超促排卵周期中血管内皮生长因子的动态变化及与卵巢过度刺激综合征的关系

目的：探讨超促排卵周期中血清血管内皮生长因子(VEGF)的动态变化以及VEGF在卵巢过度刺激综合征(0HSS)患者中的表达特征及是否具有预测价值。方法：选取行体外受精-胚胎移植治疗的不孕妇女分0HSS、高、中低反应组。收集各患者IVF周期中基础值、肌注人绒毛膜促性腺激素日(hCG日)、取卵日(0PU日)、移植日(ET日)及中、晚黄体期6个时点的血清和卵泡液，检测VEGF水平。结果：血清VEGF在超排卵周期中，各组从基础状态至中黄体期呈逐渐增高的趋势，OHSS组中黄体期和晚黄体期显著升高，卵泡液VEGF水平亦明显高于另2组，中低反应组在各时点均显著低于另2组。结论：VEGF的表达与卵巢对超促排卵刺激的反应呈明显正相关，卵泡液VEGF水平可以预测0HSS的发生。

The vascular edothelial growth factor levels throughout IVF cy cles and its relation to ovarian hyperstimulation syndrom

Objective: To investigate the VEGF levels throughout IVF cycles and to eveluate its forcast value for the syndrome. Method: Fortyone patients including OHSS group?high-responder group and low-moderate-responder group were enrolled prospectively from IVF-ET or ICSI program. Serum VEGF was assayed before godadotropin Gn, on the day of hCG administration, OPU, ET and after 7 and 14 days of ET. VEGF levels of follicular fluid (FF) were also assayed. Results: During IVF cycles, serum VEGF concentrations increased consistently till the day of ET, and those of low-moderate-responder group were all lower than those of other two groups. The difference was significant on mid luteal phase and late luteal phase between OHSS and high-responder group. FF VEGF concentration in OHSS group was higher than those of other two groups. Conclusion: VEGF levels have a positive correlation with the ovary's response to Gn during the IVF cycle. FF VEGF levels can be used to predict the occurrence of OHSS.