding age, parity, ovarian stimulation parameters, fertilization rates, and embryo freezing rates (table). Good quality embryos were significantly higher in group A as compared to group B (p = 0.02). Conclusion: High levels of VEGF in the periovulatory FF may be associated with low quality of the developing embryos derived from this cycle. Further studies involving high number of cycles are needed to verify these data. Tabled 1∗P value <0.05 considered significant between the 2 groups. ∗P value <0.05 considered significant between the 2 groups.

Effect of gonadotropins on brain-derived neurotrophic factor secretion by human follicular cumulus cells

Effect of gonadotropins on brain-derived neurotrophic factor secretion by human follicular cumulus cells

Few instead of many: human follicle collection from follicular aspirates at oocyte retrieval.

The aim of this study was to determine if follicular aspirates obtained during oocyte retrieval for IVF were a good source of ovarian follicles for research purposes. Follicular aspirates from 86 patients were collected and examined for the presence of follicles, and histological examination of tissue sample found was undertaken. Follicles were only obtained from aspirates of seven out of a total of 86 patients. From these samples a total of 14 follicles was found. The follicles were primordial, primary or secondary, 40-80 microm in diameter. Three of these recovered follicles were cultured and all degenerated within 2 days. In all aspirates some groups of granulosa cells that did not contain follicles or oocytes were found, as was vaginal epithelium that was also identified and verified by histology. Follicular aspirates are not a useful source of human follicles. Some structures found in the aspirates may be erroneously identified as follicles.

The cost effectiveness of cryopreservation of sperm harvested intraoperatively during vasectomy reversal

Objective: To determine the most cost effective strategy in managing patients undergoing vasectomy reversal. Vasectomy reversal is a commonly performed operation with excellent results. Yet, some clinicians have advocated routine harvesting and cryopreservation of sperm at the time of vasectomy reversal in case it is unsuccessful. Design: Model of expected costs and results at five institutions. Materials/Methods: We established two models for vasectomy reversal, bilateral vasovasostomy and bilateral epididymovasostomy with patency rates of 90% and 65%, respectively. Patients undergoing simultaneous sperm retrieval with vasectomy reversal were assumed to undergo TESE with vasovasostomy and either MESA or TESE with epididymovasostomy. Patients undergoing sperm retrieval following unsuccessful vasectomy reversal were assumed to undergo either PESA or TESA at the time of oocyte retrieval for IVF. The costs at the five institutions were averaged. These costs include surgeon fee, anesthesia fee where applicable, IVF laboratory fees for processing, laboratory testing fees, cryopreservation fee, and transport fees where applicable. The duration of cryopreservation for sperm retrieved at the time of vasectomy reversal was assumed to be 3 years. Results: The median cost of TESE/cryopreservation performed at the time of bilateral vasovasostomy was $1,765 (range: $1,085—$2,800). The median cost of MESA or TESE with cryopreservation performed at the time of epididymovasostomy was $1,209 (range: $905—$2,488). The median cost of PESA or TESA for those patients with a failed vasectomy reversal was $500 (range: $400—$1,455). However, since the majority of these patients will not require the procedure, their calculated financial risk following vasovasostomy is $50 and following epididymovasostomy is $175. Conclusions: Sperm retrieval with cryopreservation at the time of vasectomy reversal is not cost effective no matter how one looks at it. However, some patients may prefer to incur this cost for the peace of mind that they will not have to undergo any additional procedures despite how inexpensive or safe they may be. Supported by: None.

Predictive value of 72-hour blastomere cell number on blastocyst development and success of subsequent transfer based on the degree of blastocyst development

Objective: To determine the predictive value of 72-hour blastomere cell number on blastocyst development and to compare success rates of subsequent transfer based on the degree of blastocyst development. Design: Retrospective clinical study. Setting: Private assisted reproductive technology center. Patient(s): Ninety-three women aged 32.0 ± 5.1 years undergoing oocyte retrieval for IVF. Intervention(s): Bipronucleate oocytes obtained from IVF were grown for up to 168 hours after fertilization and subsequently transferred at the blastocyst stage. Main Outcome Measure(s): Percentages of embryos developing to blastocyst from 72-hour embryos by blastomere cell number and subsequent implantation and pregnancy rates of transferred blastocysts. Result(s): Rates of blastocyst formation and expansion increased as cell numbers at 72 hours increased. Implantation rates were 43% for embryos transferred to women receiving only expanded blastocysts and 17% for embryos transferred to women receiving one or more less developed blastocysts. Pregnancy rates were higher for women receiving only expanded blastocysts than for women receiving one or more less developed blastocysts, although the difference was not significant. Conclusion(s): More developed 72-hour embryos are more likely to become blastocysts and expand. Implantation rates are greater for the transfer of expanded rather than unexpanded blastocysts.

