Serum inhibin A, VEGF and TNFα levels after triggering oocyte maturation with GnRH agonist compared with HCG in women with polycystic ovaries undergoing IVF treatment: A prospective randomized trial

Rachel Babayof, Ehud J. Margalioth, Mahmoud Huleihel, Alaa Amash, Edit Zylber-Haran, Michael Gal, Baruch Brooks, Tzvia Mimoni, Talia Eldar-Geva

Research output: Contribution to journalArticlepeer-review

151 Scopus citations

Abstract

Background: We aimed to examine the serum levels of inhibin A, vascular endothelial growth factor (VEGF), tumour necrosis factor α (TNFα), estradiol (E2) and progesterone levels after triggering of final oocyte maturation with GnRH agonist compared with HCG in patients with polycystic ovaries (PCO) and to investigate the relationship between these markers and ovarian hyperstimulation syndrome (OHSS). Methods: Twenty-eight patients with PCO, undergoing controlled ovarian hyperstimulation with FSH and GnRH antagonist for IVF-embryo transfer treatment, were randomized for triggering of final oocyte maturation with GnRH agonist (GnRH agonist group, n = 15) or HCG (HCG group, n = 13). Blood samples were obtained on the day of randomization and thereafter every 2-7 days. Serum levels of inhibin A, VEGF, TNFα, E2 and progesterone, the incidence of OHSS, ovarian size and pelvic fluid accumulation were evaluated. Results: Serum inhibin A, E2 and progesterone levels were significantly lower in the GnRH agonist group compared with the HCG group, particularly on the day of embryo transfer (P < 0.0001). Serum VEGF and TNFα levels were similar between the two groups. Four patients in the HCG group developed severe OHSS, whereas no patient had any symptoms or signs of OHSS in the GnRH-agonist group (P < 0.05). Conclusions: In patients with PCO treated with FSH/GnRH antagonist, final oocyte maturation with GnRH agonist instead of HCG reduces significantly inhibin A, E2 and progesterone levels during the luteal phase. This phenomenon reflects the inhibition of the corpus luteum function and may explain, at least in part, the mechanism of OHSS prevention in high-risk patients. Our results do not support a crucial role for VEGF or TNFα in OHSS.

Original languageEnglish
Pages (from-to)1260-1265
Number of pages6
JournalHuman Reproduction
Volume21
Issue number5
DOIs
StatePublished - 1 Jan 2006

Keywords

  • GnRH agonist
  • Inhibin A
  • OHSS
  • PCOS
  • TNFα

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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