Human albumin enhances expression of vascular endothelial growth factor in cultured human luteinizing granulosa cells: importance in ovarian hyperstimulation syndrome.
ABSTRACT Ovarian hyperstimulation syndrome (OHSS) is a severe complication of ovarian stimulation for assisted reproductive techniques. Clinical manifestations are massive extravascular fluid accumulation and haemoconcentration. Vascular endothelial growth factor (VEGF) has been demonstrated to mediate the development of OHSS. Intravenous albumin at the time of oocyte aspiration has been suggested as an effective prophylactic treatment against the occurrence of severe OHSS. Here it is reported that in cultured human luteinizing granulosa cells, VEGF mRNA expression was enhanced by human albumin and maximum expression was observed in cultured granulosa cells obtained from patients with serum oestradiol concentrations >2000 pg/ml on the day of human chorionic gonadotrophin injection (P < 0. 05).
Article: Ovarian Hyperstimulation Syndrome: The Best Approaches for Preven-tion and Treatment: A Mini-Review[show abstract] [hide abstract]
ABSTRACT: Ovarian hyperstimulation syndrome (OHSS) is the most serious iatrogenic disorder resulting from ovarian stimulation during assisted reproductive techniques (ARTs). It can result in renal failure, thromboembolic phenomena, adult respiratory distress syndrome and, occasionally, death. Almost all previous preventive strategies resulted ineffective. Vascular Endothelial Growth Factor (VEGF) plays a pivotal role in the pathophysiology of this syndrome so VEGF antagonism has been suggested for OHSS prevention. Since VEGF is also a physiological regulator of folliculogenesis, progesterone secretion and endometrial angiogenesis, its complete inactivation by monoclonal antibodies could produce potential undesirable effects. Administration of Human Chorionic Gonadotropin (HCG) stimulation of VEGF production is fatal for the developing of OHSS; the use of GnRH agonist instead of HCG for ovulation triggering, is a promising strategy. Recently dopamine D 2 agonists have been shown to counteract VEGF induced vascular permeability. The lack of toxic or teratogenic effects could make cabergoline an effective and safe aetiological approach for OHSS prevention/treatment. A recent meta-analysis has indicated that the administration of metformin significantly prevents OHSS development in polycystic ovary syndrome, an high risk group. In the light of these new studies we believe that recent guidelines on OHSS prevention need a substantial revision.
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ABSTRACT: To evaluate the percentages of macrophages present in granulosa cells (GC) cultures from patients with different responses to the hyperstimulation, in relation to the percentages of apoptotic cells (ApC), as well as to the release of cytokines. We studied 42 patients: 12 Hyporesponders, (with < or =4 follicles), 15 Normoresponders, (5-14 follicles), and 15 Hyperresponders, (> or =15 follicles). In GC cultures percentages of macrophages and ApC were counted and, in the conditioned media, cytokines were measured. Percentages of macrophages were significantly higher in GC cultures from Hyporesponders compared with Hyperresponders patients. Also, the percentages of ApC cells were the highest in Hyporesponders. On the contrary, cytokines concentrations were the lowest in this group. The low ovarian response is probably due to the decreased angiogenesis, which in turn produces increased apoptosis and decreased production of cytokines. The increased percentage of macrophages could be related to increased frequency of apoptotic cells.Journal of Assisted Reproduction and Genetics 04/2007; 24(4):137-42. · 1.84 Impact Factor