Serum vascular endothelial growth factor levels are poorly predictive of subsequent ovarian hyperstimulation syndrome in highly responsive women undergoing assisted conception.

OBJECTIVE: To determine whether serum vascular endothelial growth factor (VEGF) levels can distinguish highly responsive women who subsequently develop ovarian hyperstimulation syndrome (OHSS) from women with a similar ovarian response who do not. DESIGN: Prospective controlled study. SETTING: University IVF unit. PATIENT(S): Women undergoing IVF who met predetermined risk criteria for OHSS. Patients developing OHSS were compared with patients who did not develop OHSS. INTERVENTION(S): Long-protocol pituitary down-regulation followed by FSH stimulation by a standard protocol without coasting. A maximum of three embryos was transferred. Vaginal progesterone was used for luteal support. MAIN OUTCOME MEASURE: Occurrence of OHSS; serum VEGF concentrations on the day of embryo transfer (ET) and at 5 and 10 days after ET. RESULTS: Serum VEGF levels at any time point did not differ significantly between 9 OHSS cases and 9 controls. Vascular endothelial growth factor levels in samples collected from cases before the onset of OHSS were higher than levels in time-matched samples from controls (medians, 177.6 [range, 64.02-549.1] pg/mL vs. 100.7 [range, 37.59-246] pg/mL, respectively), but the difference failed to reach statistical significance (P=.0518), and there was considerable overlap between cases and controls. CONCLUSIONS: Serum VEGF levels in the luteal phase do not distinguish between high-risk women who subsequently develop OHSS and women with a similar risk profile who do not develop OHSS.