Study On The Correlation Between Ovarian Hyperstimulation Syndrome And Endothelial Injury

?Objective?To investigate the change of the release of vascular endothelial active substance and the number of endothelial progenitor cells(EPCs)in women with ovarian hyperstimulation syndrome(OHSS).To explore the relationship between vascular endothelial dysfunction and OHSS.?Method?Fifty one patients with IVF were enrolled.Patients were divided into two groups according to the OHSS of Golan criteria.The group was defined as patients with OHSS,the control group of patients with non-OHSS group.Record Endothelial function was assessed by flow-mediated dilatation(FMD)on the brachial artery.Blood samples were collected on the first day to the third day of oocyte retrieval.Plasma levels of nitric oxide(NO),endothelin-1(ET-1),soluble intercellular adhesion molecule(s ICAM),soluble vascular cell adhesion molecule(s VCAM),high sensitivity C-reactive protein(hs CRP),vascular endothelial growth factor(VEGF)were determined in all participants.Flow cytometry used for determining the number of EPCs.Measurement of NO and VEGF secretion by EPCs.?Result?Compared with the control group,there was no significant difference age,body mass index(BMI),fasting blood glucose(Glu),total cholesterol(TC), high density lipoprotein(HDL),oestradiol concentration on the day of human chorionic gonadotropin(HCG)and ovary volume.OHSS groups had statistically lower levels of Quantitative insulin sensitivity check index(QUICKI).OHSS groups had statistically higher levels of Insulin(INS)and the number of oocyte retrieval.The QUICKI was negatively correlated with blood ET-1,s ICAM,s VCAM and hs CRP level(ET-1 r=-0.47,s ICAM r=-0.51,s VCAM r=-0.39,hs CRP r=-0.63,P < 0.05).The QUICKI level was positively correlated with blood NO level(r=0.47,P<0.01).OHSS groups had statistically higher levels of ET-1,s ICAM-1,s VCAM-1 hs CRP and VEGF(ET-1 7.14±0.59,s ICAM 391.88±32.47,s VCAM 786.26±85.01,hs CRP 2.03±0.27,VEGF 2.03±0.275 P < 0.01).The FMD level was negatively correlated with blood ET-1,s ICAM,s VCAM and hs CRP level(ET-1 r=-0.45,s ICAM r=-0.62,s VCAM r=-0.52,hs CRP r=-051,P<0.05).The FMD level was positively correlated with blood NO level(r=0.66,P<0.01).The number of EPCs was higher than in control group(P<0.05).The level of NO secreted by EPCs was significantly decreased,which was statistically significant(P<0.05).There was no significant difference in secretion of VEGF between the two groups.?Conclusion?Early onset of vascular endothelial injury and repair.It is suggested that OHSS is based on vascular endothelial injury.We supposed that the occurrence of OHSS is associated with endothelial dysfunction.The increase in the number of EPCs in the OHSS group may be related to the decrease in NO in vivo.