Oocyte retrieval rate through repeated controlled ovarian hyperstimulation cycles in donors

International Journal of Gynecology & ObstetricsVolume 70, Issue S4 p. D41-D41 Ovarian stimulation and IVF Oocyte retrieval rate through repeated controlled ovarian hyperstimulation cycles in donors C. Califara, C. CalifaraSearch for more papers by this authorG. Vargas, G. VargasSearch for more papers by this authorS. Cuneo, S. CuneoSearch for more papers by this authorM. Rodrǵuez, M. RodrǵuezSearch for more papers by this authorC. Simon, C. SimonSearch for more papers by this authorA. Pellicer, A. PellicerSearch for more papers by this authorJ. Remohí, J. RemohíSearch for more papers by this author C. Califara, C. CalifaraSearch for more papers by this authorG. Vargas, G. VargasSearch for more papers by this authorS. Cuneo, S. CuneoSearch for more papers by this authorM. Rodrǵuez, M. RodrǵuezSearch for more papers by this authorC. Simon, C. SimonSearch for more papers by this authorA. Pellicer, A. PellicerSearch for more papers by this authorJ. Remohí, J. RemohíSearch for more papers by this author First published: 11 December 2003 https://doi.org/10.1016/S0020-7292(00)81786-5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume70, IssueS42000Pages D41-D41 RelatedInformation

Expression of the apoptosis-related genes, caspase-1, caspase-3, DNA fragmentation factor, and apoptotic protease activating factor-1, in human granulosa cells

Objective: To investigate protein and messenger RNA expression products for a subset of apoptosis-related genes in human granulosa cells. Design: In vitro experiment. Setting: Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts. Patient(s): Women undergoing oocyte retrieval for IVF after ovulation induction with gonadotropins. Intervention(s): Granulosa cells were isolated from follicular aspirates after oocyte removal. Main Outcome Measure(s): Reverse transcription polymerase chain reaction and Western blotting for apoptosis-related gene products. Result(s): The expression of caspase-1, caspase-3, DNA fragmentation factor, and apoptotic protease activating factor-1, which are intermediate molecules in phylogenetically conserved apoptotic pathways, was demonstrated in granulosa cells from patients undergoing IVF. Moreover, proforms, but not activated enzymes, for both caspase-1 and caspase-3 were observed. Conclusion(s): Granulosa cells from patients undergoing IVF have intrinsic apoptotic machinery that could be activated for tissue remodeling.

Antibiotische Behandlung der unspezifischen Leukozytospermie vor In-vitro-Fertilisation: Ergebnisse einer kontrollierten Studie

Objective : In order to evaluate the effects of antibiotic treatment on semen quality and outcome of IVF therapy in asymptomatic infertile patients a prospetive, controlled, randomized study was performed. Patients and Methods: In male patients attending our infertility clinic semen analysis was performed according to WHO criteria (1992). Patients with ≥10 6 leukocytes/ml ejaculate and ≤10 4 bacterialml ejaculate were randomly allocated to antibiotic treatment or control. 156 consecutive patients were included in the study. Patients in the treatment group and their partners received 200 mg doxicyclin/d for 10 days. In the control group no specific antibiotic treatment was performed. Patients in both groups were reexamined after 4-6 weeks at the time of oocyte retrieval for IVF. Results: The administration of doxicyclin had no effects on leukocyte concentration, nor on sperm concentration, progressive motility or percentage of normal morphology. There was no difference between treatment and control group with respect to fertilization rate in vitro and pregnancy rate after IVF treatment. Conclusion: The results of this study indicate that short term treatment with doxicyclin for asymptomatic leukocytospermia does not affect seminal leukocyte concentration nor does it improve pregnancy rates achieved by IVF treatment.

Soluble Intercellular Adhesion Molecule-1 in Ovarian Follicles: Production by Granulosa Luteal Cells and Levels in Follicular Fluid

Objective: To determine the concentration of the soluble form of intercellular adhesion molecule (ICAM)-1 in granulosa luteal cell–conditioned media and in follicular fluid (FF). Design: Granulosa cells and FF samples were obtained at the time of oocyte retrieval for IVF. In 10 women, a total of 33 fluids were obtained from individual follicles, whereas in 70 women, the follicular aspirates were pooled. Setting: Clinica “L. Mangiagalli” and Reproductive Center, San Raffaele Hospital, Milan, Italy. Patient(s): Eighty women referred for IVF for tubal factor or male factor infertility. Intervention(s): Women underwent ovarian hyperstimulation. Main Outcome Measure(s): Soluble ICAM-1 was measured by an ELISA, and its levels were correlated with follicular size, the number of retrieved oocytes, and the number of follicles with a diameter of >15 mm. Result(s): The concentration of soluble ICAM-1 in granulosa luteal cell–conditioned media was 17.8 ± 1.8 ng/5 × 10 5 cells. Interleukin-1β can stimulate soluble ICAM-1 release in a dose-dependent manner. A significant positive correlation was demonstrated between levels of soluble ICAM-1 in pooled FF and the number of retrieved oocytes or the number of follicles with a diameter of >15 mm. Conclusion(s): Soluble ICAM-1 can be released by granulosa luteal cells and can be detected in FF after ovarian hyperstimulation. Levels of soluble ICAM-1 in FF correlate directly with some indices of ovarian function.

