Predictive Value of Serum Vascular Endothelial Growth Factor and Pigment Epithelium-derived Factor in Ovarian Hyperstimulation Syndrome

Objective To explore whether the serum concentrations of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) could serve as the predictors of ovarian hyperstimulation syndrome (OHSS) in patients undergoing in vitro fertilization-embryo transfer (IVF-ET). Methods Enzyme-linked immunoadsordent assay (ELISA) was employed to measure the serum concentrations of VEGF and PEDF on the day of hCG administration, oocyte retrieval and embryo transfer, respectively. Based on OHSS classification of the criteria of Golan, 85 patients were divided into three groups. Patients in group A (n=10) showed symptoms of severe OHSS and patients in group B (n=13) suffered from moderate OHSS. The control group (group C, n=62) contained patients without symptoms of OHSS as well as patients with mild OHSS. Results In groups A, B and C, serum concentrations of PEDF on the day of hCG administration (h-PEDF)(166.54 ± 102.81 pg/ml, 159.45 ± 136.77 pg/ml, 172.05 ± 170.95 pg/ml, P=0.48), oocyte retrieval (o-PEDF)(176.91 ± 103.37 pg/ml, 122.52 ± 92.54 pg/ml, 179.82 ± 177.47 pg/ml, P=0.27) and embryo transfer (e-PEDF)(169.02 ± 240.08 pg/ml, 136.80 ± 139.21 pg/ml, 157.38 ± 222.54 pg/ml, P=0.95), h-VEGF (175.55 ± 103.54 pg/ml, 218.84 ± 179.70 pg/ml, 153.39 ± 145.06 pg/ml, P=0.36) and o-VEGF (171.93 ± 128.55 pg/ml, 220.36 ± 149.82 pg/ml, 138.74 ± 139.30 pg/ml, P=0.15) showed no significant differences. There was a statistical difference in serum concentration of e-VEGF between group A (197.04 ± 156.63 pg/ml) and group C(110.69 ± 49.55 pg/ml)(P=0.008). The serum level of estradiol showed a positive correlation with the count of large follicles (r=0.744). The ratios of h-VEGF/h-PEDF, o-VEGF/o-PEDF and e-VEGF/e-PEDF were calculated and showed a clear difference among groups A, B and C (4.04 ± 3.39, 2.10 ± 2.14, 1.05 ± 4.80, P<0.001; 4.54 ± 5.69, 2.29 ± 1.67, 0.94 ± 0.59, P<0.001; 5.43 ± 6.16, 1.81 ± 1.36, 2.42 ± 2.60, P=0.04). Conclusion While neither serum concentrations of VEGF nor PEDF can be used as an OHSS predictor, the ratios of h-VEGF/h-PEDF, o-VEGF/o-PEDF and e-VEGF/e-PEDF may have great predictive value.