Tozer A J, Iles R K, Iammarrone E, Gillott C M Y, Al-Shawaf T, Grudzinskas J G
Williamson Laboratory, St Bartholomew's and The London Hospitals Trust, London EC1A, UK.
Hum Reprod. 2004 Mar;19(3):522-8. doi: 10.1093/humrep/deh096. Epub 2004 Jan 29.
The aim of this study was to assess the effect of withholding gonadotrophins (coasting) during controlled ovarian stimulation (COS) on individual follicle concentrations of follicular fluid vascular endothelial growth factor (VEGF) in women at high risk of developing ovarian hyperstimulation syndrome (OHSS).
Twenty-two women who had been coasted and 26 optimally responding women (control group) undergoing COS for IVF were studied. At the time of oocyte retrieval, the follicular fluid from four to six individual follicles of different sizes was collected for VEGF analysis.
A total of 118 follicles was analysed in the coasted group and 137 in the control group. A negative correlation was observed between the follicle size and VEGF concentration (r = -0.18, P = 0.03) in the control group, which was not seen in the coasted group. Similarly, the correlation between oestradiol (E(2)) and VEGF (r = 0.4, P < 0.0001) observed in the control group was not apparent in the coasted group. Significantly lower concentrations of VEGF were seen in the follicular fluid of the coasted patients.
It is clear that there are differences in follicular fluid VEGF concentrations between the two groups. It is possible that coasting alters the capacity of the granulosa cells to produce VEGF and/or their response to hCG and in this way acts to reduce the severity and incidence of severe OHSS.
本研究旨在评估在控制性卵巢刺激（COS）期间停用促性腺激素（延缓）对发生卵巢过度刺激综合征（OHSS）高风险女性卵泡液中血管内皮生长因子（VEGF）的单个卵泡浓度的影响。
对22例接受延缓治疗的女性和26例接受COS进行体外受精的反应最佳女性（对照组）进行了研究。在取卵时，收集4至6个不同大小的单个卵泡的卵泡液进行VEGF分析。
延缓治疗组共分析了118个卵泡，对照组分析了137个卵泡。对照组中观察到卵泡大小与VEGF浓度之间呈负相关（r = -0.18，P = 0.03），而在延缓治疗组中未观察到这种情况。同样，对照组中观察到的雌二醇（E₂）与VEGF之间的相关性（r = 0.4，P < 0.0001）在延缓治疗组中不明显。延缓治疗患者的卵泡液中VEGF浓度明显较低。
显然，两组之间卵泡液VEGF浓度存在差异。延缓可能改变颗粒细胞产生VEGF的能力和/或它们对hCG的反应，从而降低重度OHSS的严重程度和发生率。
