Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, PO Box 140, Haartmaninkatu 2, Helsinki, 00290, Finland.
HUSLAB, Helsinki University Hospital, Topeliuksenkatu 32, Helsinki, 00029, Finland.
Reprod Biol Endocrinol. 2024 Jan 20;22(1):14. doi: 10.1186/s12958-023-01178-3.
Erythropoietin (Epo) is a potent vascular growth factor that induces angiogenesis and antiapoptotic signalling. We investigated whether the development of numerous follicles and corpora lutea during in vitro fertilization (IVF) cycle affects circulating Epo levels and further, if Epo could be used as a novel marker for ovarian hyperstimulation syndrome (OHSS).
24 women were included in the uncomplicated IVF group and 35 women in the OHSS group. Repeated blood samples from both groups were analysed for Epo, progesterone, blood haemoglobin, and creatinine. Follicular fluid from the IVF group was analysed for Epo and progesterone. Repeated measure analysis was performed for the variables and circulating Epo levels were compared between the IVF group and early OHSS. Furthermore, related growth factors, vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1 (HIF-1) were analysed from subgroup of women to test for correlation with Epo.
During IVF, circulating Epo increased from natural mid-luteal phase to stimulated mid-luteal phase (median 9.5; 95% CI 7.2-13.4 IU/L and 12.5; 10.3-13.4 IU/L; p = 0.003). In cycles resulting in pregnancy, Epo level decreased 14 days after oocyte pick-up (OPU) and remained low thereafter. In cycles not resulting in pregnancy, Epo level increased again 35 days after OPU. Follicle fluid Epo concentration was 1.5 times higher than the serum concentration (median 15.4; 95% CI 10.4-19.2 IU/L vs. 10.2; 8.8-12.7; p = 0.006). There was no difference in circulating Epo concentration between early OHSS and uncomplicated IVF. Circulating Epo did not correlate with VEGF or HIF-1.
Circulating Epo levels fluctuate during IVF cycle. We hypothesise this may suggest Epo's involvement in ovarian physiology and angiogenesis. However, Epo was not a clinical marker for OHSS.
促红细胞生成素（Epo）是一种有效的血管生长因子，可诱导血管生成和抗细胞凋亡信号。我们研究了体外受精（IVF）周期中多个卵泡和黄体的发育是否会影响循环 Epo 水平，以及 Epo 是否可以用作卵巢过度刺激综合征（OHSS）的新型标志物。
24 名妇女纳入单纯 IVF 组，35 名妇女纳入 OHSS 组。对两组的重复血样进行 Epo、孕酮、血红蛋白和肌酐分析。对 IVF 组的卵泡液进行 Epo 和孕酮分析。对变量进行重复测量分析，并比较 IVF 组与早期 OHSS 之间的循环 Epo 水平。此外，从亚组妇女中分析相关生长因子血管内皮生长因子（VEGF）和缺氧诱导因子-1（HIF-1），以测试与 Epo 的相关性。
在 IVF 期间，循环 Epo 从自然黄体中期增加到刺激黄体中期（中位数 9.5；95%CI 7.2-13.4IU/L 和 12.5；10.3-13.4IU/L；p=0.003）。在导致妊娠的周期中，Epo 水平在取卵后 14 天（OPU）下降，并在此后保持较低水平。在未导致妊娠的周期中，Epo 水平在 OPU 后 35 天再次升高。卵泡液 Epo 浓度比血清浓度高 1.5 倍（中位数 15.4；95%CI 10.4-19.2IU/L 与 10.2；8.8-12.7；p=0.006）。早期 OHSS 和单纯 IVF 之间循环 Epo 浓度无差异。循环 Epo 与 VEGF 或 HIF-1 不相关。
循环 Epo 水平在 IVF 周期中波动。我们假设这可能表明 Epo 参与卵巢生理和血管生成。然而，Epo 不是 OHSS 的临床标志物。
