Agrawal R, Conway G, Sladkevicius P, Tan S L, Engmann L, Payne N, Bekir J, Campbell S, Jacobs H
University College London Medical School, Department of Reproductive Endocrinology, The Middlesex Hospital, London Women's Clinic, United Kingdom.
Fertil Steril. 1998 Oct;70(4):651-8. doi: 10.1016/s0015-0282(98)00249-0.
To relate changes in serum and follicular fluid vascular endothelial growth factor (VEGF) concentrations to Doppler blood flow velocities within ovarian and uterine blood vessels during IVF cycles and to assess their relation to ovarian hyperstimulation syndrome (OHSS) and polycystic ovaries (PCO)/polycystic ovary syndrome (PCOS).
Prospective descriptive study.
The London Women's Clinic.
PATIENT(S): One hundred seven patients receiving a "long" stimulation protocol of IVF.
INTERVENTION(S): Doppler blood flows were recorded in ovarian stromal and uterine arteries; serum VEGF was measured in the early follicular phase, after pituitary desensitization, on the day of hCG administration, on the day of oocyte retrieval, and on the day of ET.
MAIN OUTCOME MEASURE(S): Serum and follicular fluid VEGF concentrations and Doppler blood flow measurements.
RESULT(S): Serum VEGF concentrations rose after hCG administration. The rise was higher in women in whom OHSS developed. Women with PCO/PCOS had higher serum VEGF concentrations throughout the IVF cycle irrespective of whether OHSS developed. Follicular fluid VEGF concentrations were higher in women in whom OHSS developed and in women with PCO/PCOS. Doppler blood flow velocities in the ovarian blood vessels were higher in women in whom OHSS developed. Within ovarian and uterine blood vessels, blood flow velocities were higher in the early follicular phase and on the day of hCG administration in women with PCO/PCOS. A positive correlation was observed between the serum VEGF and E2 concentrations on the days of hCG administration and oocyte retrieval and between the serum VEGF concentration and Doppler blood flow velocities throughout the IVF cycle.
CONCLUSION(S): Our results support the role of VEGF as a mediator of OHSS and establish a possible link between VEGF, OHSS, and PCO.
探讨体外受精（IVF）周期中血清和卵泡液血管内皮生长因子（VEGF）浓度变化与卵巢和子宫血管多普勒血流速度的关系，并评估它们与卵巢过度刺激综合征（OHSS）及多囊卵巢（PCO）/多囊卵巢综合征（PCOS）的关系。
前瞻性描述性研究。
伦敦妇女诊所。
107例接受IVF“长方案”刺激的患者。
记录卵巢基质和子宫动脉的多普勒血流；在卵泡早期、垂体脱敏后、注射hCG日、取卵日及胚胎移植（ET）日检测血清VEGF。
血清和卵泡液VEGF浓度及多普勒血流测量值。
注射hCG后血清VEGF浓度升高。发生OHSS的女性升高幅度更大。无论是否发生OHSS，PCO/PCOS女性在整个IVF周期中血清VEGF浓度均较高。发生OHSS的女性及PCO/PCOS女性的卵泡液VEGF浓度较高。发生OHSS的女性卵巢血管的多普勒血流速度较高。在卵巢和子宫血管中，PCO/PCOS女性在卵泡早期和注射hCG日的血流速度较高。在注射hCG日和取卵日，血清VEGF与雌二醇（E2）浓度之间以及在整个IVF周期中血清VEGF浓度与多普勒血流速度之间均呈正相关。
我们的结果支持VEGF作为OHSS介质的作用，并确立了VEGF、OHSS和PCO之间的可能联系。
