Endocrinology: Ovarian hyperstimulation syndrome: pre-ovulatory serum concentrations of interleukin-6, interleukin-1 receptor antagonist and tumour necrosis factor- cannot predict its occurrence

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Abstract
The pathogenesis of the ovarian hyperstimulation syndrome (OHSS) is poorly understood. Since significant elevations in cytokines are found in 01155, our objective was to conduct a prospective case-controlled study to assess if preovulatory cytokine serum concentrations can predict its occurrence. The study group was selected from in-vitro fertilization patients who subsequently developed severe OHSS, along with a matched group who did not develop this complication (n = 20), and a healthy normal control group (n = 10). Interleukin-6 (IL-6), interleukin-1 receptor antagonist (IL-1RA) and tumour necrosis factor-α (TNFα) measurements were performed with sensitive immune-assays and confirmed with bioassays. Serum IL-6 (mean concentration ± SEM: 4.38 ± 0.36 pg/ml), IL-1RA (829 ± 292 pg/ml) and TNFα (15.5 ± 132 pg/ml) concentrations did not show differences throughout the normal menstrual cycle group. Cytokine variability and pre-ovulatory values were similar in OHSS compared to controlled ovarian hyperstiinulation (COH) patients. However, average follicular phase serum 1L-6 concentrations were higher in OHSS (8.71 ± 0.41 pg/ml) and COH (7.66 ± 0.38 pg/ml) patients than in normally menstruating women (4.34 ± 0.99 pg/ml) (P < 0.0001). Pre-ovulatory serum 1L-6 concentrations were also higher in OHSS (9 ± 0.94 pg/ml) and COH (73 ± 0.97 pg/ml) patients than in controls (4.57 ± 1.1 pg/ml) (P < 0.01 and P < 0.04 respectively). IL-1RA and TNFα concentrations were comparable in all the groups. This study suggests that cytokine measurements cannot be used to predict the occurrence of OHSS prior to the administration of human chorionic gonadotrophin.

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