1. Effects of controlled ovarian stimulation on vascular barrier and endothelial glycocalyx: a pilot study
- Author
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I Fetz, Andreas Dendorfer, N C Eckert, Tobias Kammerer, Nikolai Hulde, Christian J. Thaler, Alexander Choukèr, J-I Buchheim, Florian Brettner, Nina Rogenhofer, Markus Rehm, and Klaus Hofmann-Kiefer
- Subjects
Adult ,Infertility ,Controlled ovarian stimulation ,Sexual hormones ,Ovarian hyperstimulation syndrome ,Pilot Projects ,Stimulation ,Vascular permeability ,Luteal phase ,Glycocalyx ,Ovulatory cycle ,Capillary Permeability ,Andrology ,03 medical and health sciences ,0302 clinical medicine ,Ovulation Induction ,Genetics ,Humans ,Medicine ,Ovarian steroid ,Genetics (clinical) ,business.industry ,Assisted reproduction ,Obstetrics and Gynecology ,030208 emergency & critical care medicine ,General Medicine ,Endothelial glycocalyx ,medicine.disease ,Extravasation ,Reproductive Physiology and Disease ,Reproductive Medicine ,Case-Control Studies ,Female ,Endothelium, Vascular ,Syndecan-1 ,business ,Infertility, Female ,030217 neurology & neurosurgery ,Developmental Biology - Abstract
Purpose Controlled ovarian stimulation significantly amplifies the number of maturing and ovulated follicles as well as ovarian steroid production. The ovarian hyperstimulation syndrome (OHSS) increases capillary permeability and fluid extravasation. Vascular integrity intensely is regulated by an endothelial glycocalyx (EGX) and we have shown that ovulatory cycles are associated with shedding of EGX components. This study investigates if controlled ovarian stimulation impacts on the integrity of the endothelial glycocalyx as this might explain key pathomechanisms of the OHSS. Methods Serum levels of endothelial glycocalyx components of infertility patients (n=18) undergoing controlled ovarian stimulation were compared to a control group of healthy women with regular ovulatory cycles (n=17). Results Patients during luteal phases of controlled ovarian stimulation cycles as compared to normal ovulatory cycles showed significantly increased Syndecan-1 serum concentrations (12.6 ng/ml 6.1125th–19.1375th to 13.9 ng/ml 9.625th–28.975th; p=0.026), indicating shedding and degradation of the EGX. Conclusion A shedding of EGX components during ovarian stimulation has not yet been described. Our study suggests that ovarian stimulation may affect the integrity of the endothelial surface layer and increasing vascular permeability. This could explain key features of the OHSS and provide new ways of prevention of this serious condition of assisted reproduction.
- Published
- 2021