Manau Dolors, Fábregues Francisco, Peñarrubia Joana, Creus Montserrat, Carmona Francisco, Casals Gemma, Jiménez Wladimiro, Balasch Juan
Institut Clinic of Gynecology, Obstetrics and Neonatology, University of Barcelona, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Spain.
Hum Reprod. 2007 Mar;22(3):669-75. doi: 10.1093/humrep/del427. Epub 2006 Nov 1.
Vascular endothelial growth factor (VEGF) has been investigated as a marker of ovarian response to controlled ovarian hyperstimulation and as a predictor of ovarian hyperstimulation syndrome (OHSS) in IVF cycles. In most studies, serum has been used for circulating VEGF concentration measurement, but it has been suggested that plasma is the preferred medium to measure VEGF levels because of the potential contribution of VEGF released from platelets during blood clotting. This study investigated VEGF concentrations in paired serum and plasma samples from patients undergoing controlled ovarian hyperstimulation for IVF.
Serum and plasma VEGF levels, as well as the number of platelets, were measured in 30 IVF patients who comprised three study groups delineated according to the estradiol (E(2)) serum concentration reached on the day of HCG administration: 10 patients having low E(2) serum levels (<1500 pg/ml, group L), 10 patients having intermediate E(2) serum levels (1500-3000 pg/ml, group I) and 10 patients having high E(2) serum levels (>3000 pg/ml, group H).
There was a statistically significant correlation between plasma and serum VEGF levels (rho = 0.61; P < 0.005) for the entire population studied, although serum values were higher by a factor of approximately 6-fold. No significant correlation was found between peripheral blood VEGF concentrations and serum E(2) or follicle number on HCG day or the number of oocytes collected. Similarly, paired serum and plasma VEGF measurements did not correlate with platelet count.
Serum and plasma VEGF concentrations are strongly correlated in paired samples from infertile patients undergoing controlled ovarian hyperstimulation. However, neither serum nor plasma VEGF levels were correlated with parameters associated with ovarian follicular activity. Peripheral blood VEGF levels were not correlated with platelet count.
血管内皮生长因子（VEGF）已被作为体外受精（IVF）周期中卵巢对控制性卵巢过度刺激反应的标志物以及卵巢过度刺激综合征（OHSS）的预测指标进行研究。在大多数研究中，血清被用于循环VEGF浓度的测定，但有人提出血浆是测量VEGF水平的首选介质，因为血液凝固过程中血小板释放的VEGF可能有影响。本研究调查了接受IVF控制性卵巢过度刺激患者的配对血清和血浆样本中的VEGF浓度。
对30例IVF患者的血清和血浆VEGF水平以及血小板数量进行了测量，这些患者根据人绒毛膜促性腺激素（HCG）注射日达到的雌二醇（E₂）血清浓度分为三个研究组：10例E₂血清水平低（<1500 pg/ml，L组）、10例E₂血清水平中等（1500 - 3000 pg/ml，I组）和10例E₂血清水平高（>3000 pg/ml，H组）的患者。
在整个研究人群中，血浆和血清VEGF水平之间存在统计学显著相关性（rho = 0.61；P < 0.005），尽管血清值大约高6倍。未发现外周血VEGF浓度与HCG日的血清E₂或卵泡数量或采集的卵母细胞数量之间存在显著相关性。同样，配对的血清和血浆VEGF测量值与血小板计数也不相关。
接受控制性卵巢过度刺激的不孕患者的配对样本中，血清和血浆VEGF浓度密切相关。然而，血清和血浆VEGF水平均与卵巢卵泡活性相关参数无关。外周血VEGF水平与血小板计数无关。
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