Effects of GnRH on protein kinase C activity, Ca2+ mobilization and steroidogenesis of human granulosa cells.

Gonadotropin-releasing hormone (GnRH) and its agonists have been known to directly affect steroid hormone production in human granulosa cells. In this study, we examined effects of GnRH on Ca2+ mobilization, protein kinase C activity and steroidogenesis of human granulosa cells. Human granulosa cells were harvested by aspiration of follicles during oocyte retrieval for IVF. Test substances, that is, GnRH agonist ([D-Ser(TBu)6]-LHRH-EA), 12-O-tetradecanoyl-phorbol-13-acetate (TPA), A23187, 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine (H-7) and nordihydroguaiaretic acid (NDGA) were added to HTF medium with human granulosa cells. At the end of a 5-h incubation period, progesterone and estradiol in the medium were extracted and measured. GnRH agonist (10(-9)M and 10(-8)M) significantly stimulated (P < 0.05) progesterone and estradiol accumulation in the medium. TPA (10(-7)M, 10(-8)M and 10(-9)M) also significantly stimulated (P < 0.05) progesterone accumulation. A23187 (10(-6)M) significantly stimulated progesterone accumulation (P < 0.05) and significantly enhanced (P < 0.05) the stimulatory effect of TPA on progesterone production. H-7 (10(-3)M, 10(-4)M and 10(-5)M) and NDGA (10(-3)M, 10(-4)M and 10(-5)M) significantly inhibited (P < 0.05) the effect of GnRH agonist on progesterone and estradiol production by the granulosa cells. The granulosa cells were loaded with 4 microM Fura 2-AM, and the ratio of the intensities of fluorescent emission at 510 nm with excitation at 340 and 380 nm was calculated at 100-ms intervals. GnRH agonist (10(-7)M and 10(-6)M) increased (P < 0.05) [Ca2+]i significantly as compared with the control. These results suggested that the effects of GnRH on progesterone and estradiol production in human granulosa cells were mediated partially by calcium mobilization and partially by C-kinase activity, and protein kinase C, [Ca2+]i and lipoxygenase were suspected of being important intracellular messages for GnRH in human granulosa cells.

Colony stimulating factor-1 in human follicular fluid

Objective: To evaluate colony stimulating factor-1 (CSF-1) concentrations in serum and follicular fluid (FF) at the time of oocyte retrieval and to test for presence of messenger RNA (mRNA) for CSF-1 and its receptor, c-fms, in FF cells. Design: Collection of serum and FF at the time of oocyte retrieval. Setting: A university IVF program. Patient(s): Forty-five women undergoing oocyte retrieval for IVF. Intervention(s): Serum and FF were obtained from 24 women, and FF only was obtained from 21 women. Main Outcome Measure(s): Colony-stimulating factor-1 concentrations were determined by RIA, and the presence of mRNA for CSF-1 and c-fins was determined by reverse transcriptase-polymerase chain reaction. Result(s): Mean FF concentrations of CSF-1 were significantly higher than mean serum levels (10.0 ± 1.3 and 3.6 ± 0.3 (±SE) ng/mL, respectively). Colony-stimulating factor-1 and c-fms message were detected in FF cells, and alternatively spliced forms of CSF-1 message were present. Conclusion(s): The presence of CSF-1, a primary regulator of tissue macrophages, in FF, and the presence of mRNA for CSF-1 and its receptor c-fms in FF-derived cells, suggest a role for this growth factor in ovarian function.

Elevated levels of interleukin-6 in the follicular fluid at the time of oocyte retrieval for in vitro fertilization may predict the development of early-form ovarian hyperstimulation syndrome

To determine the possible predictive role of interleukin-2 (IL-2), IL-6, and tumor necrosis factor (TNF-alpha) in the development of early-form ovarian hyperstimulation syndrome (OHSS). Nested, case-control study. An IVF unit, university-based program. Follicular fluid (FF) was obtained from 322 high responders. The study group and control group comprised 10 patients who developed early, severe OHSS and 10 who did not develop OHSS, respectively. An additional control group included 10 low-responder patients who did not develop OHSS. Ovulation induction with hMG combined with GnRH analogue. All FF samples were tested for IL-2, IL-6, and TNF-alpha. The patient's serum was tested for mean E2 and P concentrations. Interleukin-6 levels in the FF were significantly higher in the OHSS group than in the two control groups, whereas no differences were found in IL-2 and TNF-alpha. No correlation was found between the FF concentrations of IL-2, IL-6, and TNF-alpha and the mean serum E2 levels or the number of oocytes retrieved. Elevated levels of IL-6 in the preovulatory FF at the time of oocyte retrieval for IVF may predict the development of early-form OHSS in high responders.