King Saud University, Saudi Arabia
Alqahtani Huda A. has completed her M.D. at the age of 30 years from King Saud University, College Sciences, Major Animal Physiology & Development since 2014. She has been a lecturer in King Saud University, Zoology department since 2011 in different specializations include Physiology, Molecular Biology, Parasitology, insects and Ecology. She applied her research in King Faisal Specialist Hospital & Research Center, and she has an intensive experience in different areas of molecular techniques. She was a member of a national project that analyzed the genetic level of Saudi women who had Polycystic Ovarian Syndrome and developed to Ovarian Hyperstimulation Syndrome. Recently, she has been moving to U.S.A to complete her Ph.D. in Molecular Endocrinology major
The ovarian hyperstimulation syndrome (OHSS) is a serious and potentially life- threatening physiologic complication, classically encountered in patients who undergo controlled ovarian hyperstimulation (COH) cycles. OHSS is a rare iatrogenic complication of ovarian stimulation occurring during the luteal phase or during early pregnancy. It is characterized by enlargement of the ovaries, fluid retention, and weight gain. Ovarian hyperstimulation syndrome is self-limiting and will undergo gradual resolution with time. The pathophysiology of OHSS is characterized by increased capillary permeability, leading to leakage of fluid from the vascular compartment, with third-space fluid accumulation and intravascular dehydration.
Young age, an explosive response to gonadotropin stimulation evident with rapid increase of serum estradiol (E2) levels, development of multiple follicles ( >20) during stimulation and the presence of polycystic ovary syndrome have been described as risk factors for the development of the syndrome in IVF patients.
There is evidence that several other factors such as vascular endothelial growth factor may play a modulatory role on ovarian physiology and in the pathogenesis of ovarian hyperstimulation syndrome.angiogenic, mitogenic and vascular permeability-enhancing activities specific for endothelial cells. The serum was obtained from 38 patients, Control Group, healthy pateints (n=8) visiting Dr. Sameer Abbas IVF clinic, H-OHSS Group (n=10) and PCOs Group (n=20) visiting the IVF clinic in King Faisal Specialist hospital. The level of VEGF was measured by using Enzyme- linked immunosorbent assay (ELISA) technique. The observed differences in the VEGF between the different groups were statistically significant (P<0.05). It was found that VEGF level in H- OHSS and PCOs groups were statistically higher when they were matched control group. The VEGF levels were markedly the highest among H-OHSS group compared to the control group. The levels were almost seven times higher among H- OHSS patients (718.186 ± 421.241pg/ml) compared to normal control (86.149 ± 73.825pg/ml). The observed differences in the VEGF between the different groups were statistically significant (P<0.05). The VEGF levels were higher among the PCOs group compared to the control group. The levels were almost three times higher among PCOs patients (350.806 ± 252.478pg/ml) compared to normal control (86.149 ± 73.825pg/ml). The observed differences in the VEGF between the different groups were statistically significant (P<0.05). The levels of VEGF were almost two times higher among H- OHSS group (718.186 ± 421.241pg/ml) compared to PCOs group (350.806 ± 252.478pg/ml). The observed differences in the VEGF between the different groups were not statistically significant (P=0.0577).The correlations between VEGF, anthropometric measurement, metabolic and hormones variables were performed in the three groups. In H-OHSS group, only a negative correlation was significant between the testosterone level and the weight of patients. In PCOS group, the level of VEGF was correlated significantly and negatively with estradiol (E2) level.
A negative significant correlation was found between the level of E2 and the age, and between E2 and the weight of patients. Also the testosterone level was correlated significantly and positively with the level of FSH.
Conclusion: the genes identified in this study may play an essential role in the pathogenicity of ovarian hyperstimulation syndrome. Also serum VEGF concentrations may predict OHSS occurrence.