Interleukin-18 levels correlate with severe ovarian hyperstimulation syndrome.

OBJECTIVE

To assess the involvement of interleukin-18 (IL-18) in the pathophysiology of severe ovarian hyperstimulation syndrome (OHSS), and study its use as a marker of disease and its correlation to capillary hyperpermeability.

DESIGN

Prospective controlled study.

SETTING

An IVF unit in a tertiary medical center.

PATIENT(S): Twenty-four patients with OHSS in an IVF program, two control groups: group 1, 40 healthy age-matched women without ovulation-induction treatment; group 2, 19 women who received the same ovulation-induction regimen without experiencing OHSS.

INTERVENTION(S): Blood samples were obtained at three times: during acute OHSS, on significant clinical improvement, after complete resolution. Ascitic and pleural fluids were obtained by therapeutic paracentesis. Serum, peritoneal, and pleural fluids were analyzed for IL-18 and IL-6, and blood for hematocrit, white blood cell count, and E(2) levels.

MAIN OUTCOME MEASURE(S): Hematocrit white blood cell count, serum, peritoneal, pleural fluid levels of IL-18, IL-6, E(2) in severe OHSS.

RESULT(S): Significantly higher IL-18 levels were detected in serum, peritoneal, and pleural fluids of patients with severe OHSS as compared with both control groups. Serum IL-18 dropped significantly on transition to the diuretic phase and resolution. A statistically significant correlation between serum IL-18 and hyperpermeability characteristics (white blood cell count, hematocrit), serum E(2), and IL-6 levels was recorded.

CONCLUSION(S): This is the first study suggesting a role of IL-18 as a marker of OHSS, with correlation to capillary hyperpermeability parameters.